Meningitis in children
WHAT IS MENINGITIS?
Meningitis is a serious condition that affects the protective membranes around the brain and spinal cord (meninges). It’s usually caused by an infection. Meningitis can affect anyone, but it’s most common in babies, young children, teenagers and young adults.
- Call 999 for an ambulance or go to your nearest A&E immediately if you think you or someone you look after could have meningitis or sepsis.
- Call NHS 111 for advice if you are unsure, worried, or you think you may have been exposed to someone with meningitis.
MENINGITIS & HOW IT'S TREATED
Early diagnosis and proper treatment give a child with meningitis the best chance of a full recovery. Most of the time, meningitis is caused by bacteria or viruses. It can cause long-term problems, and can even be fatal in some cases. When meningitis is not treated promptly, it can cause sepsis, a life-threatening condition that occurs when the immune system overreacts to infection and damages the body's own organs and tissues. If you suspect your child has meningitis or they’re displaying any of the symptoms listed below, it’s important to seek medical attention straight away.
Symptoms of meningitis can appear in any order, and some may not appear at all. The rash associated with meningitis may not appear or may fade away with pressure in the early stages, so it’s important not to wait for all symptoms to appear, or until a rash appears if you suspect your child is showing symptoms of meningitis. Trust your instincts and seek immediate medical help if you’re worried your child may have meningitis.
Symptoms of meningitis and sepsis include:
• A high temperature
• Cold hands and feet
• Vomiting
• Confusion
• Breathing quickly
• Muscle and joint pain
• Pale, mottled or blotchy skin (this may be harder to see on brown or black skin)
• Spots or a rash (this may be harder to see on brown or black skin)
• Headache
• A stiff neck
• A dislike of bright lights
• Being very sleepy or difficult to wake
• Fits (seizures)
Babies and younger children may also:
• Refuse feeds
• Be irritable
• Have a high-pitched cry
• Have a stiff body or be floppy or unresponsive
• Have a bulging soft spot on the top of their head
Someone with meningitis can get a lot worse very quickly, so it’s important to seek medical help immediately if you think your child has meningitis. Call 999 for an ambulance or go to your nearest A&E straight away.
If you think your child might have been exposed to meningitis, or your child is unwell but you’re not sure if it’s anything serious, call NHS 111 or your GP surgery for advice. If you’ve had medical advice but you’re still worried, always trust your instincts and seek medical help if you think you need to.
There are many different causes of meningitis, but it’s usually caused by a viral or bacterial infection. Viral meningitis is the most common and least serious type. Bacterial meningitis is rare, but it can lead to serious complications if it’s not treated quickly.
Meningitis can be caused by different viruses and bacteria, including:
• Haemophilus influenzae type b (Hib) bacteria
• Certain strains of the herpes simplex virus
• Enteroviruses, which usually causes mild stomach symptoms
• Mumps virus
• Pneumococcal bacteria
• Meningococcal bacteria – Men B is the most common strain in the UK, but other strains include MenA, MenC, MenW and MenY
Regardless of its cause, the symptoms of meningitis can get worse very quickly and you should seek immediate medical help if you suspect your child is showing symptoms of meningitis.
Viral meningitis is more common than bacterial meningitis and usually less serious, but it can still make your child very unwell. Many different viruses can cause meningitis, although enteroviruses are the most common cause. The symptoms of viral meningitis are similar to those of bacterial meningitis, so it’s important to seek urgent medical help if your child is showing signs of meningitis. Symptoms include:
• A high temperature
• Cold hands and feet
• Vomiting
• Confusion
• Breathing quickly
• Muscle and joint pain
• Pale, mottled or blotchy skin (this may be harder to see on brown or black skin)
• Spots or a rash (this may be harder to see on brown or black skin)
• Headache
• A stiff neck
• A dislike of bright lights
• Being very sleepy or difficult to wake
• Fits (seizures)
Babies and younger children may also:
• Refuse feeds
• Be irritable
• Have a high-pitched cry
• Have a stiff body or be floppy or unresponsive
• Have a bulging soft spot on the top of their head
If your child is showing symptoms of meningitis, your healthcare professional will likely start a course of antibiotics to treat bacterial meningitis straight away before diagnosis is confirmed, in case it’s bacterial meningitis. Your healthcare professional may then stop this treatment if test results show your child has viral meningitis.
Some children with severe viral meningitis may need treatment in hospital, but if your child has mild symptoms with viral meningitis they may be able to recover at home if they’re not too ill. Most children with viral meningitis feel better in seven to 10 days. There’s no specific treatment for viral meningitis, but plenty of rest, keeping hydrated, and over-the-counter pain medicine such as Boots Paracetamol 120 mg/5 ml Oral Suspension, (contains paracetamol. Always read the label.) if suitable, to help relieve pain and a high temperature, can all help.
