Meningitis checklist

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Contents

Contents

Event Action(s) to be taken in primary care Time frame
Contingency planning in primary care Awareness of symptoms and possible presentations of meningococcal disease.
Carriage of (in date) penicillin and kit for its IV administration, and of advice literature Regular review and checks required
Case suspected (prior to admission) Administration of antibiotics

Ensure admissions staff aware of possible diagnosis

a.s.a.p.
Case categorised as probable or confirmed meningococcal disease (see Meningitis case definitions) Provide "prophylaxis" as advised by HPU/public health a.s.a.p., and within 24 hours wherever possible
Following discharge Check that appropriate follow-up (including audiology) has been arranged As appropriate
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Actions primarily for secondary care sector

Event Action(s) to be taken in secondary care By whom / notes Time frame
Contingency planning in secondary care Awareness of symptoms and possible presentations of meningococcal disease. Clinicians Regular training
Ensure copies of this guidance documents and meningitis charity guidance for staff and leaflets for patients/¬relatives available Management Regularly
Possible case admitted Ensure case stable and receiving appropriate treatment

Inform microbiologist, discuss sampling

Medical team On admission
Ensure appropriate samples taken Medical team a.s.a.p.
Inform HPU/public health and GP Medical team OR (by local arrangement) microbiologist a.s.a.p., or following morning if after 11pm (or as agreed locally)
Categorise as possible, probable, or confirmed case. Unless “confirmed”, keep categorisation under review. Discuss with microbiologist and HPU/public health On informing HPU
Case categorised as probable or confirmed meningococcal disease Arrange chemoprophylaxis for immediate household contacts (if agreed locally that this to be done by secondary care). Note that it is essential HPU/public health is informed promptly when this is done (and given name, GP, and address of all contacts identified). Medical team a.s.a.p., and within 12 hours of diagnosis
Assist HPU/public health in identifying wider contacts.

Do NOT recommend chemoprophylaxis to contacts outside the immediate household without prior discussion with HPU. Chemoprophylaxis for contacts outside the immediate household may be arranged by HPU, according to local agreements.

Medical team in discussion with HPU/public health a.s.a.p., and within 12 hours of diagnosis
Identify any staff who require chemoprophylaxis Medical team/¬ hospital infection control team a.s.a.p., and within 12 hours of exposure
Inform patient’s family of charity help lines and consider giving them copies of relevant advice literature Medical team Before they leave the unit
Notify case formally Medical team Within 2 weeks
Confirmation of diagnosis Inform attending physician and HPU/public health Microbiologist or medical team a.s.a.p., or following morning if after 22pm (or as per local protocols)
Discharge Inform GP and HPU/public health Medical team Within 2 working days of discharge
Ensure appropriate follow-up (including audiology) arranged Medical team As appropriate
Ensure copy of discharge summary sent to HPU/public health. (Need to know outcome: whether died, discharged home, or transferred elsewhere, as minimum.) Medical team Within 3 weeks
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Actions primarily for health protection/public health

Event Action(s) to be taken by health protection/¬public health staff Notes Time frame
Check that actions listed for primary and secondary care are done
Categorise as possible, probable, or confirmed case. Unless "confirmed", keep categorisation under review. Discuss with clinician and microbiologist a.s.a.p.
Case categorised as probable or confirmed meningococcal disease Guide medical team in correctly identifying and arranging chemoprophylaxis for immediate household contacts a.s.a.p., and within 12 hours of diagnosis
Identify and arrange chemoprophylaxis for wider contacts through GPs, or as local protocols a.s.a.p., and within 24 hours wherever possible
Consider informing charities about the case Within 12 hours, or as appropriate
Contact patient’s GP and others with a “need to know”
Check for other, possibly linked cases
After discharge Complete enhanced surveillance forms
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Preparedness checklist in the event of a decision to implement a community mass intervention

Action(s) By whom / notes
Check that actions listed for other agencies are done HPU/public health
Be aware of arrangements for declaring calling an outbreak control team and declaring an outbreak HPU/public health
Ensure arrangements for communicating with media and others. Test arrangements. HPU and PCTs, LEA, universities and colleges
Identify arrangements for obtaining bulk quantities of drugs (rifampicin and ciprofloxacin), vaccine, and anaphylaxis packs Pharmacy managers of acute and community trusts
Check that supplies of advice sheets and consent forms can be obtained quickly HPU / community and acute trusts

See also

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