Meningitis can be life-threatening, so seek urgent medical advice if you think your child has it. Here we outline its symptoms and treatment.
What is meningitis?
Meningitis is an infection (bacterial or viral) of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone but is most common in babies, young children, teenagers and young adults (NHS, 2016).
Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning (septicaemia) and result in permanent damage to the brain or nerves (NHS Choices, 2016).
Meningitis symptoms can develop suddenly. While any or all (or almost none) of the symptoms may be present, symptoms can include:
- a temperature (fever) of 38°C or higher
- nausea and vomiting
- being irritable and lacking energy
- a headache
- a blotchy rash that doesn't fade when a glass is rolled over it (although this rash won't always develop)
- a stiff neck
- a dislike of bright lights
- drowsiness or unresponsiveness
- seizures (fits)
- skin that’s pale and mottled
- aching muscles and joints
- breathing quickly
- cold hands and feet.
Babies might also:
- refuse you feeding them
- show agitation and not wanting to be picked up
- have a bulging soft spot on their head (fontanelle)
- be floppy or unresponsive
- have an unusually high-pitched cry
- have a stiff body.
So there are lots of symptoms of meningitis but every case is different. The symptoms can appear in any order and some might not appear at all (NHS, 2016).
What to do if you think your child has meningitis
Make sure you get medical advice as soon as you can if you're worried about your child. Trust your instincts; don’t just wait for a rash to appear (NHS, 2016).
Call for an ambulance (999) or go to your nearest accident and emergency department if you suspect your child might be seriously ill. If you're not sure whether it's anything serious, ask for advice by calling NHS 111 or your GP (NHS, 2016).
"Meningitis is a medical emergency."
What causes meningitis?
Anyone can get meningitis but some things make it more likely. Children who have not had immunisations to prevent meningitis are at much greater risk but vaccination is not a guarantee of protection. Factors include being under five years old, your living environment, passive smoking, being around large numbers of people and immune system problems (Meningitis Now, 2018a).
Meningitis has many different causes but viruses and bacteria are the most common.
What makes meningitis more likely?
- Bacterial meningitis can be caused by a number of different bacteria (e.g. Group B Streptococcus, Escherichia coli, Listeria monocytogenes, Streptococcus pneumoniae, Neisseria meningitides, Staphylococcus aureus, Citrobacter, Salmonella, Haemophilus influenzae [type a, non-typeable, type b], Mycoplasma, Streptococcus anginosus, Mycobacterium tuberculosis).
- No vaccine protects against all types of meningitis.
- Some meningitis-causing bacteria also cause septicaemia (blood poisoning).
- Children who have had meningitis can get a variety of after-effects. These include acquired brain injury, learning and behavioural changes, hearing loss, emotional changes and sight problems.
(Curtis and Nyquist, 2011; Meningitis Now, 2018b)
Meningitis-causing bacteria usually spread from between people. The way it spreads depends on the type of bacteria involved (CDC, 2017).
Babies can get group B Streptococcus and Escherichia coli from their mothers during labour and birth. (The NHS does not routinely test for GBS in pregnant women although some other countries do, such as the US where the CDC says testing can help prevent GBS disease.) People with Hib and Streptococcus pneumoniae coughing or sneezing close by can also spread these bacteria to your child if they inhale the bacteria (CDC, 2017).
People can also spread Neisseria meningitidis through saliva. This is usually by coughing or kissing but it can be through longer contact like you’d get living in the same household (CDC, 2017).
Some bacteria, such as Listeria monocytogenes and Escherichia coli, can spread to your child via contaminated food (CDC, 2017). Escherichia coli infection can spread by someone not washing their hands before preparing food for them (CDC, 2017). People can get Listeria monocytogenes from eating contaminated foods like unpasteurised cheese or milk (CDC, 2017).
People can also be carriers, in other words they carry these bacteria in or on their bodies without this making them ill. Most carriers never become sick but can still spread the bacteria to others (CDC, 2017).
Viral meningitis isn’t usually life-threatening but it can make people feel very ill. It is also more common than bacterial meningitis.
- Viral meningitis is most common in babies and young children but anybody can get it.
- The symptoms of viral meningitis can be very similar to those of bacterial meningitis, so you must seek urgent medical help for your child if you’re worried.
- Enteroviruses are the most common cause of viral meningitis but many other viruses can cause it.
- Viral meningitis is not thought to be contagious – nearly all are isolated cases.
(Meningitis Now, 2018c; Meningitis Research Foundation, 2018)
Viral meningitis has no specific treatment. Your child would usually receive treatment with fluids to make sure they’re well hydrated, and given painkillers and plenty of rest.
Antibiotics don’t work against viruses. Antibiotics are often started on admission to hospital if the cause of meningitis is not known (Meningitis Now, 2018c).
Most people fully recover from viral meningitis although it can be a slow process. Yet some people experience serious and life-changing after-effects (Meningitis Now, 2018c,d).
A number of different vaccinations can protect against meningitis because it’s caused by several different infections (NHS Choices, 2016). The NHS vaccination programme gives children most of the vaccinations that protect against meningitis-causing infections (NHS Inform, 2018). For example, mumps commonly caused viral meningitis before the MMR vaccine protected against it (Meningitis, 2018e,f).
