QUEEN'S RESEARCHERS TACKLE MENINGITIS  

31 August 2017

A new rapid test for meningitis, a disease which affects around 3,200 people in the UK every year, has been developed for trial by Queen’s in partnership with the Belfast Trust. The test has the potential to save lives as it reduces the time required for diagnosis from days to hours.

Meningococcal disease can be difficult to detect, with many patients only identified as infected if and when a visible rash develops, which can often take up to 48 hours – which is also the time necessary for the NHS gold standard test (blood cultures) for detecting the disease.

Queen’s researchers have now developed a new diagnostic test, known as LAMP (Loop Mediated Isothermal Amplification), which provides results within an hour.

The research findings could prevent children with meningococcal disease being wrongly sent home – potentially saving dozens of lives every year.

It is also estimated that 50% of patients who turn out to have meningococcal disease have been falsely reassured in the previous 12-24 hours by their doctor and are sent home given the all-clear though they may in fact be infected.

And the study of 105 babies and children which resulted in the latest time-saving test also found that two thirds of those initially presented with suspected Meningococcal Septicaemia, were later found not to be infected and were therefore unnecessarily treated.

Meningitis and Meningococcal septicaemia (Meningococcal Disease), which is caused by a deadly bacteria that can kill in hours, is notoriously difficult to diagnose as initial symptoms mimic those of common colds. Queen’s researchers are working to improve testing to prevent avoidable deaths while at the same time reducing the number of children treated unnecessarily ‘just in case.’

Professor Mike Shields, Clinical Professor at Queen’s and Consultant Paediatrician at the Royal Belfast Hospital for Sick Children said: “If we suspect a child may have meningococcal septicaemia, we will administer antibiotic treatment straight away. If we wait a few days for the test results to confirm, it may be too late and we risk losing the child.”

Meningococcal disease which is often too late. Furthermore, traditional laboratory diagnostic tests are slow taking up to 48 hours to return results.

Treating potential cases with antibiotics for 48 hours is the safest approach in treating potential cases until new, fast diagnoses are made available. However, this approach means that for every child with meningococcal disease, four children are being over treated.

Throughout the two year study, researchers tested patients using both the standard NHS and the LAMP tests. The LAMP test proved to be as efficient as the standard test in returning accurate diagnosis though in a fraction of the time.

Dr James Mc Kenna from The Belfast Care and Social Trust and lead researcher in developing the LAMP test said: “The LAMP test enables doctors to efficiently diagnose meningococcal septicaemia within an hour. The LAMP diagnosis could significantly reduce the number of patients taking medication unnecessarily as well as preventing needless anxiety to patients and their families.”

Dr McKenna added: “The test saves lives as well as saving precious time for hospital staff so the next stage is that this test can be made readily available to clinicians. When designing the LAMP diagnosis, we focused on producing a test that would be easy to use for clinicians in a hospital setting, taking away from what can be a timely cost of tests being performed by trained lab technicians.”

Although research has proven the LAMP test’s accuracy, further research is required to demonstrate the practicality of testing being undertaken by a clinician in a hospital environment.

Dr Tom Waterfield, is leading a new research study at Queen’s in collaboration with the Paediatric Emergency Research UK and Ireland (PERUKI) network to assess the practicality of this test being used in a hospital setting. Dr Waterfield explains: “We know that scientifically the test is effective but we now need the evidence base to confirm whether it is feasible for clinicians to carry out this test as part of their role before an informed decision can be taken.

“As part of this study, we will evaluate the feasibility of clinicians using the LAMP test in a hospital setting by assessing any potential barriers and ease of use.”

 

 

The two year research study, launching in September will involve clinicians in the Royal Belfast Hospital for Sick Children using the LAMP test in the emergency department to test suspected cases of meningitis, getting results within the hour. If rolled out across the UK, the test could not only prevent children being admitted for treatment for meningococcal disease unnecessarily, but it could also stop children being wrongly sent home, potentially saving dozens of lives every year.

The work is funded by the Health and Social Care Research and Development Division, Public Health Agency and by the Royal College of Emergency Medicine.

To find out more about supporting medical research at Queen's, please contact Helen Surgenor (Head of Medical Fundraising) on +44 (0)28 9097 1568.

Media enquiries to Suzanne Lagan or tel: +44 (0)28 9097 5292.

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