What is Meningitis?

Meningitis is the inflammation of the linings of the brain and spinal cord, whereas septicaemia is another form of the disease giving blood poisoning. Each has different sets of symptoms and may happen on their own or together. They could be caused by a variety of different organisms, including bacteria, viruses and fungi. When caused by meningococcal bacteria, these two conditions together are known as meningococcal disease.

So, meningitis is inflammation of the membranes which cover the brain and spinal cord. There are two types of meningitis - viral is milder and usually needs no treatment. Bacterial can be life-threatening and requires emergency treatment.

Both viral and bacterial meningitis are usually caused by an infection and can occur at any age. However, bacterial meningitis more often affects children whilst viral meningitis more commonly affects young adults.

Who is affected?

The cause varies at different ages, so 80 per cent of bacterial meningitis occurs in the under-16 age group and the majority are under five. Viral meningitis tends to affect older children and adults.

Viral meningitis

Viral meningitis tends to appear in winter epidemics, is usually not very severe and most people recover fully, often without specific treatment. The illness is because of infection that's caused by a virus. Initially vague flu-like symptoms occur with fever and muscle aches.

Bacterial meningitis

Bacterial meningitis tends to be more severe with a serious risk of complications (one in ten have long-term problems) including death. It's mainly caused by the haemophilus influenzae bacterium, and the meningococcus type B and C bacteria.

The bacteria that causes meningitis vary with the child's age - but meningococcal meningitis is the most common, and on the increase. Non-infectious causes of meningitis include cancer and auto-immune diseases.

In bacterial meningitis symptoms develop rapidly, often over hours, whereas the symptoms of viral meningitis may take a couple of days to develop.

In meningococcal meningitis, caused by the bacteria neisseria meningitides, a rash may develop that starts as purple-red, pinprick spots and rapidly spreads to become blotchy. The rash doesn't fade when pressed.

What are the symptoms?

Meningitis tumbler test

In adults and children symptoms include:

• severe headache
• fever
• stiff neck
• dislike of bright lights
• nausea and vomiting
• irritability, lethargy, poor feeding, drowsiness or seizures. Older children may complain of the more typical meningitis symptoms - severe headache, dislike of bright light or noise, and neck stiffness. Later on babies may have a bulging fontanelle (space in the skull) and an arched back, while older children may develop a fast pulse and blue cold periphery.
• An unusual rash which doesn't blanche when pressed may be a sign of meningococcal infection.
• Complications, especially in bacterial meningitis, include damage to hearing, damage to other nerves in the body, brain abscesses, stroke, and collections of fluid on or in the brain.

Prevention and treatment

In babies symptoms include:

• high fever
• vomiting
• a stiff body with jerky movements or being floppy
• irritability with a shrill cry
• refusal to feed
• tense or bulging fontanelle (soft spot on head)

Routine vaccination protects children from developing some types of bacterial meningitis, including that caused by Haemophilus influenzae (the HiB vaccine) and some varieties of meningococcal disease. Vaccination against the mumps virus protects children from developing viral meningitis caused by the mumps virus.

Close contacts of people with bacterial meningitis may need to take antibiotics as a preventative measure.

Delays in treatment increase the risk of long-term damage. If you suspect meningitis, get urgent medical advice. The diagnosis is confirmed using a test called a lumbar puncture. In this test a fine needle is inserted, under local anaesthetic, into the child's spine to draw out fluid that can then be examined in the laboratory for infectious organisms.

Treatment depends on the cause of the meningitis but in most cases intravenous antibiotics will be started immediately and continued if tests confirm bacterial meningitis. If other causes of meningitis are diagnosed they will be treated accordingly. Other medicines may be needed to control symptoms such as seizures.

Further help

National Meningitis Trust
Fern House, Bath Road, Stroud, Gloucestershire GL5 3TJ
Tel: 01453 768000
Website: www.meningitis-trust.org.uk

See the parents guide giving answers to common immunisation questions.