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Recognising and preventing meningitis

What is it?

Meningitis is an inflammation of the membrane covering the brain and spinal cord that can develop very rapidly.

• There are many different types of the disease, but the two most usual forms are viral and bacterial meningitis.
• Viral meningitis is the most common type and can be relatively mild – some sufferers are not even aware that they have an infection.
• The bacterial form of meningitis is far less common, but is life threatening and requires prompt treatment.
• Depending on the type, bacterial meningitis is fatal in 10-20 % of cases and can cause serious disability, such as deafness or brain damage.
• Septicaemia (blood poisoning) is a serious complication of meningitis caused by bacteria entering the bloodstream and multiplying rapidly and the septicaemia form of meningitis is the most dangerous.

Can newborn babies get meningitis?

Yes. The risks are higher among premature babies and those with a birth weight lower than 2 kilograms (about 4 pounds and 6 ounces).

What are the symptoms of meningitis?

The incubation period is between two days and three weeks depending on the type of meningitis. Symptoms can be similar to influenza, and include:

• A high temperature or fever.
• Severe headache.
• Nausea.
• Vomiting.
• Dislike of light.
• A stiff neck.

Other changes you may notice in your baby include:

• A bulging fontanelle (soft spot on your baby’s head).
• Pale, blotchy or blue skin.
• Constant sleepiness and difficult to wake.
• Continuous refusal to feed.
• A blank, staring expression.
• A high-pitched moan or cry.
• Irritable when picked up.

However, the symptoms are not completely predictable; some babies may be floppy and listless, while others may be stiff with jerky movements.

What is septicaemia, and what are the symptoms?

Septicaemia is the blood poisoning form of meningitis, and is even more life threatening. The symptoms can include:

• Cold hands and feet.
• Babies often have cold hands and feet when they are well, so also look out for rapid or unusual patterns of breathing, and shivering.
• A temperature.
• Abnormally pale skin colour, possibly looking very pale, blue or dusky around lips.
• Severe leg pains, which prevent walking or standing.
• If your baby isn’t standing or walking yet, achy muscles or pain in the limbs or joints may show as your baby being irritable.
• A skin rash that appears under the skin as a cluster of tiny spots. They look like pinpricks and can start anywhere on the body.

How can I check a rash I think might be caused by meningitis?

The ‘glass test’ is often referred to when advice is given about checking for meningitis symptoms in a baby. To carry out the test, do the following:

• Press the side of a clear drinking glass on to the spots.
• If they’re nothing to worry about, they should fade.
• However, a meningitis rash won’t fade under the pressure of the glass.

What should I do if I’m worried my baby is at risk?

If you’re worried, check on your baby frequently. Even if no rash appears, but your baby’s condition is getting worse, take your baby to your GP or your nearest hospital immediately.

How is meningitis diagnosed?

• The diagnosis is made using a lumbar puncture.
• A hollow needle is inserted into the lower spine, a sample of fluid removed from the spinal cord, and then examined.
• The process takes less than twenty minutes.

How is it treated?

• Bacterial meningitis is treated with antibiotics.
• Viral meningitis doesn’t respond to antibiotics, so treatment is based on rest and nursing care.
• After viral meningitis, headaches, tiredness, and depression can last for some time.
• In rare cases, viral meningitis can cause encephalitis (inflammation of the brain) and in these cases, anti-viral treatment may be needed.

Is meningitis infectious?

• Bacterial meningitis is spread by sneezing or, in adults, intimate kissing.
• The bacteria that can cause it are extremely common, living in the back of the nose and throat. People can carry them without becoming ill.
• People who’ve been in close contact (usually defined as sharing a house) with someone with bacterial meningitis, or meningococcal septicaemia, are offered antibiotics because of the risk of infection.
• Most cases are isolated, but occasionally clusters of meningococcal meningitis appear.
• Viral meningitis is spread just like other viruses, from person to person.
• Sometimes it’s spread by coughing and sneezing and at other times by poor hygiene.
• Viral meningitis used to be a complication of childhood illnesses like measles and mumps, but the MMR vaccination has virtually eliminated this threat.

Are immunisations available for meningitis?

There is no effective vaccine against the most common form of bacterial meningitis which is meningococcal Group B disease.

However, the Department of Health and Children launched a National Meningitis Immunisation Programme against Group C meningitis in 2002. The programme is for everyone in Ireland aged up to and including 22 years.

The programme was carried out in three phases. The first targeted those at greatest risk who were children under five years and people aged fifteen to eighteen years. The second phase targeted primary school children and post-primary students aged twelve to fourteen years. The third phase targeted young people aged nineteen to twenty-two years.

As a result of the programme, there has been an overall reduction of 96% in the number of group C cases notified in 2004, compared with those notified in 2000. The vaccine has been incorporated into the Primary Childhood Immunisation Programme for children up to two years of age and is administered at two, four and six months of age.

Are there some other diseases that can lead to meningitis?

Yes. The following diseases can cause meningitis:

Haemophilus influenzae type b (Hib)

How is it spread? By droplet infection person to person.

What are the symptoms? The symptoms of Hib are flu-like, such as: a sore throat, chest infections and ear infections.

What complications can it cause? Meningitis or blockages of the throat.

Is an immunisation available? Babies are offered the immunisation injection at eight, twelve and sixteen weeks of age.

Pneumococcus

How is it spread? Caused by infection with the influenza virus.

What are the symptoms? Infected individuals may develop sudden fever, chills, headache, myalgia (muscle aches), sore throat and a cough which does not produce any phlegm.

What complications can it cause? Pneumococcus can lead to serious illnesses such as meningitis, septicaemia (blood poisoning) and pneumonia. One in ten cases of meningitis is caused by pneumococcal bacteria, and this form of meningitis is more dangerous than meningitis C.

Is an immunisation available? The pneumococcal vaccine is currently being introduced. Babies will be offered it at eight and sixteen weeks, with a booster at thirteen months.

Need more information?

The Meningitis Research Foundation is a national charity that works to raise awareness about meningitis and septicaemia. The charity also funds research and offers support through in-depth information and befriending services to patients and families affected by meningitis and septicaemia.

Meningitis Research Foundation

51 Cullenswood Road
The Triangle
Ranelagh
Dublin 6
Helpline: 1890 41 33 44 open 24 hours per day)
Tel: (01) 496 9664 or (01) 496 9665
Fax: (01) 496 9656