Infectious diseasesepidemiology and surveillance

Page contents: Symptoms in children and adults | Symptoms in infants and young children | Immediate actions | Antibiotic therapy | Notification | Poster for medical practitioners | Immunisation advice

Consider a diagnosis of meningococcal disease if signs and symptoms include:

In children and adults:

• Fever, pallor, rigors, sweats
• Headache, neck stiffness, photophobia, backache, cranial nerve palsy
• Vomiting and/or nausea, and sometimes diarrhoea
• Lethargy, drowsiness, irritability, confusion, agitation, seizures or altered conscious state
• Moaning, unintelligible speech
• Painful or swollen joints, myalgia; difficulty walking
• Whilst the absence of a rash does not exclude meningococcal disease, note in particular any haemorrhagic rash, particularly of a pinprick, petechial or purpuric appearance

In infants and young children the following may also occur:

• Irritability, dislike of being handled
• Tiredness, floppiness, drowsiness
• Twitching or convulsions
• Grunting or moaning
• Turning from light

Note in particular:

• Rapid deterioration in clinical condition
• Repeat presentations to surgery/hospital
• Normally calm friends/relatives who are more worried than symptoms apparently justify

Immediate actions

Carry benzylpenicillin in the doctor's bag. If meningococcal disease is suspected:

Immediately:

• Call an ambulance, and;
• Administer antibiotics IV (IM if IV impossible)
• Only if possible, collect blood for culture

Immediate antibiotic therapy (all ages)

Empirical therapy prior to hospitalisation:

• Benzylpenicillin: 60 mg/kg up to 3g IV/ IM or; Ceftriaxone: 50 mg/kg up to 2g IV/ IM.
• Penicillin should only be withheld in cases who have a definite history of anaphylaxis. If in doubt, check with Infectious Diseases Physician at nearest hospital

Notification

All cases of meningococcal disease, whether suspected or confirmed, must be notified immediately, by telephone, to the Communicable Diseases section of the Department of Health - 24 hour/7 day service.

Contact the Communicable Diseases section

The Communicable Disease Section is responsible for identification of contacts who require clearance antibiotics, and other public health aspects of this disease.

Poster for medical practitioners