By Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes, Julius Weinberg
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Extra resources for Communicable Disease Control Handbook, 2nd edition
This requires close liaison with clinicians and microbiologists to ensure that appropriate investigations are carried out. If the initial diagnosis is viral meningitis, then no further action is needed at this stage, although it may be necessary to provide information to GPs and parents if the case appears to be linked with others. If bacterial meningitis is suspected, then further measures will depend on the cause. Again, optimum investigation is essential as the nature of the public health response differs for each organism.
2 Continued No Koplik’s spots in mouth before rash on 4th day of illness Profound Around ears, then face, then trunk. Conﬂuent Variable No Nil Nil Trunk Initially High fever and irritability Moderate Moderate Trunk then face No Short, mild fever and malaise Fever and sore throat Mild Mild or absent No Moderate to high Moderate Face then trunk and limbs Face, then rapidly generalized Petechial rash may be preceded by maculopapular rash Usually in older children; herald patch at onset Dramatic improvement in child when rash appears on 4th or 5th day Posterior occipital lymphadenopathy No Rash blanches on pressure; strawberry tongue and perioral pallor Haemorrhagic rashes Acute lymphoblastic Mild, non-speciﬁc leukaemia Absent or mild/ moderate Moderate Nil Pallor, lymphadenopathy and hepatosplenomegaly may be present Henoch-Sch¨onlein purpura Mild, sometimes symptoms of upper respiratory tract infection Nil to mild Mild or moderate Moderate Anywhere, including mucous membranes Mainly limbs, especially legs and buttocks No Rash is urticarial initially.
Group B streptococcal meningitis in neonates can be prevented by intrapartum antibiotic treatment of colonised women. • Immunisation. Childhood immunisation schedules in Europe ensure protection against meningitis caused by mumps, polio and H. influenzae type b (Hib). In some countries, including the UK, N. meningitidis group C and tuberculosis are also in the schedule. Polysaccharide vaccines are available for N. meningitidis (serogroups A, C, Y and W135) and Streptococcus pneumoniae (23 serogroups) although neither of these vaccines is currently suitable for routine use in infants.
Communicable Disease Control Handbook, 2nd edition by Jeremy Hawker, Norman Begg, Iain Blair, Ralf Reintjes, Julius Weinberg