Meningococcal disease

Red flags

All patients with suspected meningococcal disease should be transferred urgently to hospital.

  • Petechial rash
  • Headache
  • Altered conscious level
  • Fever

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.

  • Presence of any red flags
  • Duration of symptoms
  • Contacts
  • Immunisation status
  • Predisposing conditions
    • Hyposplenism
    • Previous splenectomy
    • Immunosuppression

Out of catchment

Metro North Health is responsible for providing public health services to the people who reside within its boundaries. Special consideration is made for patients requiring tertiary care or services that are not provided by their local Hospital and Health Service. If your patient lives outside the Metro North Health area and you wish to refer them to one of our services, inclusion of information regarding their particular medical and social factors will assist with the triaging of your referral.

  • Impact on employment
  • Impact on education
  • Impact on home
  • Impact on activities of daily living
  • Impact on ability to care for others
  • Impact on personal frailty or safety
  • Identifies as Aboriginal and/or Torres Strait Islander
  • To establish a diagnosis
  • For treatment or intervention
  • For advice and management
  • For specialist to take over management
  • Reassurance for GP/second opinion
  • For a specified test/investigation the GP can’t order, or the patient can’t afford or access
  • Reassurance for the patient/family
  • For other reason (e.g. rapidly accelerating disease progression)
  • Clinical judgement indicates a referral for specialist review is necessary
  • Presenting symptoms (evolution and duration)
  • Physical findings
  • Details of previous treatment (including systemic and topical medications prescribed) including the course and outcome of the treatment
  • Body mass index (BMI)
  • Details of any associated medical conditions which may affect the condition or its treatment (e.g. diabetes), noting these must be stable and controlled prior to referral
  • Current medications and dosages
  • Drug allergies
  • Alcohol, tobacco and other drugs use
  • Full name (including aliases)
  • Date of birth
  • Residential and postal address
  • Telephone contact number/s – home, mobile and alternative
  • Medicare number (where eligible)
  • Name of the parent or caregiver (if appropriate)
  • Preferred language and interpreter requirements
  • Identifies as Aboriginal and/or Torres Strait Islander
  • Full name
  • Full address
  • Contact details – telephone, fax, email
  • Provider number
  • Date of referral
  • Signature
  • Willingness to have surgery (where surgery is a likely intervention)
  • Choice to be treated as a public or private patient
  • Compensable status (e.g. DVA, Work Cover, Motor Vehicle Insurance, etc.)