Positive Relationships: Meningitis - In the balance

Isabella Troiano's first Christmas was memorable for all the wrong reasons - she was fighting for her life.

'Isabella woke in the early hours of the Sunday before Christmas and didn't seem herself, but I put it down to teething. I just gave her some Calpol and put her back to bed,' says her mother, Gemma Allen-Troiano, from Dursley in Gloucestershire.

'I awoke at 10.30am to realise she hadn't stirred, which wasn't normal. She was drowsy and grumpy and curling herself up into the foetal position so I decided to take her to the doctor.'

He ran some tests and said to continue giving Isabella Calpol and fluids if possible. But the next day she had worsened, so Gemma took her to hospital. 'It was her high-pitched cry that alerted me that something was seriously wrong - it was horrendous, she was wailing like a banshee.'

Isabella was swiftly admitted to hospital and doctors prescribed antibiotics, took blood tests and did a lumbar puncture to remove fluid from around the spinal cord, but Isabella's condition did not improve. She was moved to intensive care. 'It was a very scary time,' says Gemma. 'Isabella was laid on her back with her arms out and I couldn't hold her because of all the tubes. I kept wondering whether she would die.

'Two days before Christmas a doctor told us Isabella had pneumococcal meningitis, a life-threatening infection that causes inflammation of the layers that surround the brain and spinal cord.'

On Boxing Day the swelling on Isabella's brain caused her to have a fit and her hearing was also affected. But gradually it went down and Isabella was allowed home on New Year's Day.

Isabella, now two years old, is a 'lively soul'. She regained hearing in her right ear but the auditory nerve in her left ear is damaged, so she has learned to communicate with sign language.

Gemma now gives talks on meningitis in local nurseries and schools. 'I can't stress enough that parents and carers should know all the signs and symptoms of meningitis,' she says. 'I didn't realise how ill Isabella was and she could have died. Meningitis is so serious that minutes count.'

WHAT MANAGERS SHOULD DO

The National Day Nurseries Association advises that in the event of a child contracting meningitis, nursery managers should:

- look at the guidance available on the Health Protection Agency website, www.hpa.org.uk, about different types of meningitis and infection risk

- inform relevant bodies such as the local health protection unit and Ofsted. They will support the setting in informing parents and also advise about necessary exclusion periods by type of meningitis and any treatment children may require

- speak to the local authority early years unit

- detail the procedure for dealing with a serious communicable infection in the nursery's health policy.

Purnima Tanuku, NDNA chief executive, adds, 'A child suffering from meningitis is a distressing situation for everyone involved, but it is important that settings remember that parents of other children attending the nursery will be worried too. Alongside informing the relevant bodies such as the local health protection unit, nurseries need to provide information and support to other parents who will be concerned about the risk to their child. Nurseries should seek advice from the health protection unit, which should be able to help with giving the type of information parents will need.

'It is also crucial that nurseries have a strong policy and procedure in place about what happens in the event of a communicable disease, so that parents are aware of the process. Throughout the situation, the nursery should look to keep families fully updated with information and any advice they need to know.'

The Meningitis Research Foundation is aiming to raise awareness of meningitis. Childcarers can request free information packs highlighting the early warning 'red flag' symptoms of meningitis and septicaemia. Call the Freefone helpline on 080 8800 3344 or visit www.meningitis.org.