What is meningitis?
Meningitis is inflammation of the protective layers that surround the brain and spinal cord. These layers are called the meninges.
What is MenA, B, C, W and Y?
Meningococcal bacteria, the most common cause of bacterial meningitis in the UK, can be divided into several groups. The groups that most commonly cause the disease are A, B, C, W and Y.
What causes meningitis?
- Viral meningitis is more common than bacterial meningitis, but rarely fatal
- Bacterial types are comparatively rare, but extremely dangerous and can be fatal
- The most common bacterial cause in the UK is the meningococcus. This can cause both meningitis and septicaemia (meningococcal disease)
- Other types of bacterial meningitis include pneumococcal, Hib, neonatal (usually caused by group B streptococcus and E. coli) and TB
How do you get meningitis; can anyone get meningitis?
Everybody is at risk, but certain age groups are more susceptible.
- The under-fives are most at risk, particularly the under-ones
- Teenagers and young adults are the second most at-risk group
- Those over 65 are also at increased risk
Can you get meningitis more than once?
It is very unusual for anyone to have meningitis more than once, but it is possible. Most people some develop immunity to the organism that has caused their disease. However, there are several different causes of meningitis and therefore it is possible, but rare, to have the disease more than once.
Although extremely rare, some viruses can cause recurring meningitis. This is known as Mollaret’s meningitis.
Is meningitis seasonal?
Although meningitis can occur at any time of the year, in the UK the number of bacterial meningitis cases rises during the winter months and the number of viral meningitis cases increases during the summer months.
What is meningococcal disease?
- Meningococcal bacteria can affect the body in different ways
- Meningitis is caused when the bacteria enter the bloodstream and travel to the meninges where they multiply and cause inflammation
- Septicaemia is blood poisoning; bacteria in the bloodstream multiply rapidly and release toxins (poisons) as they die. These toxins damage blood vessels throughout the body; this can lead to organ damage
- It is common for meningococcal bacteria to cause both meningitis and septicaemia; this is known as meningococcal disease
What is septicaemia?
Septicaemia is blood poisoning and can be caused by some types of bacteria that also cause meningitis. The bacteria enter the bloodstream and multiply uncontrollably. As the bacteria die and breakdown, they release toxins (poisons) into the blood. These toxins damage the blood vessels throughout the body, causing organ damage. The rash associated with meningitis is actually caused by septicaemia.
Many medical experts now use the term sepsis instead of septicaemia. Sepsis describes the life-threatening condition that arises when the body's response to an infection injures its own tissues and organs.
What is the difference between meningitis and meningococcal septicaemia?
The meningococcal bacteria can affect the body in several ways:
- Meningitis is caused when bacteria enter the bloodstream and travel to the meninges, where they multiply and cause inflammation
- Septicaemia is caused when bacteria enter the bloodstream and multiply rapidly. They release toxins that poison the blood. If the bacteria do not reach the meninges, meningitis does not occur
- Commonly, the bacteria will multiply in both the meninges and the bloodstream, causing meningococcal meningitis and septicaemia to occur. This is referred to as meningococcal disease.
What are the main symptoms?
The common signs and symptoms associated with meningitis and septicaemia can appear in any order, and some may not appear at all.
Fever with cold hands and feet - Vomiting - Drowsy, difficult to wake - Confusion and irritability - Severe muscle pain - Pale blotchy skin, spots or a rash that does not fade under pressure - Severe headache - Stiff neck - Dislike of bright lights - Convulsions/seizures
Fever with cold hands and feet - Refusing food or vomiting - Fretful, dislike of being handled - Drowsy, floppy, unresponsive - Rapid breathing or grunting - Pale blotchy skin, spots or a rash that does not fade under pressure - Unusual cry, moaning - Tense, bulging fontanelle - Neck stiffness - Dislike of bright lights - Convulsions/seizures
What is the rash?
When meningococcal bacteria multiply in the blood stream, they release toxins (poisons) that damage the blood vessels. The rash is caused by blood leaking from the damaged blood vessels into the tissues underneath the skin.