Bacterial meningitis is rare, but it’s usually serious and can be life-threatening if not treated straight away. Symptoms can develop very suddenly and early treatment is essential, so it’s important to call 999 or go to your nearest A&E immediately if you suspect your child is showing signs of meningitis. Always trust your instincts and seek urgent medical help if something doesn’t feel right. Symptoms of meningitis include:
• A high temperature
• Cold hands and feet
• Vomiting
• Confusion
• Breathing quickly
• Muscle and joint pain
• Pale, mottled or blotchy skin (this may be harder to see on brown or black skin)
• Spots or a rash (this may be harder to see on brown or black skin)
• Headache
• A stiff neck
• A dislike of bright lights
• Being very sleepy or difficult to wake
• Fits (seizures)
Babies and younger children may also:
• Refuse feeds
• Be irritable
• Have a high-pitched cry
• Have a stiff body or be floppy or unresponsive
• Have a bulging soft spot on the top of their head
Antibiotics are necessary for treating bacterial meningitis and stopping it from getting worse, so if doctors suspect your child has meningitis they’ll start a course of antibiotics straight away while they wait for test results to confirm which type of meningitis it is.
Urgent medical intervention can make a significant difference in the outcome when someone has bacterial meningitis.
Viral meningitis can be caused by a variety of viruses, including the varicella zoster virus, which is the same virus that causes chickenpox and shingles. Viral meningitis can occur at the same time as chickenpox, or on its own without any sign of rash or spots on the skin. Find out more about meningitis and chickenpox in our guide.
Sepsis, sometimes called septicaemia or blood poisoning, is a life-threatening condition that occurs when the body has an exaggerated response to an infection. Bacterial meningitis can lead to sepsis. Both meningitis and sepsis are serious medical conditions which can develop quickly and lead to life-threatening complications. It’s important to know the symptoms of both meningitis and sepsis and seek urgent medical help if you suspect your child has either meningitis or sepsis. Always trust your instincts and seek urgent medical help if something doesn’t seem right. Meningitis and sepsis have similar symptoms, so it can be difficult to know which one it is without testing. Common symptoms include:
• Fever with cold hands and feet
• Vomiting
• Drowsy or difficult to wake
• Confusion or irritability
• Severe muscle pain
• Pale blotchy skin, spots or rash
• Severe headache
• Stiff neck
• Dislike of bright lights
• Convulsions or seizures
Find out more about meningitis and sepsis.
Keeping up to date with the recommended vaccinations is one of the best ways to help protect your child against meningitis. The vaccinations available to help protect babies and children against meningitis include:
• MenB vaccination – offers protection against meningococcal group B bacteria, which are a common cause of meningitis in young children in the UK.
• 6-in-1 vaccination – also known as the DTaP/IPV/Hib/Hep B vaccine, offers protection against diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae (type b (Hib)
• Pneumococcal vaccination – offers protection against serious infections caused by pneumococcal bacteria, including meningitis
• Hib/MenC – offers protection against a type of bacteria called meningococcal group C bacteria, which can cause meningitis
• MMR vaccination – offers protection against measles, mumps and rubella
• MenACWY vaccination – offers protection against meningococcal bacteria groups A, C, W and Y
These vaccinations should be offered as part of your child’s routine immunisations. Speak to your GP for more information on childhood vaccinations. The viruses and bacteria that cause viral and bacterial meningitis can be spread through:
• Sneezing
• Coughing
• Kissing
The infection is usually spread by people who carry these viruses or bacteria in their nose or throat but aren’t ill themselves. The infection can also be spread by someone with meningitis, although this is less common. If you think your child has been exposed to someone with meningitis, call NHS 111 or your doctor’s surgery for advice.
Meningitis can be difficult to diagnose as the symptoms can be similar to other illnesses. Several tests may be carried out to confirm whether it’s meningitis, and to check whether it’s caused by a viral or bacterial infection. These tests may include:
• A physical examination to look for symptoms of meningitis
• A blood test to check for bacteria or viruses
• A lumbar puncture – this is where a sample of fluid is taken from the spine and checked for bacteria or viruses
• A CT scan to check for any problems with the brain, such as swelling
As bacterial meningitis can be very serious, treatment with antibiotics will usually start before the diagnosis is confirmed and will be stopped later on if tests show the condition is being caused by a virus.
