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A hospital in Northern Ireland is to start using a new test for meningitis which could expedite diagnosis and potentially save thousands of lives.
Meningitis is an infection of the protective membranes that surround the brain and spinal cord and can either be viral or bacterial with the latter being life threatening – one in ten cases of bacterial meningitis are believed to be fatal. Babies, children, teenagers and young adults are the most likely to contract the illness although anyone can get it.
At present diagnosis of meningitis is heavily dependent on clinical judgement. Given that the disease can spread quickly and cause the patient to deteriorate rapidly, clinicians understandably err on the side of caution and often initiate treatment without confirmed diagnosis. In fact, at present a confirmed diagnosis can take around two days. This does mean that in certain cases, patients undergo treatment despite eventually finding out they had not contracted the illness.
On the other hand the subjective nature of diagnosis can mean that clinicians miss the symptoms and initiate treatment too late. In these instances the consequences can be so severe that patients and their families may seek to pursue a medical negligence claim.
A rapid “lamp” (Loop Mediated Isothermal Amplification) test on blood, spinal fluid or nasal swab samples is being trialled to help detect cases of meningitis earlier. Researchers are trialling the lamp at the Royal Belfast Hospital over the next two years, but believe this could give results in under 60 minutes – helping lead to a confirmed diagnosis in a far shorter timeframe than is currently possible. Any potential bacterial meningitis case will still be treated with antibiotics for the duration of the pilot.
Dr Tom Waterfield a researcher from Queen’s University, Belfast, believes it could help prevent less obvious cases being missed:
“With the best will in the world you can still miss cases if a child looks quite well and you think it is viral rather than bacterial…..The test could also provide reassurance earlier to anxious parents that their sick child is getting the right treatment. Two days is a long time to wait for a confirmed diagnosis.”
Whilst we are unlikely to know how successful the new test is in assisting with early diagnosis of meningitis for the duration of the pilot, the potential effect could be widespread. This could in turn have a dramatic impact on not only saving lives but also preventing unnecessary treatment for those who present many of the symptoms of meningitis but who have not actually contracted the illness. This could in turn have an impact on the annual volume of misdiagnosis claims as well as having the potential to reduce medical negligence claims for meningitis going forward.