Table 3.
Frequency of presenting symptoms in children with minor non-febrile infections, minor febrile infections, and meningococcal disease.
| Symptom | Minor non-febrile infections, n (%) | Minor febrile infections, n (%) | Meningococcal disease, n (%) | Meningococcal disease, adjusted %a |
|---|---|---|---|---|
| Classic meningeal features | ||||
| Photophobia | 5/517 (1.0) | 16/407 (3.9) | 73/345 (21.2) | 25.5 |
| Neck pain or stiffness | 16/517 (3.1) | 23/407 (5.7) | 86/345 (24.9) | 30.3 |
| Headacheb | 56/430 (13.0) | 130/366 (35.5) | 79/250 (31.6) | 35.1 |
| Suggested red flags | ||||
| Leg painb | 16/430 (3.7) | 21/366 (5.7) | 94/250 (37.6) | 43.8 |
| Cold hands and feet | 23/517 (4.4) | 74/407 (18.2) | 139/345 (40.3) | 43.1 |
| Pale colour | 73/517 (14.1) | 169/407 (41.5) | 65/345 (18.8) | 14.0 |
| Other features | ||||
| Confusionb | 0/430 (0) | 7/366 (1.9) | 101/250 (40.4) | 46.4 |
| Fever or high temperature | 0/517 (0) | 407/407 (100.0) | 323/345 (93.6) | 95.4 |
| Drowsy or very sleepy | 48/517 (9.3) | 142/407 (34.9) | 275/345 (79.7) | 85.5 |
| Rash or new spots on skinc | 90/517 (17.4) | 57/407 (14.0) | 267/345 (77.4) | 77.6 |
| Nausea or vomiting | 78/517 (15.1) | 147/407 (36.1) | 250/345 (72.5) | 72.7 |
| Irritable or miserable | 104/517 (20.1) | 213/407 (52.3) | 236/345 (68.4) | 72.6 |
| General aching | 33/517 (6.4) | 94/407 (23.1) | 129/345 (37.4) | 41.2 |
| Refusing food or feeds | 85/517 (16.4) | 181/407 (44.5) | 200/345 (58.0) | 62.8 |
| Difficult/laboured breathing | 24/517 (4.6) | 54/407 (13.3) | 42/345 (12.2) | 10.5 |
| Diarrhoea | 48/517 (9.3) | 80/407 (19.7) | 35/345 (10.1) | 6.5 |
| Sore throat | 114/517 (22.1) | 198/407 (48.6) | 50/345 (14.5) | 17.0 |
| Tummy pain | 68/517 (13.2) | 95/366 (26.0) | 12/250 (4.8) | 5.7 |
| Cough | 221/517 (42.7) | 268/407 (65.8) | 6/345 (1.7) | 1.9 |
Standardised to UK case-fatality rates (CFR) using weighted mean frequency (CFR = 3.6% for all children <15 years; CFR = 3.2% when children <1 year are excluded).
Analysed in children >1 year of age.
Rash was defined as any type of rash, and in the meningococcal dataset included all rash types mentioned by the parent and/or GP. While this estimate incorporates GP input in some cases and could have overestimated its frequency in the meningococcal dataset (and/or underestimated its frequency in children with minor infections), it is unlikely that a rash was reported by the GP but not reported at all by the parent, and thus the estimated frequency is likely to be representative of parental reporting of this symptom.