Meningitis

What is meningitis?

What are the symptoms?

Can newborn babies get it?

When do I need help?

How is meningitis diagnosed?

What's the treatment?

Is meningitis infectious?

How can meningitis be prevented?

What is meningitis?

Meningitis is an inflammation of the membrane covering the brain that can develop very rapidly. There are many different types of meningitis. The two main forms are viral and bacterial. Viral meningitis is the most common type and can be relatively mild (some sufferers are not even aware that they have an infection). The bacterial form is uncommon, but is life threatening and requires prompt treatment.

Bacterial meningitis also comes in many forms (meningococcal and pneumococcal are the two main types). It is always a serious and severe illness, but rapidly developing complications can make it even more dangerous. Depending on the type, bacterial meningitis is fatal in 10-20 per cent of cases and can cause serious disability such as deafness or brain damage, so immediate treatment is vital. Septicaemia (blood poisoning) is a serious complication of meningitis caused by bacteria entering the bloodstream and multiplying rapidly. The septicaemic form of meningitis is the most dangerous.

What are the symptoms?

There's no textbook pattern to the disease. The incubation period is between two days and three weeks depending on the type of meningitis. Symptoms can occur in any order or not at all. Often similar to influenza, they include high temperature or fever, severe headache, nausea and vomiting, dislike of light, and a stiff neck. Not all symptoms are predictable; some babies may be floppy and listless, while others may be stiff with jerky movements.

There may be a rash caused by septicaemia, which appears under the skin as a cluster of tiny spots. They look like pinpricks and can start anywhere on the body. If untreated, they develop a bruise-like appearance, followed by purple skin damage and discolouration.

You can use the "glass test" to check suspicious rashes. Press the side of a clear drinking glass on to the spots. If they're nothing to worry about, they should fade; a meningitis rash won't. If there's any doubt, call for medical help immediately. This is one of the later signs of sepsis after which your child's condition can rapidly become critical, but there are earlier signs to look out for.

In January 2005, experts from Oxford University highlighted earlier symptoms of septicaemia that can be identified hours before the disease reaches this critical stage. Early signs of septicaemia include:

• cold hands and feet with a temperature

• abnormally pale skin colour, such as, looking very pale, blue or dusky around lips

• severe leg pains, which prevent walking or standing

If your baby isn't standing or talking yet, achy muscles or pain in the limbs or joints may show as your baby being irritable. Babies often have cold hands and feet when they are well, so also look out for rapid or unusual patterns of breathing, and shivering, which are other symptoms of the disease. It is hoped that if parents seek medical help when they spot these early symptoms more lives will be saved.

Check on your baby frequently if you have any suspicions of worsening illness. If no rash develops but your child's condition is deteriorating rapidly, take your baby to hospital immediately.

Can newborn babies get it?

Neonatal meningitis is most often caused by E.coli, group B streptococcus, or listeria. The risks are higher among premature babies and those with a birth weight lower than 2 kilograms (about 4 pounds and 6 ounces). Other babies are also vulnerable to meningitis, but it can be difficult to diagnose.

Baby Watch, launched by Victoria Beckham and Dr Hilary Jones for the Meningitis Research Foundation advises parents to trust their instincts and be alert for special signs, such as a bulging fontanelle and skin that is pale, blotchy or turning blue. Babies with meningitis may have a fever, be difficult to wake, may refuse feeds continuously, and have a blank, staring expression. Parents also sometimes notice a high-pitched moan or cry, and that their baby is irritable when picked up.

When do I need help?

If you suspect meningitis, seek treatment immediately from your GP or the nearest hospital Accident & Emergency department. If the problem is bacterial, early treatment with antibiotics is vital to avoid damaging side-effects or loss of life. Always trust your instincts.

How is meningitis diagnosed?

Diagnosis is by lumbar puncture - a health professional will insert a hollow needle into the lower spine, remove a sample of fluid from the spinal cord, and examine it. The procedure takes under 20 minutes and may result in a headache afterwards.

What's the treatment?

Viral meningitis doesn't respond to antibiotics, so treatment is based on rest and nursing care. It often clears up quickly, though headaches, tiredness, and depression can last for some time. In very rare cases, viral meningitis can affect the substance of the brain and cause encephalitis (inflammation of the brain). In these cases, anti-viral treatment may be needed. Bacterial meningitis requires immediate treatment with antibiotics.

Is meningitis infectious?

Most cases of bacterial meningitis are isolated, but clusters of meningococcal meningitis occasionally appear. People who've been in close contact (usually defined as sharing a house) with someone with bacterial meningitis or meningococcal septicaemia are offered antibiotics because of the risk of infection. Infection is spread by sneezing or, in adults, intimate kissing. The bacteria that cause the problem are extremely common, living naturally in the back of the nose and throat, and many people carry them without becoming ill.

Viral meningitis is spread, just like other viruses, from person to person, some by coughing and sneezing and others by poor hygiene, such as not washing your hands after going to the toilet. Viral meningitis used to be a complication of childhood illnesses like measles and mumps, but the MMR vaccination has virtually eliminated this threat.

How can meningitis be prevented?

Babies now receive the Hib (Haemophilus influenzae type B) vaccine at two, three and four months. The Hib vaccination also offers protection against bacterial infections such as septic arthritis and cellulitis. The vaccine schedule for meningitis C is currently being changed to allow for the introduction of a pneumococcal vaccine. The pneumococcal bacteria is the cause of one in ten cases of meningitis. The new schedule will give babies the pneumococcal vaccine at two, four and 13 months and the meningitis C vaccine at three and four months with a combined Hib/meningitis C booster at 12 months.

There is no vaccine yet against meningococcus group B, the most common group causing meningococcal meningitis. Research suggests that smoking within the household can increase the chances of a child contracting meningitis, so giving up may reduce the risk. Contact Quit if you need help.

For further information:
• Contact The Meningitis Trust.

Meningitis describes an infection and inflammation of the membranes and fluids that surround and protect the brain. A serious condition that can be fatal, meningitis is most often diagnosed in children under the age of five, but can occur at any age.

Meningitis symptoms include severe, throbbing head pain that encompasses the entire head ("global" head pain). Head pain is often associated with nausea, vomiting, fever, light sensitivity (photophobia), and a stiff neck. Changes in consciousness and seizures are also symptoms of meningitis.

Young children and infants may cry constantly from meningitis head pain, lose their appetites and seem unusually sleepy or irritable. The fontanels, or soft spots on an infant's skull) may bulge outwards due to meningitis inflammation.
Encephalitis and the Brain
Encephalitis is a rare condition that occurs when the brain tissue becomes infected and inflamed. Viral illness is the usual cause of encephalitis. Mild cases of encephalitis often have no noticeable symptoms. Severe encephalitis causes a number of symptoms, including intense head pain. Other symptoms may include:
bulging fontanels in infants
confusion
drowsiness
fever
nausea and vomiting
seizures and convulsions.
Head pain associated with encephalitis stems from brain tissue inflammation, which can cause mental disability, respiratory arrest, coma, and death.

Brain Abscesses
A brain abscess is caused by infections that start in the nasal cavities or ears. Bacteria or fungus enters brain tissue, where it eventually forms a solid mass of white blood cells, dead cells, and other matter. The inflamed abscess puts pressure on the brain in a manner similar to brain tumors, and the resulting head pain and symptoms are essentially the same as those for a brain tumor.

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