The meningococcal meningitis season is once more upon us. Unfortunately, the recent Meningitis Awareness Week received rather less media publicity than it might have expected coinciding as it did with more propitious world events. As with any condition, awareness is the keystone to an early diagnosis, or any diagnosis at all for that matter, as one can never make a diagnosis that has not been considered. We make no excuse for stressing this point. When faced with an undiagnosed acutely ill patient always THINK MENINGITIS.

This treatment should certainly be given PRIOR to transport to the receiving hospital. It does not compromise later diagnosis.

The introduction of the meningococcal group C conjugate vaccine has dramatically reduced the incidence of group C disease, in the under 20s, but it still occurs and a higher proportion of cases are now outside this typical age range. Group B disease remains as frequent as previously in all age groups.

In older children and most adults the presentation of meningococcal disease tends to be more classical (if only that were always true!), but the diagnosis in babies has always been more difficult. Figure opposite details the symptoms and signs that should raise suspicion in babies.

Once the patient has been stabilised please spare us at CDC a thought. ALL cases of suspected meningitis should be notified to CDC. Once the "M" word has been mentioned there is inevitably a need to reduce

Following last month’s article, I have been told that Southampton General Hospital holds a number of mercury spillage kits, which are available to GP practices. The cost includes both the kit and the appropriate disposal of the recovered mercury, which sounds like a very practical and straightforward solution to a problem which should not occur very often.

Contact Nickie Collins at SGH Pharmacy, on (023) 8079 6599

Dr A Rivett, SCMO, Communicable Disease Control

anxiety in the relatives before the community bush telegraph runs riot. That’s our role. We provide a 24 hours a day service (for contact arrangements see over). In consultation with the attending clinician we assess the likelihood of meningococcal disease and, when appropriate offer reassurance and advice on prophylactic antibiotics.

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This vaccine has been in extremely short supply for well over a year, and then only available in multi-dose vials which meant that centres still providing the service had to organize special clinic sessions. All the corresponding chaos appears to be coming to an end. Once a small amount of unlicensed product has been used, single dose vials will become generally available and the approved centres will be able to resume normal service. Our thanks to all the practices that have cooperated with us and run clinics during the period of shortage.