Health Centres - Meningitis (cerebrospinal meningitis)
What is meningitis?
The very mention of meningitis strikes fear into the heart of most parents in the UK. Such fears are understandable because meningitis is an inflammation of the lining of the brain and spinal cord and can be a very serious illness. Meninigitis is often associated with septicaemia, otherwise known as blood poisoning, which can also be extremely serious.
Although most people recover from the disease, some are left deaf or blind, and in others it may prove fatal.
One of the biggest problems with meningitis is that it can develop very quickly. A child (or adult) can seem perfectly well and then, just a few hours later, be extremely ill with the disease. Another problem is that the symptoms can be difficult to distinguish from other, less serious infections.
What are the symptoms of meningitis?
It is important to know that not everyone will develop the symptoms below and that they can appear in any order. If someone gets some of the symptoms listed below you should seek medical help immediately because the disease can become extremely serious in just a few hours. If you cannot get in touch with your doctor, or are still worried after getting advice, trust your instincts and take your child to the emergency department of your nearest hospital. You know your child best.
In babies and young children meningitis can cause fever, vomiting, refusal to feed, a high-pitched or moaning cry and irritability.
Babies may also develop a tense or bulging fontanelle (the soft spot on the top of the baby's head), blotchy or pale skin, rapid breathing, a floppy body or stiffness with jerky movements.
Older children and adults may experience a severe headache, stiff neck and aversion to bright lights as well as fever and vomiting. Eventually, the person may become drowsy or unconscious.
If septicaemia (blood poisoning) is also present a rash may develop that starts off looking like tiny red pinpricks. Later, the rash changes to purplish red blotches. If you press on the rash with a glass tumbler, the spots will not fade.
Older children and adults with septicaemia may complain of cold hands and feet, aching muscles and joints, and stomach pain (sometimes with diarrhoea).
Recent research has found that key early warning signs of meningitis in children under 17 years old often include cold hands and feet, abnormal skin colour, and leg pains. These symptoms are early signs of septicaemia and can often occur hours before other classic symptoms such as a rash and dislike of bright light.
Septicaemia is a medical emergency that requires urgent treatment with antibiotics. If your child has these early warning signs and you suspect they have septicaemia or meningitis, do not wait for a rash to appear but seek medical advice immediately.
What causes meningitis?
Bacterial meningitis is less common, but is always a severe and serious illlness. Children in the UK are now offered vaccination against three of the main causes of bacterial meningitis, meningococcal group C, Hib (
Hib meningitis was the most common form in children before the introduction of the Hib vaccine in 1992, but since then has been virtually eliminated.
There are more than 13 known groups of meningococcal bacteria. Group C used to account for one third of cases, but vaccination introduced in the UK in November 1999 now prevents virutally all cases.
Meningococcal group B bacteria now cause the most number of cases of meningitis in Britain.
Unfortunately, there is no safe and effective vaccine against meningococcal group B bacteria.
Pneumococcal meningitis is the second most common form of meningitis in the UK, though this may change now that a pneumococcal vaccine has been added to the childhood immunisation schedule. With this form of meningitis people do not usually get the rash that is associated with meningococcal meningitis, though the other symptoms are similar.
How do you get it?
Vaccinations
The meningitis C vaccine (Meningitec, Menjugate or NeisVac-C)
is made from a small inactivated part of the meningococcal group C bacteria. It stimulates the body's immune system to produce antibodies that act as a defence against group C meningococcal disease.
If an immunised person comes into contact with the real bacteria, the antibodies will prevent their body from becoming infected with the group C bacteria and will protect the person from developing meningococcal meningitis C or septicaemia.
The meningitis C vaccine is given in two doses, at three months and four months .
If you are aged under 25 years and have never been immunised against meningitis C it is recommended that you should also have this vaccination.
The Hib vaccine is made from a small inactivated part of the Haemophilus influenzae type B bacteria and works in a similar way. It protects the person from developing Hib meningitis or septicaemia. The Hib vaccine is part of one combination vaccine (Pediacel) that also protects against whooping cough, diptheria, tetanus and polio. It is given in three doses, at two, three and four months of age.
A combination Hib and meningitis C booster (Menitorix) is given at 12 months.
The pneumococcal vaccine (Prevenar) is another inactivated vaccine. It prevents the body being infected with Streptococcus pneumoniae and will protect the person from developing pneumococcal meningitis or septicaemia. This vaccine is now given routinely to children at the ages of two, four and thirteen months.
The meningitis C, Hib and pneumococcal vaccines are also recommended for people who have had their spleen removed, for example after a car accident, or who have a poorly functioning spleen, eg due to sickle cell disease.
These vaccines do not prevent infection with other viruses or bacteria, including group B meningococcus.
As these vaccines are not 'live', they cannot give anyone meningitis or septicaemia.
How is meningitis treated?
Bacterial meningitis is treated with antibiotics, usually either benzylpenicillin
or cefotaxime.
People who have been in close contact of someone that has been diagnosed with meningitis may also need antibiotics.
Viral meningitis cannot be helped by antibiotics and treatment is based on good nursing care.
A number of different viruses and bacteria can cause meningitis. Viral meningitis is the most common form, but fortunately is less severe than the bacterial type. However, it can still be serious and very rarely, can progress from headache, fever and drowsiness, to deep coma.
The bacteria that can cause bacterial meningitis are very common and don't usually cause any harm. They are found naturally in the nose and throat, particularly in teenagers and young adults. The bacteria can be spread through prolonged close contact, coughing, sneezing and kissing. However, only in a small number of people do the germs overwhelm the body's immune system to cause meningitis or septicaemia.
Vaccinations introduced in recent years have gone a long way to reducing the number of cases of meningitis seen in this country. The three major vaccines that can help protect your child from getting meningitis now form part of the childhood immunisation schedule.
Anyone suspected of having meningitis should be taken to hospital urgently. The sooner they are diagnosed and treated, the greater the chance of recovery.
© Copyright 1998 - 2009 NetDoctor.co.uk - All rights reserved
