Each year there are around 4,000 reported meningitis cases in the UK.
Meningitis is an inflammation of the membranes, or meninges, that cover the brain and spinal cord. A number of different viruses and bacteria can cause it. Bacterial meningitis can be life-threatening, and those who recover may, despite prompt antibiotic treatment, be left with long-term damage.
Bacterial meningitis is most common in children under the age of five, although it can occur at any age. Viral meningitis is more common and considered less serious than bacterial meningitis. It generally affects children over the age of four.
There are many different kinds of bacteria that cause meningitis. The most important are meningococcus and pneumococcus. While less common, they are very serious, as once in the bloodstream the bacteria multiply rapidly and force the immune system to go into overdrive at a frightening speed.
Therefore, the speed at which the condition is recognised is crucial - even a delay of a few hours could be fatal. If you suspect that any child in your care has meningitis you must seek urgent medical assistance.
How is meningitis spread?
Bacterial meningitis is caused by many different germs which can be spread by coughing, sneezing, kissing and close prolonged contact, and overwhelm the body's defences. Fortunately, as the bacteria do not thrive for long outside the body, it is not picked up through water or buildings.
Can children be protected against it?
The Hib vaccination routinely given with other infant immunisations offers excellent protection to children against one of the meningococcal strains (group C), which causes about 40 per cent of cases. Unfortunately, there is still no effective vaccine against the other major strain of the disease (group B), and children up to the age of five are most at risk. It is vital that carers and parents are aware of the signs and symptoms.
What are the symptoms of meningitis?
These vary with age. In younger children and babies the symptoms can be non-specific. For example, meningitis can cause:
* general irritability
* drowsiness
* poor feeding
* fever (although this is not always a high fever).
In older children, symptoms often include fever, stiff neck, headache, vomiting and dislike of bright light and loud noise. But it is difficult to determine just by symptoms whether a baby has meningitis or not.
In the septicaemia form of the disease, the signs are often associated with other less serious diseases, and include rapid breathing, vomiting, abdominal pain and muscle aches. A child can seem perfectly well but, within hours, be extremely ill with the meningitis. Therefore, if you are worried about a child in your care, you should check them very regularly and keep looking for a rash or other signs of deterioration, or seek urgent medical advice.
Glass tumbler test
A glass tumbler can be used to test whether a rash might be septicaemia by pressing it firmly against the child's skin. If the rash does not fade and shows through the glass, call a doctor immediately.
Immediate action
If a child is abnormally drowsy and develops at least two of the symptoms of meningitis, take them to a doctor or to the nearest accident and emergency department immediately. There, the child may be given a lumbar puncture to test for either viral or bacterial meningitis to identify the organism responsible. Blood samples will also be taken to identify bacteria.
Treatment
Bacterial meningitis:
The child will be immediately started on a course of high-dose antibiotics if bacterial meningitis is suspected. As soon as the laboratory results are revealed, the antibiotic treatment will be continued or changed to target the bacterium identified. Treatment may continue for up to ten days. Anyone who has been in direct, close and prolonged contact with the infected child may also need appropriate protective antibiotics.
Viral meningitis:
If viral meningitis is confirmed, the antibiotics can be discontinued and only painkillers prescribed. The infection should clear up within five to 14 days, depending on the virus type. There are rarely any after-affects.
Prevention
It is extremely important to be aware of the warning signs, as there is no known way of preventing meningitis. Vaccines are available against some types of bacterial meningitis. The main thing that carers and parents can do is to be on the look-out for any of the signs mentioned here, especially under conditions of a local or community outbreak of the infection. Even if you are not sure, seek medical advice just to be on the safe side.
Researched and written by Marcella McEvoy
Further information
* The Meningitis Trust runs a 24-hour helpline on 0845 600 0800
