Meningitis and septicaemia

Meningitis and septicaemia are very serious diseases that can affect anyone, of any age, very quickly. They are uncommon, but it is important to know the signs and symptoms and get medical help quickly.

What are meningitis and septicaemia?

Meningitis means swelling of the linings of the brain and spinal cord (meninges). Septicaemia is blood poisoning. These conditions can be caused by the same bacteria and viruses and can occur separately or together. Viral meningitis is more common than bacterial, but is less serious. If treated early enough, most children will survive.

Signs and symptoms of meningitis

The early signs and symptoms in babies may be difficult to spot as they are similar to flu, but include:

• high-pitched moaning cry
• being irritable when picked up
• a bulging fontanelle (soft spot on baby’s head)
• feeling drowsy and non-responsive to you or being difficult to wake
• being floppy/listless and having no energy or being stiff with jerky movements
• refusal to feed and vomiting
• skin that is pale, blotchy or turning blue
• a rash that does not fade under pressure (see the ‘glass test’ below)
• a fever.

In older children, adolescents and adults, the main symptoms of meningitis may include:

• a stiff neck (check that they can kiss their knees or touch their forehead with their knees)
• a very bad headache
• a dislike of bright lights
• vomiting
• a fever
• feeling drowsy, less responsive and confused
• a rash (see the ‘glass test’ below).

Signs and symptoms of septicaemia

In babies, the main symtpoms of septicaemia may include:

• skin that is pale, blotchy, or turning blue
• rapid or unusual patterns of breathing
• fever with cold hands or feet
• shivering
• vomiting, refusing feeds
• pain or irritability from muscle aches or severe limb/joint pain
• 'floppiness'
• red or purple bruise-like spots that do not fade under pressure (see the ‘glass test’ below).

In older children, adolescents and adults, the main symptoms of septicaemia may include:

• sleepiness, being less responsive, uninterested or confused (a late sign in septicaemia)
• severe aches and pains in the arms, legs and joints
• very cold hands and feet
• shivering
• rapid breathing
• red or purple spots that do not fade under pressure (do the ‘glass test’ explained below)
• vomiting
• a fever
• diarrhoea and stomach cramps.

Symptoms of meningitis or septicaemia can occur in any order. Not all babies develop all of the symptoms. Trust your instincts. If you suspect meningitis get medical help urgently.

The ‘glass test’

The rash, if present, starts as tiny red pinprick spots or marks and later changes to purple blotches, which can look like bruises or blood blisters. The rash can be anywhere. Press a clear drinking glass firmly against the rash so you can see if the rash fades and loses colour under pressure.

If it doesn’t change colour, contact your doctor immediately. The spots and rash are more difficult to see on darker skin, so check paler areas such as the palms of the hands, soles of the feet and the eye area. Not everyone who gets meningitis will have this rash.

What to do next

Remember that not all babies will develop the signs and symptoms listed above. If they develop some of them, especially the red or purple spots, get medical help urgently. If you can’t get in touch with your doctor or are still worried after getting advice, trust your instincts and take your baby to the emergency department of your nearest hospital. These conditions are dangerous and can develop very quickly. The earlier babies are treated, the better their chances of making a full recovery.

Prevention

Vaccines are available for meningitis and septicaemia but they don’t protect against all forms. PCV provides some protection against one of the commonest causes of meningitis, and also against other conditions such as severe ear infections (otitis media) and pneumonia caused by pneumococcal bacteria. This vaccine does not protect against all types of pneumococcal infection and does not protect against meningitis caused by other bacteria or viruses.

The Hib vaccine protects against Hib meningitis only and no other forms. The MenC vaccine protects against meningitis and septicaemia caused by meningococcal group C bacteria only.