People with meningitis and meningococcal septicaemia need URGENT medical attention

What is meningitis?

Meningitis is an inflammation of the tissues (called meninges) that cover the brain and spinal cord. It can develop very rapidly, and in young children the earliest symptoms are often hard to recognise. Most people recover from the disease but it can leave permanent disability.

What is septicaemia?

Septicaemia is a type of blood poisoning, which can be caused by the same bacteria that cause meningitis. It often accompanies meningitis and can progress to coma and death. Septicaemia can also make you very ill because it can reduce the amount of blood reaching your vital organs, such as the liver and kidneys.

What causes meningitis?

In the UK, most cases of meningitis are caused by either bacteria or viruses. Bacterial meningitis is generally more serious than viral meningitis. There are many types of bacterial meningitis including meningococcal group B, meningococcal group C, pneumococcal, Hib and group B streptococcal.

What is meningococcal meningitis?

Meningococcal group B and meningococcal group C are two types of bacteria that cause many cases of meningitis and septicaemia in the UK. Although meningococcal group B meningitis is the commonest, meningococcal group C meningitis causes more deaths. These bacteria can cause either meningitis or septicaemia, or both at once. There is a new vaccine for group C meningitis ('meningitis C vaccine') but (in 2005) there is no effective vaccine for meningococcal group B meningitis.

How are meningitis and septicaemia contracted?

The bacteria that can cause meningitis and septicaemia live naturally in the throats or noses of about one in ten people, without causing them any illness. This figure can be even higher among young people: almost one in four. In a few people, however, the bacteria can overcome their immune defences and pass through the lining of the nose and throat into the bloodstream. In the bloodstream, the bacteria can cause two types of infection: meningococcal meningitis and/or septicaemia. Meningococcal bacteria can be spread by coughing, sneezing or direct contact such as kissing.

Why do some people develop meningitis and septicaemia?

Scientists do not yet fully understand why a few people develop meningitis or septicaemia from those bacteria that are harmless to most of us. Although anyone can get meningitis or septicaemia, we know that children under the age of five and young adults have a higher risk of developing these diseases.

How common are meningitis and septicaemia?

Meningitis and septicaemia are not very common, but they are serious. These diseases are the commonest cause of death among children aged one to five years, and the most common infectious disease causing death in children and young people. Viral meningitis, although probably more common than meningococcal meningitis and septicaemia, is rarely serious. There are also other types of bacterial meningitis in the UK, but they are less common.

Can meningitis and septicaemia be treated?

Yes, meningitis and septicaemia can be treated. Because the diseases develop extremely rapidly, it is important to know their signs and symptoms so you can get medical help quickly. People who doctors think might have meningitis or septicaemia are given antibiotics straight away, and have to stay in hospital. The earlier they are treated, the better their chances of making a full recovery. At least 95% of people recover from meningococcal meningitis; however, the recovery rate for patients who have meningococcal septicaemia can be as low as 50%, depending on the severity of the disease. Both types of infection can kill very quickly if they are not recognised and treated in time.

Symptoms of meningitis in a baby

Symptoms of meningitis in a baby

Some or all of:

  • Fever; hands and feet might also be cold

  • Refusing feeds or vomiting

  • High-pitched moaning cry or whimpering

  • Dislike of being handled, fretful

  • Neck retraction with arching of back

  • Blank and staring expression

  • Difficult to wake, lethargic

  • Pale, blotchy complexion

Symptoms of meningitis in an older child or adult

Symptoms of meningitis in an older child or adult

Some or all of:

  • High temperature

  • Fever

  • Vomiting

  • Sometimes diarrhoea

  • Severe headache

  • Neck stiffness (unable to touch the chin to the chest)

  • Dislike of bright lights

  • Drowsiness

  • Joint or muscle pains (sometimes stomach cramps if septicaemia)

  • Fitting

  • The patient might be confused or disoriented

Why can septicaemia cause spots and bruises?

In septicaemia, the bacteria release toxins into the blood, which break down the walls of the blood vessels allowing blood to leak out under the skin. This leaking causes marks on the skin. At first, you might see a rash of red or brown pin-prick spots, which can develop into purple bruises, blood blisters or blood spots. These spots do not fade under pressure (see the tumbler or glass test below).

What is the tumbler or glass test?

If a tumbler (or glass) is pressed firmly against a septicaemic rash, the rash will not fade but will remain visible through the glass. If this happens, seek medical advice immediately. This is a good test but not 100% reliable. Any sick child with a rash should be taken for medical review.

What should I do if I suspect meningitis or septicaemia?

