Bacterial Meningitis

Please click the frequently asked questions below for further information and IPC precautions required:

• What is Bacterial Meningitis / Neisseria meningitidis?

  Meningitis is when bacteria reach the meninges (the lining around the brain and spinal cord) and cause dangerous swelling. Septicaemia is when bacteria enter the bloodstream and cause blood poisoning. Both forms of meningococcal disease can trigger sepsis. While bacterial and viral meningitis can initially present with the same symptoms viral meningitis is much less sever and most people recover on their own.

  

• How does it spread?

  Meningococcal bacteria are commonly carried in the back of the throat but only very rarely cause illness. The bacteria do not spread easily and only those who have had prolonged, close contact with the person who is ill are at a slightly greater risk of becoming ill themselves. The best way to stop the disease spreading is by giving antibiotics to the very close contacts of the person who is ill.

   

• What are the main symptoms of Meningitis?

  Although the risk is very small, it is sensible to be aware of the main signs and symptoms of meningococcal meningitis and septicaemia.

  Some common signs and symptoms of meningococcal disease include:

  • High temperature
  • Rapid breathing
  • Vomiting/ diarrhoea and stomach cramps
  • Joint or muscle pain
  • Cold hands and feet
  • Severe headache
  • Pale blotchy skin
  • Stiff neck
  • Confusion and/or irritability
  • Dislike of bright light
  • Drowsiness or difficult to wake
  • Rash/ bruising rash
  • Seizures
• IPC Precautions
  • Droplet precautions should be used
  • Hand Hygiene should be completed as per the 5 moments in line with usual practice.
  • Fluid Resistant Surgical Mask should be worn
  • Eye protection should always be risk assessed and used with any patient where there is a risk of splashes including spitting and productive coughing.
  • Gloves and Aprons should be risk assessed.
  • Laundry should be treated as contaminated, placed into an alginate bag and placed into a red laundry bag.
• What Cleaning is required?

  All equipment and the ambulance should have an in-between patient clean  paying particular attention to touch points.

• Why is this information important?

  If NIAS staff are aware that the patient has a suspected or confirmed case this should be communicated to the Control Room (Emergency or Non-emergency as appropriate) and the staff in the receiving unit when transferring the patient to ensure effective patient care and management.

  It also ensures that staff can risk assess for the appropriate PPE to prevent staff exposure and potential need for prophylaxis.

• Do staff need prophylaxis or follow up?

  Immediate action: Inform Station Officer / Line Manager and contact the IPC team for advice as soon as possible during working hours.

   

  A risk assessment will be completed by the IPC team in connection with the Station Officer who will liaise with staff involved. This will be done in line with the current PHA guidance.

  People who have not had prolonged, close contact (including classmates, friends, acquaintances, visitors to the house etc) are NOT at any greater risk than the rest of the population and do not need antibiotics. Those who have shared drinks, e-cigarettes or cigarettes with the case but have not had prolonged close contact also have no increased risks.

  Chemoprophylaxis is recommended only for those healthcare workers whose mouth or nose is directly exposed to large particle droplets/secretions. This type of exposure will only occur among healthcare staff who are working close to the face of the case without wearing a mask or other mechanical protection.

  Exposure of the eyes to respiratory droplets is not considered an indication for prophylaxis. Such exposure may, however, carry a low risk of meningococcal conjunctivitis and subsequent invasive disease.

  Staff should seek early treatment if conjunctivitis should develop within 10 days of exposure.

• Why do all staff not receive Prophylaxis?

  Immediate action: Inform Station Officer / Line Manager and contact the IPC team for advice as soon as possible during working hours.

  An initial risk assessment of the exposure will be discussed with the Station Officer and the IPC team.

  Occupational health will then complete a risk assessment for staff to decide if prophylaxis is required. This will be done in line with the current PHA guidance.

• Link to Guidance

  Guidance for public health management of meningococcal disease in the UK (publishing.service.gov.uk)