Meningitis is an infection of the protective membranes that surround the brain and spinal cord.
This infection causes these membranes (the meninges) to become inflamed, which in some cases can damage the nerves and brain.
Signs and symptoms of meningitis
Anyone can get meningitis, but babies and young children under five years of age are most at risk. A baby or young child with meningitis may:
have a high fever, with cold hands and feet
vomit and refuse to feed
feel agitated and not want to be picked up
become drowsy, floppy and unresponsive
grunt or breathe rapidly
have an unusual high-pitched or moaning cry
have pale, blotchy skin, and a red rash that doesn’t fade when a glass is rolled over it
have a tense, bulging soft spot on their head (fontanelle)
have a stiff neck and dislike bright lights
have convulsions or seizures
The above symptoms can appear in any order, and some may not appear at all.
The rash can be harder to see on dark skin, in which case check for spots on paler areas like the palms of the hands, soles of the feet, on the tummy, inside the eyelids and on the roof of the mouth.
However, don’t wait for a rash to develop. If your child is unwell and getting worse, seek medical help immediately.
In older children, teenagers and adults, the symptoms of meningitis can include:
a fever, with cold hands and feet
drowsiness and difficulty waking up
confusion and irritability
severe muscle pain
pale, blotchy skin, and a distinctive rash (although not everyone will have this)
a severe headache
sensitivity to light (photophobia)
convulsion or seizures
Again, these symptoms can appear in any order, and not everyone will get all of them.
Don’t wait for a rash to develop. Seek immediate medical help if someone is unwell and displays the symptoms of meningitis.
The glass test
If you press the side of a clear glass firmly against the skin and the rash doesn’t fade, it’s a sign of meningococcal septicaemia.
A person with septicaemia may have a rash of tiny “pin pricks” that later develops into purple bruising.
A fever with a rash that doesn’t fade under pressure is a medical emergency, and you should seek immediate medical help.
Types of meningitis
There are two types of meningitis. They are:
bacterial meningitis – caused by bacteria such as Neisseria meningitidis or Streptococcus pneumoniae and through close contact
viral meningitis – caused by viruses that can be spread through coughing, sneezing and poor hygiene
Bacterial meningitis is very serious and should be treated as a medical emergency. If the bacterial infection is left untreated, it can cause severe brain damage and infect the blood (septicaemia).
In 2011-12, there were around 2,350 cases of bacterial meningitis and septicaemia in the UK. The number of cases has dropped since the introduction of vaccines that protect against many of the bacteria that can cause meningitis, including the meningitis C vaccine, MMR vaccine and pneumococcal vaccine.
It’s essential to know the signs and symptoms, and to get medical help if you’re worried.
Bacterial meningitis most commonly affects children under five years of age, particularly babies under the age of one. It’s also common among teenagers aged 15 to 19.
Viral meningitis is the most common, and less serious, type of meningitis. It’s difficult to estimate the number of viral meningitis cases, because symptoms are often so mild that they’re mistaken for flu.
Viral meningitis is most common in children and more widespread during the summer.
Diagnosing meningitis can be difficult because it often comes on quickly and can be easily mistaken for flu, as many of the symptoms are the same.
However, it’s very important to seek immediate medical help if you notice any of the symptoms of meningitis, particularly in a young child.
This may mean going to the accident and emergency (A&E) department of your local hospital in the middle of the night.
Don’t wait for a purple rash to appear, because not everyone with meningitis gets one.
If meningitis is suspected, treatment will usually be started before the diagnosis is confirmed. This is because some of the tests can take several hours to complete, and it could be dangerous to delay treatment.
The doctors will carry out a physical examination to look for signs of meningitis (see above) or signs of septicaemia, such as a rash. They will also carry out a number of other tests to confirm the diagnosis.
Viral meningitis usually gets better within a couple of weeks, with plenty of rest, painkillers for the headache and anti-sickness medication for the vomiting.
Bacterial meningitis is treated with intravenous antibiotics (delivered through a vein in the arm). Admission to hospital will be needed, with severe cases treated in intensive care, so the body’s vital functions can be monitored and supported.
If antibiotics don’t work, you will need to be in hospital for a week or less. If the infection is more severe, you may need to stay in for longer.
Several decades ago, the outlook for bacterial meningitis wasn’t good, and almost everyone who had the condition would die.
Nowadays, most deaths are caused by septicaemia (blood poisoning) rather than meningitis. Meningococcal disease, meningitis or septicaemia caused by Neisseria meningitidis bacteria results in about 1 death in every 10 cases.
Up to a quarter of people may experience complications of meningitis, such as hearing loss, after having bacterial meningitis.
The best way to prevent meningitis is by ensuring vaccinations are up-to-date. Children in the UK should receive the available vaccines as part of the childhood vaccination programme.
It’s also important to check your travel vaccinations are up-to-date before travelling in certain parts of the world.