If someone you know is ill and you suspect either meningitis or meningococcal septicaemia, contact your general practitioner (GP) immediately. Describe the symptoms carefully, and mention that you think it might be meningitis or meningococcal septicaemia. If your doctor is not available, go straight to the nearest Accident and Emergency Department.

Why should I seek help immediately?

If it is meningitis or meningococcal septicaemia, early treatment with antibiotics is vital. Do not wait for a rash to develop, it might be the last symptom to appear. In cases of meningitis without septicaemia, the rash may not appear at all.

Are there any vaccines against meningitis and septicaemia?

Yes, there are vaccines that protect against meningitis and septicaemia; however, although most of the vaccines provide excellent protection, they can not prevent all strains of these diseases.

If people are now being vaccinated against meningitis and septicaemia, why is it important to know the symptoms of these diseases?

As yet, no single vaccine can prevent all forms of meningitis and septicaemia. Furthermore, there is no effective vaccine can protect against group B meningococcal meningitis and septicaemia, which is the most common type of the disease in the UK - so knowing the signs and symptoms is vital to ensure early treatment and improved response.

Which type of meningitis vaccine is used in the childhood immunisation programme?

A vaccine that protects against Hib meningitis has been offered since 1992 as part of the childhood immunisation programme. It is very safe and has nearly wiped out Hib meningitis in the UK. The vaccine does not contain live bacteria and can not give anyone meningitis or septicaemia. Recently, the new meningitis C vaccine has also been offered for babies.

What is the meningitis C vaccine?

A meningitis C vaccine (introduced to the UK in 1999) protects against group C meningococcal meningitis and septicaemia. It will not protect against other types of meningitis, including the commonest type: group B meningococcal meningitis and septicaemia. It is made from a small part of the meningococcal bacteria and is made in the same way as the Hib vaccine, which has been given routinely to babies since 1992. The vaccine does not contain live bacteria and can not give anyone meningitis or septicaemia. Although this is a fairly new vaccine, it contains ingredients that are very similar to those of the Hib vaccine. It has been thoroughly tested in children of all ages and provides good protection with very few side effects. By 1999, 60 000 doses had been given worldwide. The new vaccine has been tested carefully and found to be safe; it can also be given at the same time as other vaccines. The 'old' polysaccharide meningitis C vaccine might be used in some outbreaks of meningococcal group C disease, if supplies of the new vaccine are limited, or for travellers abroad.

Can everyone be vaccinated?

Some people, for medical reasons, can not be vaccinated - please ask your doctor or nurse for further information.

How does the meningitis C vaccine work?

The meningitis C vaccine causes the immune system to produce antibodies to protect the body against group C meningococcal disease. If an immunised person comes into contact with the live bacteria, the antibodies will recognise them and provide protection.

Which vaccines are used for travellers abroad?

The 'old' polysaccharide vaccine against meningococcal group C meningitis and septicaemia also provides protection against meningococcal group A disease, which is prevalent in parts of Sub-Saharan Africa and the Indian subcontinent. Travellers to some countries in these regions might require this older type of vaccine. For further information contact your GP.

Are there any vaccines against pneumococcal meningitis?

In 2005, in the UK, there is no routine vaccination programme against pneumococcal meningitis, which is the second-commonest cause of bacterial meningitis. This is because the existing vaccine against pneumococcal infection is only partially effective and does not work in children under two years of age. However, people who are considered to be at high risk of pneumococcal infection, and who are aged two years or older, should have this vaccine.

Who is most at risk from pneumococcal meningitis?

Those at highest risk of contracting pneumococcal meningitis include people who have:

  • No spleen or a non-functioning spleen, owing to accident or disease;

  • Sickle-cell disease;

  • Coeliac syndrome;

  • A deficient immune system, owing to disease, or treatment for cancer, organ transplantation or HIV etc;

  • Chronic heart, lung or kidney disease (including nephrotic syndrome);

  • Diabetes;

  • Chronic liver disease including cirrhosis.

Where possible, the pneumococcal meningitis vaccine should be given four to six weeks (but at least two weeks) before either chemotherapy for cancer treatment, or elective removal of the spleen (for medical reasons). The level of protection this vaccine provides against pneumococcal meningitis is not known, but it is important for people who are most susceptible to the infection to reduce their risk by getting vaccinated.

This information has been modified from information on the Meningitis Trust website, the Meningitis Research Foundation, and the 'Meningitis C: reduce the risk - Your guide to the new meningitis C vaccine' booklet, published by the NHS.

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For further information contact your general practitioner (or NHS Direct: 0845 4647)

 
Last updated: 7 January 2005
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