Meningitis

About meningitis

Meningitis is an infection 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.

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.

A number of vaccinations are available that offer some protection against meningitis.

Symptoms of meningitis

Symptoms of meningitis develop suddenly and can include:

• a high temperature (fever) over 37.5C (99.5F)
• being sick
• a headache
• a blotchy rash that doesn’t fade when a glass is rolled over it (this won’t always develop)
• a stiff neck
• a dislike of bright lights
• drowsiness or unresponsiveness
• seizures (fits)

These symptoms can appear in any order and some may not appear.

When to get medical help

You should get medical advice as soon as possible if you’re concerned that you or your child could have meningitis.

Trust your instincts and don’t wait until a rash develops.

Phone 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you think you or your child might be seriously ill.

Phone 111 or your GP practice for advice if you’re not sure if it’s anything serious or you think you may have been exposed to someone with meningitis.

How meningitis is spread

Meningitis is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis.

Infections that cause meningitis can be spread through:

• sneezing
• coughing
• kissing
• sharing utensils, cutlery and toothbrushes

Meningitis is usually caught from people who carry these viruses or bacteria in their nose or throat but aren’t ill themselves.

It can also be caught from someone with meningitis, but this is less common.

Read more about the causes of meningitis

Vaccinations against meningitis

There are vaccinations offer some protection against certain causes of meningitis.

These include the:

• meningococcal B vaccine – offered to babies at 8 weeks, 12 weeks and between 12 and 13 months
• 6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age and at 18 months
• pneumococcal vaccine for babies – offered to babies at 16 weeks and between 12 and 13 months old
• MMRV vaccine – offered to babies aged between 12 and 13 months, and 18 months
• meningococcal ACWY vaccine – offered to young people at around 14 years of age

Treatments for meningitis

People with suspected meningitis will usually have tests in hospital to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection.

Bacterial meningitis usually needs to be treated in hospital for at least a week. Treatments include:

• antibiotics given directly into a vein
• fluids given directly into a vein
• oxygen through a face mask

Viral meningitis tends to get better on its own within 7 to 10 days and can often be treated at home. Getting plenty of rest and taking painkillers and anti-sickness medication can help relieve the symptoms in the meantime.

Read more about how meningitis is treated

Outlook for meningitis

Viral meningitis will usually get better on its own and rarely causes any long-term problems.

Most people with bacterial meningitis who are treated quickly will also make a full recovery, although some are left with serious, long-term problems. These can include:

• hearing loss or vision loss, which may be partial or total
• problems with memory and concentration
• recurrent seizures (epilepsy)
• co-ordination, movement and balance problems
• loss of limbs – amputation of affected limbs is sometimes necessary

Overall, it’s estimated that up to 1 in every 10 cases of bacterial meningitis is fatal.

Read more about the complications of meningitis

Causes of meningitis

Meningitis is usually caused by a viral or bacterial infection.

Viral meningitis is the most common and least serious type. Bacterial meningitis is rare but can be very serious if not treated.

Several different viruses and bacteria can cause meningitis, including:

• meningococcal bacteria – there are several different types, called A, B, C, W, X, Y and Z
• pneumococcal bacteria
• Haemophilus influenzae type b (Hib) bacteria
• enteroviruses – viruses that usually only cause a mild stomach infection
• the mumps virus
• the herpes simplex virus – a virus that usually causes cold sores or genital herpes

A number of meningitis vaccinations provide protection against many of the infections that can cause meningitis.

How meningitis is spread

The viruses and bacteria that cause meningitis can be spread through:

• sneezing
• coughing 
• kissing
• sharing utensils, cutlery and toothbrushes

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.

It’s possible to get meningitis more than once.

Who’s most at risk?

Anyone can potentially get meningitis, but it’s more common in:

• babies and young children
• teenagers and young adults
• elderly people
• people with a weak immune system – for example, those with HIV and those having chemotherapy

You can reduce the risk of getting meningitis by ensuring all your vaccinations are up-to-date.

Read more about meningitis vaccinations

Treating meningitis

People with suspected meningitis will usually need to have tests in hospital and may need to stay in hospital for treatment.

Tests in hospital

Several tests may be carried out to confirm the diagnosis and check whether the condition is the result of 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 – where a sample of fluid is taken from the spine and checked for bacteria or viruses
• a computerised tomography (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.

Treatment in hospital

Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring.

