Nursery meningitis policy

A case of meningitis in a nursery, even a suspected case, can cause panic and disruption among staff and parents for a long time. The first aim should be to try and dispel any fear that the parents, staff and children may have.

Types and symptoms

There are many different types of meningitis that can affect a person of any age. The two main types of meningitis are Meningococcal and Meningococcal septicaemia.

Meningococcal has five main groups. These are A, B, C, W135, and Y. This type of meningitis causes most cases of bacterial meningitis in the UK. The bacteria are very common and live naturally in the nose or throat. Only rarely do the bacteria overcome the body's defences and cause meningitis. Meningococcal septicaemia is caused by the same bacteria as meningococcal but the bacteria multiply quickly in the blood stream causing blood poisoning.

The main symptoms for both types are:

• Severe headache
• Stiff neck
• Dislike of bright lights
• Fever / vomiting
• Drowsy
• Seizures or fits may also be seen
• Cold hands and feet
• Sweating
• Rapid breathing
• Stomach / joint / muscle pain.

In young babies and toddlers you may also notice:

• Blotchy skin getting paler / blue
• Refusing feeds
• Irritable
• Floppy / lifeless / stiff body
• Tense or bulging soft spot.

Both adults and children may have a rash anywhere on the body and it will not fade with pressure. To check if it is a septicaemia rash, press a glass tumbler firmly against the rash. If you can still see the marks through the glass it is septicaemia.

Symptoms do not appear in any order and some may not appear at all.

You should know how to recognise the signs and symptoms of meningitis and septicemia. In some cases, acting quickly to get medical help can mean the difference between life and death.

Action to be taken

If you are concerned that a child is showing symptoms of meningitis you must inform the Nursery Manager immediately. They will seek medical advice and then contact the child’s parents.

If a child has signs of a rash that doesn’t fade the Manager must contact the child’s parents and inform the parent to meet you at their GP or the local Accident and Emergency department of the nearest hospital, whichever is nearest. If the GP is not available the child should be taken to the Accident and Emergency department of the nearest hospital. The Manager should give a full explanation of the symptoms and an explanation that you think it could be meningitis or septicaemia.

The Manager should contact the Public Health Doctor at the Local Health Authority and explain the situation. They will give advice and decide on what needs to be done to protect the children and parents that use the nursery. They will ensure that anyone who is at an increased risk of meningitis is given the medical help required. The Care Inspectorate will also be informed.

A letter will be sent out to parents and this should be accompanied by leaflets giving parents advice on meningitis. A supply can be ordered from the meningitis trust or the Local Health Authority. The Local Health Authority will often assist in the preparation of a letter. Where this does not occur an example letter is shown over the page.

Regular contact should be maintained with the child’s parents and the Public Health Doctor. In all situations the emphasis should be on the increased awareness of the disease and symptoms.

Contacts

Meningitis Trust - meningitis-trust.org or +44 (0)845 120 4885

Meningitis Research Foundation - meningitis.org or +44 (0)333 405 6262