Meningitis: everything you need to know

Meningitis can lead to life-threatening blood poisoning. Here's how to spot it before it gets to this stage, plus what's the difference between viral and bacterial meningitis?

meningitis

Meningitis can affect any baby and there is an increased risk for newborns, as their immune systems are not fully developed.

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Meningitis can turn into a life-threatening blood poisoning – called septicaemia. Once septicaemia has taken hold the telltale rash can appear (meningitis alone rarely causes a rash) – but this is in the later stages of meningitis, so it’s important to be aware of the symptoms of meningitis in order to (hopefully) avoid things developing further.

Don’t wait for the rash – as it can take some time to come and may not appear at all.

As our trusted GP, Dr Philippa Kaye, says: “The rash is not the main sign to look for and actually can come rather later in the condition. 

“If your child is unresponsive, more drowsy than usual, has cold hands and feet etc or if you are concerned then please please seek urgent medical advice.  You know your child better than anyone else – if you are worried please take action.”

Meningitis warning signs are:

  • high temperature
  • clammy pale skin
  • sleepiness and difficult to rouse
  • refusal to feed
  • vomiting (this can also be projectile and in large quantities)
  • bulging or tense fontanel (the soft spot on top of your baby’s head)
  • seems irritable when handled
  • high-pitched shrieking or crying. especially when handled
  • cold hands and feet despite a high temperature
  • purple rash that does not fade with pressure (see the tumbler test above) This does not always appear in babies and is usually only present when the child also has scepticaemia (see below)
  • neck stiffness and a dislike of bright lights are symptoms of meningitis, but are unusual in babies
Meningitis symptoms checker image

Septicaemia warning signs are:

  • fever
  • vomiting
  • cold hands and feet
  • raised respiratory rate
  • rash

The tumbler test / glass test

Should your baby have a rash, use the tumbler test to check for septicaemia (blood poisioning which can develop from meningitis):

  • Press a glass tumbler firmly against the rash. If it doesn’t fade, it could be a septicaemic rash.
  • If this happens, seek medical advice immediately. And even if you’re not quite sure, don’t wait.

tumbler

We also got in touch with the Meningitis Research Foundation: Claire Wright, Evidence & Policy Manager there, told us: “The early signs of meningitis and septicaemia are often similar to the symptoms of less serious illnesses, making these serious conditions very difficult to spot at first.

Parents know their children best so check on them often and trust your instincts. When a child is ill and getting rapidly worse, parents should not be afraid to seek urgent medical help - even if they’ve already been seen by a doctor that same day.

“We encourage everyone to take up the offer of the vaccines that are included in the routine immunisation schedule to protect themselves and their families.

“However, there are not yet vaccines available to prevent all types of meningitis and septicaemia. That’s why it’s important to know the symptoms.”

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What should I do if I suspect my child has meningitis?

  • Know the symptoms and monitor your child. Trust your instincts – you know your child better than anyone else.
  • Get medical help immediately – someone with meningitis or septicaemia can get a lot worse very quickly.
  • Be persistent. Don’t be afraid to voice your fear. Be direct – ask, ‘Could it be meningitis?’.

What’s the treatment for meningitis?

 “Bacterial meningitis needs to be diagnosed and treated in hospital with IV antibiotics. Rapid diagnosis and treatment provide the best chance of a good recovery,” advises Claire.

Treatment depends on the severity, speed of detection and your baby’s constitution. Some can be treated in hospital with strong antibiotics and other children will go straight to the critical stage and need intensive care and ventilation.

Knowing the symptoms and getting your child to a doctor as soon as possible are critical to treatment.

Bacterial meningitis versus viral meningitis

There are 2 types of meningitis to be aware of – bacterial and viral. Dr Philippa say that it’s actually very difficult to tell the difference between the 2, adding: “I wouldn’t recommend parents try to do this.  In fact in hospital we would just treat as bacterial until cultures come back as negative.”

Bacterial meningitis

Bacterial meningitis can be life-threatening and needs urgent medical attention.

Most people who suffer from bacterial meningitis recover, but a third of survivors will be left with life-changing after-effects including deafness, epilepsy and learning difficulties and 1 in 10 will die.

While you may notice a rash with viral meningitis, a rash is usually associated with bacterial meningitis. A rash that does not fade under pressure (often a glass is used to test this, see the tumbler test above) is a sign of meningococcal septicaemia. It is normally referred to as the meningitis rash.

If someone is ill and getting worse do not wait for a rash, it can appear late or not at all. A fever with spots or a rash that does not fade under pressure is a medical emergency.

Viral meningitis

Viral meningitis is more common than bacterial meningitis and, although rarely life-threatening, it can make people very unwell.

Many people who have experienced viral meningitis feel that they are dismissed as having the ‘milder’ form of meningitis and that very little is understood about the recovery and after-effects.

Meningococcal group B vaccine

All newborn babies are now offered this vaccine, which protects against meningococcal group B bacteria –  a common cause of meningitis in young children in the UK.

The vaccine is recommended for babies aged 8 weeks, followed by a second dose at 16 weeks and a booster at 1 year.

However we have other vaccines which protect against meningitis as part of the routine vaccination schedule, as Dr Philippa says, these include:

  • Haemophilus influenzae B (HiB), which is part of the 6 in 1 jab you get in the primary course of immunisations at 2, 3 and 4 months old
  • the pneumococcal vaccine which you have at 8 weeks, 16 weeks and 1 year old
  • the Hib/Men C vaccine which combines Hib as above and meningococcal group C vaccine given at 1 year. 
  • the MMR at 1 yr and preschool protects againt mumps meningitis 
  • the Meningitis ACWY whcih protects against 4 groups of meningitis causing bacteria, groups A, C W and Y.  It is given to teenagers. 
  • What other vaccines should your baby have?

Read more

Pics: Getty

About the expert: Dr Philippa Kaye, a mum of 3,  serves as a GP in both NHS and private practise. She attended Downing College, Cambridge, then took medical studies at Guy’s, King’s and St Thomas’s medical schools in London.

She has trained in paediatrics, gynaecology, care of the elderly and acute medicine, psychiatry and general practise.

Dr Philippa has also written a number of books on topics including pregnancy, baby and child health, diabetes in childhood and adolescence and more. She has advised MadeForMums on numerous child health-related topics over the past 4 years.

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