Meningitis

What is meningitis?

Meningitis is an inflammation of the meninges, the lining surrounding the brain and spinal cord. It can occur at any age but it is most likely to affect young children and young adults. Thankfully, it is a rare illness but although some cases are mild, meningitis can be fatal if not dealt with quickly. As the symptoms can often be mistaken for flu, or a heavy cold, it is vital you know how to recognise the warning signs.

Types of meningitis

There are two main types of meningitis, bacterial (caused by bacteria) and viral (caused by a virus). Knowing, which type is causing meningitis is important because of the severity of the illness and the different treatments given.

‘Bacterial’ meningitis is quite rare. The two main types of bacterial meningitis in the U.K. are:

• Meningococcal- there are 3 strains of meningococcal meningitis - A, B and C.
• Pneumococcal

Both types are named after the germs that cause the infection.

If bacterial meningitis is diagnosed early and treated promptly, the majority of people will make a full recovery. However, in some cases it can be fatal or lead to permanent handicaps like deafness and brain damage.

Before the 1990's, H.I.B. (Haemophilus Influenzae type B) was the leading cause of bacterial meningitis in children, fortunately because of immunization this type of meningitis is now very rare.

Viral meningitis is more common than bacterial meningitis and is rarely life threatening. People who suffer a mild attack of viral meningitis, may not even need to go to their doctor, so they won't realise they have had meningitis.

What is septicaemia?

Septicaemia is a form of blood poisoning, which is caused by the same bacteria that causes meningitis and often occurs with meningococcal meningitis. Septicaemia is very serious and must be treated straight away.

Septicaemia develops when bacteria enters the body through the throat and travels into the blood stream. The bacteria releases toxins into the blood, which break down the walls of the blood vessels, allowing blood to leak out under the skin (it is this leaking that causes the rash). Sometimes, the bacteria infects the bloodstream and the meninges at the same time, causing both septicaemia and meningitis to develop.

Septicaemia reduces the amount of blood reaching vital organs such as the liver and kidney.

What causes bacterial meningitis and how is it spread?

The germs that cause bacterial meningitis are common and live naturally in the back of the nose and throat. However, in a few people the bacteria overcome the body’s immune defences and pass through the lining of the nose and throat into the bloodstream. Once in the blood it can cause meningococcal meningitis or septicaemia. Scientists are still not clear why a few people develop meningitis or septicaemia from bacteria that are harmless to most of us. A possible explanation may be due to a specific weakness in the immune system of people who develop the illness.

Coughing, sneezing and kissing can also spread the germs, but they can not live outside the body for very long. As a result, you would have to be in very close contact with an infected person before the bacteria could pass between you and even then it is unlikely that you would go on to develop meningitis.

What causes viral meningitis and how is it spread?

Viral meningitis can develop as a result of infection with many different viruses such as : herpes simplex, chickenpox, measles, mumps or polio. However, in most cases the specific virus which caused viral meningitis can not be identified. Viral meningitis can be spread between people sneezing or coughing, or even through poor hygiene.

What are the symptoms of bacterial meningitis?

The biggest problem with meningitis it that most of the early symptoms can be mild and similar to those you get with the flu. Symptoms may not all appear at the same time and can include any of the following:

In adults and older children:

• Severe headache.
• Stiff neck.
• Dislike of bright lights.
• Severe sleepiness.
• High temperature and fever.
• Vomiting.

In babies and infants:

• Fever with hands and feet feeling VERY cold.
• High pitched moaning and cries.
• Refusing feeds and vomiting.
• Blank and staring expression.
• Dislike of being handled.
• Difficult to wake.
• Pale blotchy complexion.
• Neck retractions (where the neck is arched back) and arching of the back.

In cases of meningitis with septicaemia adults and children may develop a rash (see below). Not all symptoms may be present and unfortunately many ordinary infections produce similar symptoms.

What are the symptoms of septicaemia?

The main symptom of septicaemia is a rash that starts as tiny red pinprick marks and then if untreated develops into purple bruises or blood blisters. The rash can appear anywhere on the body and is usually a late symptom, in severe cases it may spread as you watch it. It may be more difficult to see the rash if you have dark skin. If you develop any unusual spots or bruises they must be taken seriously.

You may also have diarrhoea, muscle or joint pains with septicaemia.

A ‘glass test’ can be used to see if the rash might be septicaemia. This involves pressing the side of a glass tumbler, firmly against the rash to see if the rash fades and loses colour under pressure.
If the rash doesn’t change colour contact your doctor immediately. If a doctor is unavailable go straight to your nearest accident and emergency department and insist on seeing someone.

What are the symptoms of viral meningitis?

The symptoms are similar to those of bacterial meningitis and the flu, though the symptoms of bacteria meningitis usually progress more rapidly. People will normally make a full recovery in two to three weeks, though they may feel very unwell for the duration of the illness. Symptoms of viral meningitis include:

• Headache, which can be severe.
• High temperature.
• Painful joints.
• Sore throat.
• Diarrhoea.

You must be careful not to mistake the potentially serious bacterial meningitis with viral meningitis. If the symptoms of viral meningitis are severe, you may need to be admitted into hospital for tests to identify, which form of meningitis you are suffering with.

If you are worried or not sure you should always seek medical advice.

Who is at risk of getting meningitis and septicaemia?

Anyone of any age can get meningitis or septicaemia, however, both conditions are most common in:

• The under five’s.
• Teenagers and young adults.
• The elderly.

How are meningitis and septicaemia treated?

As viral meningitis is caused by a virus, antibiotics will not help and it will clear up on it's own. The best way to make a full recovery is by resting and drinking plenty of fluids. You should also take paracetamol to relieve any headaches and to reduce a temperature.

Bacterial meningitis and septicaemia must be treated immedaitely with antibiotics, usually via an injection, directly into the bloodstream. If you have bacterial meningitis you will usually be monitored in hospital for some time. Anyone who has been in close contact with the patient may also be prescribed medication to protect them. With all cases of meningitis, the earlier the diagnosis is made the better the outlook for the patient.

What are the after effects of meningitis and septicaemia?

The majority of people with viral meningitis will make a full recovery, though they may feel severely weak and depressed for a short period of time afterwards.

Bacterial meningitis and septicaemia can kill in hours if not treated or can leave people with disabilities such as brain damage, hearing loss or learning disabilities.

In cases of acute septicaemia there may be severe tissue damage and so you may need skin grafts or to have a limb or digit amputated.

IF YOU SUSPECT MENINGITIS OR SEPTICAEMIA, CALL YOUR DOCTOR IMMEDIATELY, IF YOUR DOCTOR IS NOT AVAILABLE GO STRAIGHT TO THE NEAREST HOSPITAL CASUALTY DEPARTMENT. TRUST YOUR INSTINCTS A LIFE COULD DEPEND ON IT.

Immunization

There are vaccines available for H.I.B. and bacterial meningitis C. The H.I.B. vaccine is usually given to babies at the age of 2 months, along with vaccines for diphtheria, whooping cough, tetanus, and polio.

The vaccine for bacterial meningitis C only protects against group C meningitis and not against type B. Type B is the most common type of meningitis in the U.K., though meningitis C causes more deaths. The meningitis C vaccine is still fairly new and available for children aged 2 - 4 months and children up to the age of 17. If your child has not been vaccinated against meningitis C, ask your doctor for information.

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