What you need to know about meningitis
by Dr Anshu Bhagat, founder of the UK’s first on-demand app for GP visits, GPDQ
What is meningitis?
The term ‘meningitis’ describes inflammation of the membranes that surround the brain and the spinal cord. These membranes are called the meninges – they help protect the brain from injury and infection.
One of the main causes of meningitis is meningococcal disease, which can develop after infection from several types of meningococcal bacteria – most commonly, groups A, B, C, W and Y. Group B causes the majority of meningitis cases in the UK and you have probably heard of the Men B vaccine (more on that later).
In worse cases, meningococcal disease leads to meningitis and septicaemia (blood poisoning). Many people associate meningitis with the rash that doesn’t fade under the pressure of a glass – that rash is a sign that the patient may have also developed septicaemia.
How serious is it?
Whilst meningitis is rare, it is a serious condition and symptoms can develop very quickly. It’s estimated that 1 in 10 cases of bacterial meningitis are fatal. If treated quickly, it is possible to make a full recovery, but some are left with long-term issues such as hearing or vision loss, epilepsy and loss of limbs.
In the UK, over 50% of cases occur in children under 5 years old.
Meningitis is contagious and the bacteria that causes it can be spread through anything from coughing and sneezing to shared cutlery.
Signs and Symptoms
Symptoms of meningitis and associated septicaemia can appear in any order and some may not appear at all. These are the common signs and symptoms to look out for:
- Cold hands and feet
- Drowsiness, difficulty waking
- Confusion and irritability
- Severe muscle pain
- Severe headache
- Stiff neck
- Sensitivity to bright lights
In some cases, you may also notice pale, blotchy skin or spots/a rash. When this happens, you can try the glass test:
- Press the side of a clear glass firmly against the skin where the rash has appeared
- The spots/rash may fade at first, but keep checking
- If the spots/rash do not fade under pressure from the glass, seek urgent medical attention – especially if combined with a fever
The rash usually appears in the later stages of the illness and may not appear at all – do not wait for a rash before seeking medical attention. If someone is ill and getting worse, get medical help immediately.
It’s important to bear in mind that symptoms can sometimes appear differently in very young children. The symptoms already mentioned may present, but you may also notice the following:
- Staring expression
- Loss of appetite
- Not wanting to be held
- Irritable and unusual crying
- Becoming flopping and unresponsive, or stiff with jerky movements
If you’re worried about meningitis, don’t waste time. Trust your instincts and get medical help immediately.
In an emergency:
- Go to A&E – search for your nearest A&E department
- Call emergency services – dial 999 in the UK
Vaccinations to prevent meningitis in young children
The majority of cases of bacterial meningitis in the UK are caused by meningococcal group B (MenB) bacteria.
A Men B vaccine, to protect against meningococcal group B disease, was introduced into the routine
immunisation schedule available through the NHS in September 2015. A total of three doses are given at 8 weeks, 16 weeks and 12 months of age.
The Men B vaccine is delivered as an injection into your baby’s thigh. Babies usually develop a fever in the first 24 hours after the Men B vaccination when given alongside their other routine vaccinations at 8 and 16 weeks. This is normal and liquid paracetamol can help alleviate the fever and tenderness around the injection site. Other side effects may include redness and swelling at the injection site, vomiting, diarrhoea and irritability.
The Men B vaccine can be given to children of any age, but only the ages mentioned above are covered by the NHS. If you are not covered by the NHS, you can contact a private GP service, such as GPDQ, to find out more.
The Hib/Men C vaccine protects against meningococcal group C disease and Haemophilus influenzae tybe B (an infection that can also cause meningitis and septicaemia, as well as pneumonia). This is also available as part of the NHS routine immunisation schedule and is given to babies at 12 – 13 months.
Hib/Men C is given as a single injection and common side effects can include redness, swelling and tenderness at the site of the injection, fever, loss of appetite, sleepiness and irritability.
In very rare cases, babies may develop a rash after the Hib/Men C vaccination. If this happens, contact a doctor immediately.
Vaccinations can very rarely result in an allergic reaction, or anaphylaxis. If this does happen, it will be within minutes of the injection, so you should still be with the doctor or nurse who administered it. They will be fully trained to deal with an allergic reaction and babies do recover completely when treated.
If you are concerned about your baby’s health after a vaccination, contact your doctor as soon as possible.