Experts warn symptoms of MenW mimic drug misuse or being drunk

06 Dec 2018
Experts warn symptoms of MenW mimic drug misuse or being drunk
  • Teens and young adults are at increased risk of meningococcal disease
  • The new MenW type has different symptoms to other kinds of meningococcal disease
  • Meningitis Research Foundation (MRF) warns that sick teens could be mistaken for being drunk or under influence of drugs

A letter from public health experts, published in the Journal of Infection, has warned that doctors may miss the symptoms of a new meningitis bug in young people. Teenagers unwell with the disease could be mistaken for being drunk or under influence of drugs.

Meningococcal disease - which can cause meningitis or septicaemia/sepsis - is notorious for its sudden onset and rapid progression to life-threatening infection and death. The condition can mimic other illnesses, such as influenza, food poisoning, drug misuse or alcohol intoxication, so the diagnosis of meningococcal disease may not be considered by doctors.

“It’s a tragedy for a young person to die from a disease if rapid diagnosis and treatment could have offered a chance of survival." Vinny Smith, MRF

Vinny Smith, Chief Executive at Meningitis Research Foundation (MRF) said, “It’s a tragedy for a young person to die from a disease if rapid diagnosis and treatment could have offered a chance of survival.

“Patients who are seriously ill with meningococcal disease can be confused or delirious and we often hear stories of young people who are initially thought to be under the influence of drugs or alcohol, when in fact they needed urgent medical help to fight an infection. We’ve been working to highlight this issue.

“The new strain of meningococcal W meningitis and septicaemia (MenW) has been spreading in recent years and often these patients have mainly gastrointestinal symptoms such as vomiting, but without the characteristic non-blanching rash.

“We welcome the publication of this letter which highlights why early recognition of meningococcal disease is absolutely crucial.”

The letter follows recent cases where meningitis has been missed, and details the tragic story of an 18-year who developed a headache, cold hands and feet, stomach ache and vomiting over two days. The parents contacted the out-of-hours doctor and a clinical diagnosis of acute food-poisoning was made during the telephone consultation. Tragically, it was not food-poisoning and the teenager died just hours later. Many of the symptoms were early signs of septicaemia/sepsis but this was missed.

Only toxicology samples were taken for analysis for drugs and alcohol which meant the cause of death was not found. Despite the clinical history being consistent with serious bacterial infection, a drug-related cause of death was suspected because of the age of person who died.

It later became apparent that testing for meningococcal disease (or any other infectious disease) had not been undertaken. When they were eventually allowed to test for meningitis and septicaemia, MenW was confirmed.

Whilst drug misuse remains a common cause of sudden and unexpected death in teenagers and young adults, other causes, especially those related to infection, should be considered so that antibiotics can be given quickly if necessary.

Not only is confirming meningococcal disease crucial in terms of offering the best chance of survival for the patient, it is also has potential clinical and public health implications for the family and the wider community.

The letter highlights that additional investigations such as molecular testing for meningococcal disease and other infectious diseases should be routinely performed in all fatal cases where the cause of death is not ascertained.

MenW

MenW

Meningococcal W meningitis and septicaemia: a new, virulent strain in the UK, particularly affecting young adults
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