The treatment for meningitis will depend on your child’s age and symptoms, as well as what type of meningitis they have. Bacterial meningitis needs to be treated as soon as possible, with antibiotics. If you suspect your child has meningitis, it’s likely that they’ll be given antibiotics straight away while tests are carried out to find out which type of meningitis it is. Your healthcare provider may stop this treatment if tests show your child has viral meningitis. However, if your child has severe viral meningitis, they may also need to be treated in hospital. Hospital treatment for meningitis includes:
• Antibiotics given through a vein
• Fluids given directly into a vein to help reduce dehydration
• Steroids to help reduce the swelling and pressure in the brain, in some cases
• Oxygen given through an oxygen mask, if needed to help with breathing difficulties
Most children with viral meningitis get better on their own without treatment. Babies and children with a weakened immune system may need to be looked after in a hospital, but usually, children with viral meningitis can recover well at home. There are things you can do to help your child while they’re recovering from viral meningitis, including:
• Making sure they get plenty of bed rest
• Giving them lots of fluids
• Giving appropriate pain relief to help with fever or headache
If you’re struggling to manage your child’s symptoms at home, or you feel like they aren’t recovering well, speak to your GP for advice. Additional treatment and support may be needed if your child has complications of meningitis, such as hearing loss.
Vaccinations play an important role in protecting people of all ages against meningitis. You can help protect your child against meningitis by keeping up to date with the recommended childhood vaccinations. There are several vaccinations available to help protect babies and young children against meningitis, including:
• MenB vaccination, which helps protect against the meningococcal group B bacteria. This is recommended for babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at one year
• 6-in-1 vaccination helps protect against Haemophilus influenzae type b (Hib), which is a type of bacteria that can cause meningitis. Three doses are given, at 8, 12, and 16 weeks of age
• Pneumococcal vaccination helps protect from pneumococcal bacteria which can cause serious diseases, including meningitis. Two doses are given to babies, at 12 weeks and 1 year
• Hib/MenC vaccination helps provide immunity against Hib and meningococcal group C bacteria. This is given to babies at 1 year of age
• MMR vaccination provides protection against measles, mumps and rubella, which can sometimes lead to viral meningitis. This is given at 1 year, followed by a second dose at 3 years and 4 months
The MenACWY vaccination, is usually offered to teenagers in school years 9 and 10 and provides protection against meningitis caused by meningococcal bacteria strains A, C, W, and Y. It’s important that students entering university or college for the first time are up to date on their MenACWY vaccine as well as the two doses of MMR vaccine. This can be requested from the GP if needed. You may be able to access the MenB vaccination privately at a participating Boots pharmacy through our MenB Vaccination Service,13 which is suitable for children aged 2 years and over.
While most children make a full recovery from meningitis, it can sometimes cause serious long-term problems and can even be life-threatening. It’s important to get urgent medical help if you suspect your child may have meningitis. Complications are more common with bacterial meningitis. They can also occur with viral meningitis, although this is much rarer. The main complications of meningitis include:
• Partial or total hearing loss – people who have had meningitis will usually have a hearing test after a few weeks to check for any problems
• Recurrent seizures (epilepsy)
• Problems with memory and concentration
• Co-ordination, movement and balance problems
• Learning difficulties and behavioural problems
• Partial or total vision loss
• Loss of limbs – amputation is sometimes necessary to stop the infection spreading through the body and to remove damaged tissue
• Bone and joint problems, such as arthritis
• Kidney problems
It’s estimated that one in 10 cases of bacterial meningitis is fatal. To help protect against meningitis, it’s important to keep on top of your child’s vaccinations.
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FREQUENTLY ASKED QUESTIONS
The infections that cause bacterial and viral meningitis can be spread from person to person through sneezing, coughing and kissing. It’s usually caught by someone who carries the virus in their throat or nose but isn’t ill themselves. The infection can also be spread by someone with meningitis, although this is less common.
If your child has meningitis they may get a lot worse very quickly, so it’s important to keep a close eye on them and get medical help immediately if you suspect they may have meningitis. Always trust your instincts.
People with sepsis caused by meningitis may develop a red rash of tiny ‘pin pricks’ which can develop into purple bruising. This rash does not fade under pressure. The meningitis glass test can help determine if a rash is a sign of meningitis or not. Simply press the side of a clear glass firmly against the area where the rash appears. If the spots or rash don’t fade under the pressure of the glass, call 999 straight away. On dark skin the rash may be more difficult to spot, so try checking lighter areas such as the palms of the hands or soles of the feet. It’s important to remember that the rash may not be one of the early symptoms to occur, and may not even appear at all, so you should be aware of all of the signs and symptoms of meningitis. Trust your instincts and seek medical help straight away if you suspect your child might have meningitis.
13 Available in selected UK Boots pharmacies, subject to availability. Eligibility criteria and charges apply. Please note this is not an NHS service.
