Hospital doctors - paediatrics
Algorithm for Early Management of Meningococcal Disease in Children
This protocol is for doctors in A & E, Paediatrics, Paediatric Intensive Care Units, Anaesthetics and General Medicine in the UK.
Meningococcal disease may progress very rapidly and has a mortality of up to 50% in the most severely ill cases. Early recognition, aggressive resuscitation, specialist advice and transfer to PICU can reduce this mortality to less than 5%. Following initial resuscitation, frequent review is imperative to detect disease progression. This protocol has been developed as a result of experience of 425 paediatric cases of meningococcal disease referred to St Mary's PICU from 72 different hospitals over six years. With the help of research funding from the Charity, the team achieved a reduction in the meningococcal disease death rate from 29% to 2%, against a predicted mortality of 30% over this period.
The protocol was developed by Dr Andrew Pollard, Dr Simon Nadel, Dr Parviz Habibi, Dr Saul Faust, Dr Ian Maconochie, Dr Nilesh Mehta, Dr Joseph Britto and Professor Mike Levin at St Mary's PICU and is published by Meningitis Research Foundation as a poster (A2) or leaflet, available free of charge from any of the Foundation's UK offices.
First published in 1998, the earliest edition appeared in Archives of Disease in Childhood 1999; 80:290-296 with a detailed exposition of the clinical management plan. It has also been published in:
- Journal of the Royal College of Physicians 1998; 32(4): 319-328
- Paediatric Drugs 1999; 1(4):264-282
- p.383, chapter 24 in A. J. Pollard and M. C. J. Maiden (ed.), Meningococcal Disease: Methods and Protocols; vol. 67: Methods in Molecular Medicine, Humana Press Inc., New Jersey
- as a 'How to Guide' in the November 1998 issue of Care of the Critically Ill. 1998; 14.8
The protocol is also available on Isabel, an on-line paediatric clinical decision-making support system www.isabel.org.uk. If you'd like copies of the posters and/or leaflets contact your local Foundation office or use our online ordering facility for these and other Foundation resources.
The protocol also forms part of our resources for doctors in training.