Meningitis

Meningitis is an infection of the meninges (the protective membranes that surround the brain and spinal cord).

The infection can be caused by bacteria or a virus, and it leads to the meninges becoming inflamed (swollen). This can damage the nerves and brain.

Bacterial meningitis

Bacterial meningitis is the more serious form of the condition. The symptoms usually begin suddenly and rapidly get worse. If you suspect a case of bacterial meningitis, you should phone 999 immediately to request an ambulance.

There are some early warning signs that you may notice before the other symptoms appear.

Early warning signs

Bacterial meningitis has a number of early warning signs that can occur earlier than the other symptoms. These are:

•pain in the muscles, joints or limbs, such as in the legs or hands

•unusually cold hands and feet, or shivering

•pale or blotchy skin and blue lips

The presence of a high temperature (fever) plus any of the above symptoms should be taken very seriously. Phone 999 immediately to request an ambulance.

Early symptoms

The early symptoms of bacterial meningitis are similar to those of many other conditions, and include:

•a severe headache

•fever  (see Previous note)

•nausea (feeling sick)

•vomiting (being sick)

•feeling generally unwell

Later symptoms

As the condition gets worse it may cause:

•drowsiness

•confusion

•seizures or fits

•being unable to tolerate bright lights (photophobia) – this is less common in young children

•a stiff neck – also less common in young children

•a rapid breathing rate

•a blotchy red rash that does not fade or change colour when you place a glass against it – the rash is not always present

Babies and young children

The symptoms of bacterial meningitis are different in babies and young children. Possible symptoms include:

•becoming floppy and unresponsive, or stiff with jerky movements

•becoming irritable and not wanting to be held

•unusual crying

•vomiting and refusing feeds

•pale and blotchy skin

•loss of appetite

•staring expression

•very sleepy with a reluctance to wake up

Some babies will develop a swelling in the soft part of their head (fontanelle).

Viral meningitis

Most people with viral meningitis will have mild flu-like symptoms, such as:

•headaches

•fever (see previous note)

•generally not feeling very well

In more severe cases of viral meningitis symptoms may include:

•neck stiffness

•muscle or joint pain

•nausea (feeling sick)

•vomiting (being sick)

•diarrhoea (passing loose, watery stools)

•photophobia (sensitivity to light)

Unlike bacterial meningitis, viral meningitis does not usually lead to septicaemia (blood poisoning).

Bacterial meningitis

Bacterial meningitis is very serious and should be treated as a medical emergency. If the bacterial infection is left untreated, it can cause severe brain damage and infect the blood (septicaemia).

In 2008 and 2009 in England and Wales, around 1,166 cases of meningitis were caused by the Neisseria meningitidis bacteria. The number of cases has decreased in recent years because of a successful vaccination programme that protects against many of the bacteria that can cause meningitis.

However, there is currently no vaccine to prevent meningococcal group B disease, which is the most common cause of bacterial meningitis in the UK. It is essential to know the signs and symptoms to look for and get medical help if you are worried.

Bacterial meningitis is most common in children who are under five years old, and in particular in babies under the age of one. It is also common among teenagers aged 15 to 19 years. 

Viral meningitis

Viral meningitis is the most common and less serious type of meningitis. It is difficult to estimate the number of cases of viral meningitis because the symptoms are often so mild that they are mistaken for flu.

Viral meningitis is most common in children and is more widespread during the summer months.

Outlook

Viral meningitis usually gets better within a couple of weeks, with plenty of rest and painkillers for the headache.

Bacterial meningitis is treated with antibiotics (medication that treats infections caused by bacteria). Treatment will require admission to hospital, with severe cases treated in an intensive care unit so that the body's vital functions can be supported.

Several decades ago, almost everyone who had bacterial meningitis would die. Nowadays, deaths are mainly caused by septicaemia (blood poisoning) rather than meningitis. Meningococcal disease (the combination of meningitis and septicaemia) causes death in around one in 10 cases.

Up to a quarter of people may experience complications, such as hearing loss, after having bacterial meningitis (see Meningitis - complications).

The best way to prevent meningitis is by ensuring that vaccinations are up to date. See the Vaccination planner for more information about all the different types of vaccines that are available and when they should be given.