Statement from NHS Greater Glasgow
The Public Health Protection Unit of NHS Greater Glasgow is currently investigating the death of a woman from blood poisoning (a form of invasive meningococcal disease) suspected to be due to meningococcus germ.
As a precaution, close relatives of the deceased have been treated with antibiotics and a letter giving information and advice has been issued by Public Health to parents of children attending and staff working at the Broomlea School, Broomhill, Glasgow where she worked.
NOTES TO EDITORS:
What is Invasive Meningococcal Disease (IMD)?
IMD is a clinical spectrum of serious disease caused by invasion of sterile spaces in the body, such as the blood stream or the space around the brain, by the meningococcus germ (a bacterium). It ranges from ‘meningococcal blood poisoning' (meningococcal septicaemia) to ‘meningococcal meningitis'. Patients with IMD can demonstrate varying degrees of the two conditions with usually one dominating.
Where does the meningococcus bacteria come from?
This germ lives quite happily at the back of people's throats without doing any harm at all in a significant percentage of the population. However, when circumstances change, the bacteria can move through the protective barrier and cause blood poisoning or meningitis. As yet, we don't know what causes the bacteria to change from a harmless state to one which causes septicaemia or meningitis. We suspect that the immunity of the individual has been temporarily suppressed in some way and quite often there is a history of a viral infection beforehand.
What is Meningococcal Blood Poisoning (septicaemia)?
Meningococcal septicaemia occurs when the meningococcus germ enters the blood stream and multiplies. It can cause a range of complications including brain damage, damage to joints, loss of blood supply to skin and limbs or the release of toxins that can cause vital organs to fail. In very serious cases, particularly if treatment is delayed, it can cause death.
What is Meningococcal Meningitis?
Meningococcal meningitis is an inflammation of the outer covering of the brain and spinal cord caused by the meningococcus germ. Although it is fortunately uncommon, it is serious in that the germ rapidly multiplies in the space around the central nervous system and can damage the brain and nerves and cause death if not treated immediately. The prognosis is slightly better than with meningococcal septicaemia.
Is IMD contagious?
The meningococcus germ that causes IMD is not very contagious, requiring close and prolonged contact (usually by mouth-to-mouth kissing) to spread between individuals. When it does spread in such a way it tends not to cause serious illness, just asymptomatic carriage. As a result, most cases of IMD are single (what we called sporadic cases) and do not spread to other cases. However, there is a small excess risk of developing IMD if you are a household contact of a new case of this disease. For this reason we carry out contact tracing for every new case of IMD and advocate that close overnight and household contacts of cases receive an oral antibiotic.
Am I at risk of IMD if I work or go to school with someone who has been diagnosed with IMD?
No, the evidence suggests that you are not at risk. However, we advise all such contacts to avoid delaying seeking medical attention should they develop the signs or symptoms of IMD (which are listed below).
What are the signs or symptoms of IMD?
In the first instance it is very like getting flu or any other acute infection - the person feels off-colour. Then they develop a high temperature. They usually have a severe headache or shy away from bright lights. They may develop a stiff neck, sore back or pain in their joints, feel sleepy, vomit or become confused. Two thirds of people also develop a rash of red and purple spots or bruises anywhere on the body. This rash may start off as a tiny blood spots which look like pin-pricks. If it is not treated early, they get bigger and join up and become darker in colour. This rash does not disappear when pressed with a clear object such as a glass.
The symptoms may not all appear at the same time and they may be different in young babies. Babies with meningitis can be very difficult to wake up, have a staring expression and a fever. They may refuse feeds or vomit or they may be distressed and make a shrill or moaning cry when you pick them up. The skin may be pale and blotchy and there may also be a rash of red and purple spots or bruises anywhere on the body.
Is IMD treatable?
Yes, very much so. The meningococcus germ responds readily to antibiotics.