Doctors should be careful not to play down the risk of meningitis in an effort to comfort parents, a London researcher warned at yesterday's conference.
Dr Nelly Ninis, clinical research fellow at the Royal College of Paediatrics and Child Health, said medical professionals should encourage parents to continue to look for the symptoms of the disease even if it had not been identified in a medical examination. They should be particularly wary, she said, of giving definite diagnoses in a well-meaning attempt to allay fears when the effect could be to stop parents from continuing to look for symptoms.
Dr Ninis was commenting on research carried out by the college in England, Wales and Northern Ireland in a 15-month period up to last February in which the cases of 190 children who died from meningococcal disease were examined.
The parents of the children who were interviewed showed a high degree of awareness about the symptoms of meningococcal disease. However, Dr Ninis said, many were unable to put the theory into practice.
Some had carried out the tumbler test (whereby a septicaemic rash should show up by not fading when a glass tumbler is pressed against it) but had misread the results, believing wrongly that the rash should have been accompanied by spots or should have sat on top of the skin. "We found the word `rash' means something different for parents and for doctors," she said.
A number of examples of misdiagnosis were also given, among them that of a two-year-old child who died after being sent home from hospital despite having classic meningococcal symptoms such as joint pains, fever and a rash.
In a number of cases the children had to wait up to nine hours before being seen by a doctor, which she said in no way amounted to "observation".
Of the 190 children in the study, 75 died in the final three-month winter period, highlighting what is traditionally the worst time of the year for the disease. A quarter of the fatalities were under a year old, 36 per cent were 1-4 years, 16 per cent were 5-14 years, and 21 per cent were 15-16 years.
The study also showed the predominance of the group B strain of bacterial meningitis in infants and young children. The reverse was the case with older teenagers with group C accounting for almost 80 per cent of cases in the 15-16 years bracket.
