Arch Dis Child 1999;80:290-296 ( March )

Personal practice

Emergency management of meningococcal disease

A J Pollard, J Britto, S Nadel, C DeMunter, P Habibi, M Levin

Paediatric Intensive Care Unit, Department of Paediatrics, Imperial College School of Medicine, St Mary's Hospital, London W2 1NY, UK

Correspondence to: Dr Pollard

The first 150 words of the full text of this article appear below.

	Introduction

Neisseria meningitidis is the leading infectious cause of death in childhood in the UK.^1 2 There were over 2500 cases and 246 deaths in 1997³ and the disease has an overall mortality of about 10%.^4 5 Although mortality rises to 50% in the most severely ill patients,^4-6 data from our unit suggests that early recognition,⁷ aggressive resuscitation, specialist advice, and transfer to paediatric intensive care^8 9 can reduce this mortality to less than 5%.¹⁰

Critically ill children are best managed in a specialist paediatric intensive care unit,¹¹ but most patients with meningococcal disease will present to a hospital without tertiary care facilities and will require transport to a specialist centre. The immediate institution of lifesaving therapeutic measures is more crucial to patient outcome than the speed and urgency with which the paediatric intensive care retrieval team arrives.⁹ Therefore, the resuscitation and stabilisation expertise available at the referring hospital must be harnessed while the specialist intensive . . . [Full text of this article]

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