What does it look like?
The rash can start anywhere on the body. It begins as tiny red pin pricks, but may quickly develop to look like fresh bruising. The Glass Test can be used to see if the rash might be septicaemia. If you press the side of a clear drinking glass firmly onto the spots or bruises, they will not fade. A rash will not always appear with meningitis and can be one of the last symptoms to be displayed. Never wait for a rash if you suspect meningitis.
Are signs and symptoms different for septicaemia?
If someone has septicaemia alone, the common signs of meningitis, such as a severe headache or neck stiffness, may not be present. The early signs and symptoms of septicaemia include:
- Fever with cold hands and feet
- Severe muscle pain
- Pale blotchy skin
- Stomach cramps and diarrhoea
Septicaemia can progress very quickly, resulting in severe shock and, in some cases, death within hours. If septicaemia is suspected, urgent medical help is needed.
What should you do if someone has signs and symptoms?
If you have identified signs and symptoms and someone's general health is deteriorating, you need to act quickly.
- Seek medical help immediately
- Describe the symptoms as accurately as possible
- Say that you think it could be meningitis or septicaemia
- If you have had advice and are still worried, get medical help again
The National Institute for Health and Care Excellence (NICE) provides national guidance and advice to improve health and social care. The following links are relevant to the diagnosis and treatment of meningitis and septicaemia:
How is meningitis treated?
- Bacterial meningitis and septicaemia need urgent hospital admission so appropriate care and treatment can be given as quickly as possible
- Bacterial meningitis can be treated with antibiotics, but depending on the condition of the patient many other procedures and interventions can be needed
- The progression of the disease varies, with some people needing only a few days in hospital and others needing a longer stay with treatment in an intensive care unit
- There is no specific treatment for viral meningitis, however some people will need hospital care, ensuring the patient has plenty of fluids, pain relief and rest
Why are antibiotics given to some people after a case of bacterial meningitis?
When there is a case of meningococcal disease there is a slightly increased risk of the disease spreading to the household and kissing contacts of a primary case.
Antibiotics are given to kill any meningococcal bacteria which may be carried at the back of the throat of the contact and prevent any further transmission. These antibiotics are not a form of prevention. If someone is already incubating the disease, the antibiotics will not stop them developing meningitis and/or septicaemia.
It is still important to look out for signs and symptoms.
What vaccines are available?
Vaccines are available to prevent some types of meningitis and most of these are available as part of the UK routine immunisation schedule. However, not all types of meningitis can be prevented by these vaccines.
- A combined vaccine that protects against Hib, diptheria, tetanus, polio, pertussis and hepatitis B is offered to babies at 2, 3 and 4 months
- A Men B vaccine is offered to babies at 2, 4 and 12 months
- A pneumococcal conjugate vaccine (PCV) protects against 13 strains that commonly cause disease. Babies born on or after 1 January 2020 are offered the vaccine at 12 weeks and 12-13 months.
- A different combined vaccine (Hib and MenC) is offered at 12-13 months
- A Men C vaccine – combined with Hib – is offered to infants at 12-13 months
- The MMR vaccine protects against measles, mumps and rubella and is offered at 12-13 months and again at around 4 years
- The MenACWY vaccine is offered around 14 years of age. It is also offered to new university entrants up to the age of 25 years, who have not previously been vaccinated
- A pneumococcal polysaccharide vaccine (PPV) is offered to anyone aged 65 years and over
- The MenACWY vaccine is available to people travelling to areas of the world with a high incidence of MenA, C, W or Y disease e.g. sub-Saharan Africa or Saudi Arabia during Hajj and Umrah pilgrimages
What are the after-effects?
Brain injury - Deafness - Learning difficulties - Epilepsy - Mood swings - Disruptive behaviour - Sight problems - Headaches - Tiredness - Memory loss - Concentration problems
The toxins that are released during septicaemia cause damage to blood vessels. This can prevent the vital flow of blood and oxygen to major organs and can result in after-effects such as:
- Skin and tissue damage
- Organ failure
Have you been affected by meningitis and need support?
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