Delay in Reporting Meningitis Case
The NHS waited two days before raising the alarm about the meningitis outbreak, the BBC has learnt.
The UK Health Security Agency (UKHSA) was first alerted to a case by the Queen Elizabeth the Queen Mother Hospital in Margate on the afternoon of Friday 13 March.
That patient had arrived at the hospital two days earlier, but there was a delay in reporting to health officials despite a legal requirement for cases to be reported immediately.
This delay hindered the tracing of close contacts of the patient and potentially delayed identifying a wider outbreak.
The hospital, operated by East Kent Hospitals NHS Trust, admitted to the BBC that it had missed an opportunity to alert UKHSA sooner, explaining it had waited until there was a formal diagnosis via a confirmed test.
Dr Des Holden, acting chief executive of East Kent Hospitals NHS Trust, said the patient first presented on Wednesday evening.
"We recognise there was an opportunity prior to diagnosis to notify UKHSA.
We cannot go into the detail of individual patients' care, but the trust has been in close contact with UKHSA since Friday 13 March to discuss the management of patients presenting with suspected meningitis."
Legal Requirements and Urgency
Invasive meningitis is classified as an urgent notifiable disease, and under the Health Protection Regulations 2010, it is mandatory to report cases to health protection officials as soon as a case is suspected. Hospitals are not required to wait for tests and a formal diagnosis before reporting.
Expert Criticism of Delay
Experts have criticised the delay, suggesting it may have put people at risk since earlier public health warnings could have encouraged those developing symptoms to seek medical help sooner.
Of the 23 suspected and probable cases, all involving young adults and teenagers, two people have died and four were in intensive care as of Monday.
Ten individuals reportedly developed symptoms between the first-known admission and the point at which UKHSA issued a public alert on the evening of Sunday 15 March warning of the outbreak, according to figures released by UKHSA.
"Delaying reporting a case is indefensible," said Prof Paul Hunter, an infectious disease expert at the University of East Anglia.
"You don't wait for a formal diagnosis when it comes to meningitis – you report it straight away so it can be investigated.
Not only do you want to trace the close contacts to give them preventative treatment, you also want to see if there are other cases developing."
He added: "You had significant numbers of young people developing symptoms as the days went by, but they were unaware there was an outbreak. If they had known, they may have come forward for treatment sooner."
He said quick treatment was essential to increase the chances of survival and to avoid life-changing disabilities, such as loss of limbs, blindness and brain injury.
Patient Identity and Reaction
While the hospital has not confirmed the identity of the patient, the BBC understands it was Annabelle Mackay, 21, a University of Kent student.
She first spoke to the BBC last week and has since expressed surprise that her case was not reported sooner.
"It was treated as meningitis as soon as I was taken in. If the report had been made earlier, other people could have been warned to look out for symptoms."
UKHSA Response and Further Reporting Delays
UKHSA acknowledged that an opportunity had been missed to report the case sooner and also questioned how quickly East Kent reported subsequent cases.
It stated it was only notified by the trust of more cases on Saturday evening despite additional patients arriving with suspected meningitis at East Kent services on Friday. The trust operates two major hospitals in the county.
UKHSA said it was unclear what impact this delay had on identifying whether there was a cluster of cases.
In a statement regarding the delay in reporting the first case, UKHSA said it would have started investigating the situation sooner and provided antibiotics to close contacts of the patient to prevent invasive meningitis.
However, it noted there were no confirmed cases linked to this individual so far.
Once it became evident that there were a number of seriously ill people, UKHSA triggered a "large-scale public health response."
On Sunday morning, internal health service communications were distributed across Kent and Medway to inform services of the outbreak, ensuring NHS 111, local A&Es, and GPs were on alert for cases.
