25 July 2012

Help with Identifying Meningitis in Children and Young People

NICE's latest quality standard on bacterial meningitis in children and young people can help GPs and other primary care professionals spot early signs and symptoms of the condition.

Meningococcal meningitis and meningococcal septicaemia, known collectively as meningococcal disease, remain a leading cause of mortality in early childhood causing death in around 1 in ten cases.

This is despite the introduction of the meningitis C vaccine, which has reduced the incidence of meningococcal disease in recent years.

Prompt diagnosis and treatment is critical, yet identifying children with meningococcal disease can be difficult. Research suggests that around half of children with meningococcal disease are not identified at their first primary care consultation.

To help with diagnosis and follow-up treatment, NICE has produced a quality standard that will provide support for all those involved in providing services to children and young people with bacterial meningitis.

The standard consists of 14 quality statements and associated quality measures, which together will help practices meet outcome goals set in the NHS Outcomes Framework.

The quality standard covers the entire pathway of care from initial presentation to discharge.

It states that children and young people with suspected or confirmed bacterial meningitis or meningococcal septicaemia have the following monitored at least hourly until stable:

  • temperature
  • respiratory rate
  • pulse
  • blood pressure
  • urine output
  • oxygen saturation
  • neurological condition

The standard also says that children and young people presenting with petechial rash receive antibiotics in accordance with NICE guidance. The associated measure states service providers ensure systems are in place to for children and young people to receive the antibiotics for petechial rash

Sue Davie, Chief Executive at Meningitis Trust, said: "The prompt diagnosis and treatment of meningitis and meningococcal disease is critical to save lives and much progress has been made with the introduction of the NICE Guidelines and now this new Quality Standard."

Linda Glennie, Head of Research and Medical Information at Meningitis Research Foundation, added: "The new NICE quality standard will ensure that service providers, commissioners and health professionals have the information they need to deliver the best care for these children, from early symptoms assessment through to specialist treatment and universal follow-up.

"An integrated approach to the bacterial meningitis and meningococcal septicaemia care pathway is crucial in achieving this."

A variety of resources are available to help put the quality standard into practice.

These include a BMJ Learning module for meningococcal disease in children produced in association with NICE.

The hour-long accredited module has been described, by users as "useful", "concise" and good at "emphasising that presence of typically known features in meningococcal disease may not manifest in earlier stages of the disease".

Other resources include the Spotting the Sick Child tool commissioned by the Department of Health, and Meningococcal Meningitis and Septicaemia Guidance Notes produced by the Meningitis Research Foundation.

Look out for a primary care mailing from the Meningitis Research Foundation delivered to all GP surgeries in England and Wales in the week commencing 17 September.

The mailing pack will contain a number of resources including guidance notesfor GPs, posters and leaflets.