Doctors are still failing to diagnose meningitis

Despite the number of cases reaching a 50-year high, many GPs are not taking the basic precautions to fight the deadly brain disease
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Family doctors are failing to recognise the signs of meningitis in children and young people despite cases of the disease being at a 50-year high and a record number of claims for compensation being made against medical professionals, GPs were warned yesterday.

Family doctors are failing to recognise the signs of meningitis in children and young people despite cases of the disease being at a 50-year high and a record number of claims for compensation being made against medical professionals, GPs were warned yesterday.

Too many doctors do not consider meningitis as a possible cause when a child is brought into the surgery with a high temperature, the Meningitis Research Foundation said. Many fail to take the elementary precaution of phoning parents an hour later to find out if the child has got worse.

Launching a new diagnostic guide from the foundation, Dr Laurence Buckman said: "Too many lives are being lost. If this induces GPs to call back in an hour, it will save lives."

The booklet makes plain that in the crucial early stages meningitis can be almost impossible to diagnose or distinguish from a bad case of flu. Its publication comes at a time when claims against GPs for failing to spot meningitis have risen to record levels. Last year the Medical Defence Union reported it was handling one claim a week relating to a failure to diagnose meningitis, and in one case a record £4.5m payout was made.

Meningitis C, one form of the disease, has been virtually eliminated by a new vaccine introduced last year, saving an estimated 25 lives. However meningitis B, which claims more lives, cannot be vaccinated against and the number of cases is rising.

The guidance warns doctors to look out for high temperature, fever, vomiting, malaise and lethargy in the early stages of the disease. Symptoms can be impossible to distinguish from other viruses such as flu.

GPs should reassure patients, children and their parents to "trust their instincts", tell them to monitor children carefully and to call for immediate medical help if symptoms get worse, the guide says.

Classic symptoms in the later stages often include a rash, increased heart rate, clammy hands and feet, drowsiness, a stiff neck and an aversion to bright light. By the time these symptoms appear a child's condition can deteriorate rapidly and the disease can kill within hours.

The "tumbler test" is the best known means for parents to spot the disease. A glass tumbler is pressed sideways on the rash. If the rash remains visible through the glass and does not blanch, the illness is likely to be meningitis and constitutes a medical emergency.

Dr Buckman, chairman of the BMA's family doctors' committee, called on GPs who saw a child with a high fever to phone parents after an hour, to check that the child had not deteriorated ­ a simple precaution that would save lives.

Dr Steve Jones, a GP and broadcaster, said doctors needed to be more aware of meningitis in the early stages. "Knowing about the tumbler test is not enough. We are still losing children, teenagers and adults from meningitis. It is an incredibly difficult diagnosis to make in the early stages. GPs and hospital casualty officers need to spot symptoms earlier. If it is missed patients can deteriorate extremely quickly and dramatically."

He admitted wrong diagnoses were "not uncommon", leading to lack of trust and a loss of confidence in GPs. "There have been cases where patients have been turned away by more than one doctor. Sometimes criticism is well founded, although GPs have also been unfairly criticised.

"We need to raise awareness among doctors and the public over just how difficult it is to spot this disease."

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