Optimising investigation of meningococcal disease to enhance surveillance

Efforts were made to implement guidelines for microbiologists in order to optimise investigation and improve laboratory confirmation in children admitted to hospital with suspected meningococcal disease. In 1998, 75% of diagnoses (30/40) were confirmed microbiologically, compared with 51% (209/411) of cases elsewhere in the West Midlands. Thirty-two of the children admitted to our paediatric unit (80%) were investigated according to the guidelines; 94% of these cases were laboratory confirmed. Microbiological confirmation of clinical meningococcal disease is all the more important with the advent of mass vaccination. Our study shows that implementation of guidelines for the investigation of clinically suspected meningococcal disease improves the rate of confirmation.