An evaluation of the accuracy of clinical diagnosis at admission in a population with epidemic meningococcal disease

Mathiassen, B; Thomsen, H.; Landsfeldt, U.

doi:10.1111/j.1365-2796.1989.tb01364.x

Cited by 6 publications

(2 citation statements)

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“…Seventy-one percent of the patients were between 10 and 24 years of age [3]. Both in Norway [10] and on the Faroe Islands [11] It was found to be low among adults and 0-2-year-old children [14]. This finding might incidate a late admission to hospital of adults with MD with a more severe course of disease as a consequence.…”

Section: The Outbreakmentioning

confidence: 87%

An outbreak of serogroup B:15:P1.16 meningococcal disease, Frederiksborg county, Denmark, 1987–9

Samuelsson

Ege²,

Berthelsen³

et al. 1992

Epidemiol. Infect.

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SUMMARYEpidemiological features of an outbreak of group B:15:P1.16 meningococcal disease (MD) in Frederiksborg country, Denmark, 1987–9, were investigated. The study comprised 149 cases notified during the outbreak and the two preceding years; 115 were confirmed by the isolation of Neisseria meningitidis. In 1989 the incidence had increased to 14·1 per 100 000 population. Among group B strains, B:15:P1.16 accounted for 80% (77/97). The overall mortality rate was 10% (15/149). Regarding cases due to group B:15:P1.16 strains a significant time-space clustering, which exclusively occurred within the 10–19 years age group, was demonstrated. The link between cases within clusters was indirect or unknown, except for ten patients with contact to one particular school. The prophylactic measures used included administration of rifampicin to household contacts. During the outbreak the proportion of secondary cases was high (6–15%). All secondary cases occurred outside the household indicating that the household had been protected.

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Section: The Outbreakmentioning

confidence: 87%

An outbreak of serogroup B:15:P1.16 meningococcal disease, Frederiksborg county, Denmark, 1987–9

Samuelsson

Ege²,

Berthelsen³

et al. 1992

Epidemiol. Infect.

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“…[17] GPs correctly diagnose patients with meningococcal disease in 70 to 80% of the cases that they admit. [17][18][19][20] However, around 50% of cases are seen by a doctor but not admitted to hospital during the early stages of their illness [13,18] because the symptoms are nonspecific. [11] A GP is significantly more likely to make a diagnosis if specific signs such as neck stiffness or petechiae are present.…”

Section: Recognitionmentioning

confidence: 99%

Recognition, Treatment and Complications of Meningococcal Disease

Riordan

Thomson

1999

Pediatric Drugs

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Meningococcal disease remains a major cause of death in young children. A decrease in mortality requires recognition and treatment of the disease at a number of stages in the illness. Life-threatening meningococcal disease usually presents as septicaemia rather than meningitis. The cardinal feature of meningococcal septicaemia is the purpuric rash. Many parents recognise the rash and seek medical advice because of it. When primary care physicians recognise the rash, the administration of parenteral penicillin may decrease mortality. However, antibacterials are not given promptly if there is no rash or if the disease presents in an atypical form. In hospital, antibacterial therapy with a third-generation cephalosporin should be given. Disease severity needs to be assessed by a valid method, such as the Glasgow Meningococcal Septicaemia Prognostic Score (GMSPS). This can identify those patients who need intensive care and/or might benefit from new therapies. The 2 life-threatening complications are septic shock and meningoencephalitis with raised intracranial pressure. Despite numerous case reports of success with potential new treatments, none has been proven safe and/or effective by controlled trials. Although it is tempting to focus on new treatments, the early recognition of severe meningococcal disease by parents, primary care physicians and junior hospital doctors is equally, if not more, important as a potential means of decreasing mortality.

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