Meningococcal disease

Meningococcal disease is a potentially life-threatening illness and is often rapidly progressive. Any patient suspected of this disease should be rapidly transferred to hospital after receiving an iv/im dose of Ceftriaxone or Benzyl Penicillin as instructed below. In view of the infectivity, paramedics should be informed of the likely diagnosis on request of the ambulance transfer.

Suspicion of the condition alone is enough to prompt urgent referral and treatment. Do not wait for results of investigations as all investigations can be performed in Emergency.

Other important information for referring practitioners

Medical management

• If possible, collect a specimen of blood for cultures prior to administration of any antibiotic but this should not delay patient transfer to hospital
• All suspected case should be immediately transferred to hospital after the administration of iv/im antibiotics as follows
  • Ceftriaxone iv/im. Cefotaxime is first choice, if not available give Benzyl Penicillin (as below)
  • Benzyl Penicillin 60mg/kg (for all ages) iv (give im if unable to gain access to iv route)
  • If anaphylactic allergy to penicillin arrange immediate transfer to hospital but do not administer a Cephalosporin
• All close contacts of the patient (if proven to be meningococcal disease) should be offered prophylactic treatment
  • Adults give Rifampicin 10mg/kg orally 12 hrly (max 600mg) for 2 days
  • Infants (over 1 month old) and children give Rifampicin 10mg/kg orally 12 hrly for 2 days
  • Infants less than 1 month old give rifampicin 5mg/kg 12 hrly for 2 days
  • In pregnancy or if Rifampicin is contraindicated give Ceftriaxone 125mg (<12 yrs), 250mg (12 yrs and over) im as single dose
• Vaccination is also now available for meningococcal B as well as C infections

Referral requirements

A referral may be rejected without the following information.