Read our article on vaccines that can help protect your child against meningitis.
The glass test
If you find a blotchy rash that does not fade when you press a glass firmly over it, this is a typical symptom of meningitis. Yet this symptom doesn't always develop. Some other conditions can look similar so detailed assessment by an appropriate health worker is necessary.
This rash can also be more difficult to see on darker skin. So check paler areas, such as the tummy, the palms of the hands, soles of the feet, inside the eyelids, and the roof of the mouth, for the rash (NHS, 2016).
The rash often starts off looking like small, red pinpricks. You would then see it spread quickly and turn into red or purple blotches. A non-fading rash seen under a clear glass firmly pressed against the skin is a sign of septicaemia caused by meningitis (NHS, 2016).
You must get medical advice for your child immediately if you find this rash on them.
If meningitis is suspected, your child will need to be admitted to hospital and will need tests and possibly a stay in hospital.
Tests will normally confirm whether your child has meningitis and will check whether it arose from a viral or bacterial infection. Antibiotic treatment usually starts before a confirmed diagnosis because bacterial meningitis can be so serious. It will be stopped if your child has viral meningitis.
Your child might have tests that include:
- a physical examination
- a blood test for bacteria or viruses
- a lumbar puncture – spinal fluid is taken to check for bacteria or viruses
- a computerised tomography (CT) scan to see whether there are any problems with the brain like swelling.
Treatment in hospital
If your little one has bacterial meningitis, they’ll receive hospital treatment because it can be so serious and they’ll need to be closely monitored. Children with severe viral meningitis might also be treated in hospital.
Treatments might include intravenous antibiotics and fluids (to prevent dehydration), oxygen for any breathing difficulties, and steroid medication for any swelling around the brain (NHS, 2016).
Treatment at home
Normally, your child will be able to go home if their meningitis is mild and if it’s viral. This is because viral meningitis usually improves on its own in seven to 10 days and tends not to cause serious problems (NHS, 2016).
While your child recovers, try to make sure they get lots of rest, and take painkillers and anti-sickness medicine as advised.
Recovery from meningitis
Meningitis affects children in different ways. Recovery will depend on the type of meningitis they contracted, how quickly it was treated and the extent of any complications (NHS, 2016).
Many children make a full recovery. Others might need additional treatment and long-term support to help with any serious complications or after-effects of meningitis.
This page was last reviewed in May 2018.
Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.
NCT and the British Red Cross run First Aid courses for parents with babies and children up to 12 years old on life-saving topics, such as meningitis, CPR, stopping bleeding and what to do if your child is choking. Find your nearest course.
You might find attending one of NCT's Early Days groups helpful as they give you the opportunity to explore different approaches to important parenting issues with a qualified group leader and other new parents in your area.
Make friends with other parents-to-be and new parents in your local area for support and friendship by seeing what NCT activities are happening nearby.
Meningitis Now is a meningitis patient group and a charity dedicated to fighting meningitis in the UK. Find lots more information about meningitis on their website.
NHS Choices has information and advice on meninigitis.
Further information on immunisation for children can be found at NHS Choices.
CDC (Centres for Disease Control and Prevention). (2017) Bacterial meningitis. How it spreads. Available at: https://www.cdc.gov/meningitis/bacterial.html [accessed 8th May 2018].
Curtis D, Nyquist AC. (2011). Meningitis. In: Kerby, G. (Ed.) Berman's Pediatric Decision Making (Fifth Edition). Elsevier Health Sciences, London: 638-644.
Meningitis Now. (2018a) What is meningitis? Available at: https://www.meningitisnow.org/meningitis-explained/what-is-meningitis/how-to-catch-meningitis/ [accessed 8th May 2018].
Meningitis Now. (2018b) Types and causes of meningitis/bacterial meningitis. Available at: https://www.meningitisnow.org/meningitis-explained/what-is-meningitis/types-and-causes/bacterial-meningitis/ [accessed 8th May 2018].
Meningitis Now. (2018c) Viral meningitis. Available at: https://www.meningitisnow.org/meningitis-explained/what-is-meningitis/types-and-causes/viral-meningitis/ [accessed 8th May 2018].
Meningitis Now. (2018d) After meningitis. Available at: https://www.meningitisnow.org/meningitis-explained/after-meningitis/ [accessed 8th May 2018].
Meningitis Now. (2018e) Viral meningitis. Available at: https://www.meningitisnow.org/meningitis-explained/what-is-meningitis/types-and-causes/viral-meningitis/ [accessed 8th May 2018].
Meningitis Now. (2018f) Resources. Available at: https://www.meningitisnow.org/how-we-help/resources/view-download-order/fact-sheets/ [accessed 8th May 2018].
Meningitis Research Foundation. (2018) After effects. Available at: https://www.meningitis.org/meningitis/after-effects [accessed 8th May 2018].
NHS. (2016) Meningitis. Available at: https://www.nhs.uk/conditions/meningitis/ [accessed 8th May 2018].