Severe viral meningitis may also be treated in hospital.

Treatments include:

• antibiotics given directly into a vein
• fluids given directly into a vein to prevent dehydration
• oxygen through a face mask if there are any breathing difficulties
• steroid medication to help reduce any swelling around the brain, in some cases

People with meningitis may need to stay in hospital for a few days, and in certain cases, treatment may be needed for several weeks.

Even after going home, it may be a while before you feel completely back to normal.

Additional treatment and long-term support may also be required if any complications of meningitis occur, such as hearing loss.

Treatment at home

You’ll usually be able to go home from hospital if you or your child has mild meningitis and tests show it’s being caused by a viral infection.

This type of meningitis will normally get better on its own without causing any serious problems. Most people feel better within 7 to 10 days.

In the meantime, it can help to:

• get plenty of rest
• take painkillers for a headache or general aches
• take anti-emetic (anti-sickness) medicine for any vomiting

Preventing the spread of infection

The risk of someone with meningitis spreading the infection to others is generally low. But if someone is thought to be at high risk of infection, they may be given a dose of antibiotics as a precautionary measure.

This may include anyone who has been in prolonged close contact with someone who developed meningitis, such as:

• people living in the same house
• pupils sharing a dormitory
• a boyfriend or girlfriend

People who have only had brief contact with someone who developed meningitis won’t usually need to take antibiotics.

Complications of meningitis

Most people make a full recovery from meningitis, but it can sometimes cause serious, long-term problems and can be life threatening.

This is why it’s so important to get medical help as soon as possible if you think you or your child has symptoms of meningitis, and why meningitis vaccinations are offered to certain groups.

It’s estimated up to 1 person in every 2 or 3 who survives bacterial meningitis is left with 1 or more permanent problems.

Complications are much rarer after viral meningitis.

Main complications

Some of the most common complications associated with meningitis are:

• hearing loss, which may be partial or total – 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
• vision loss, which may be partial or total
• loss of limbs – amputation is sometimes necessary to stop the infection spreading through the body and remove damaged tissue
• bone and joint problems, such as arthritis
• kidney problems

Overall, it’s estimated up to 1 in every 10 cases of bacterial meningitis is fatal.

Treatment and support

Additional treatment and long-term support may be required if you or your child experience complications of meningitis.

For example:

• cochlear implants, which are small devices that are inserted into the ears to improve hearing, may be needed in cases of severe hearing loss – read more about treatment for hearing loss
• prosthetic limbs and rehabilitation support may help if it was necessary to amputate any limbs – read more about recovering after an amputation
• counselling and psychological support may help if the trauma of having meningitis causes problems such as disturbed sleep, bedwetting, or fear of doctors and hospitals

You may also find it useful to get in touch with organisations such as the Meningitis Research Foundation or Meningitis Now for support and advice about life after meningitis.

Preventing meningitis

Several vaccinations offer some protection against meningitis.

These vaccines are offered to children and young people as part of the NHS vaccination schedule.

Meningococcal B (MenB) vaccine

The meningococcal B (MenB) vaccine helps protect against meningitis and sepsis (blood poisoning) caused by meningococcal bacteria B.

Babies are offered a dose of the MenB vaccine when they’re:

• 8 weeks old
• 12 weeks old
• 12 to 13 months old

Read more about the meningococcal B (MenB) vaccine

6-in-1 vaccine

The 6-in-1 vaccine (also known as the DTaP/IPV/Hib/HepB vaccine) helps protect your child against diphtheria, tetanus, whooping cough (pertussis), polio, hib, and hepatitis B.

Hib (haemophilus influenzae type B) can cause meningitis.

Babies are offered a dose of the 6-in-1 vaccine when they’re:

• 8 weeks old
• 12 weeks old
• 16 weeks old
• 18 months old

Read more about the 6-in-1 vaccine

Pneumococcal vaccine for babies

The pneumococcal vaccine for babies offers protection against serious infections caused by pneumococcal bacteria, including meningitis.

Babies are offered a dose of the pneumococcal vaccine when they’re:

• 16 weeks old
• between 12 and 13 months.

Read more about the pneumococcal vaccine for babies

MMRV vaccine

The MMRV vaccine protects against measles, mumps, rubella, and varicella (chickenpox). These are serious diseases that can be life-threatening.

The MMRV vaccine is offered to children as part of the routine childhood vaccination programme. When your child will be offered the vaccine depends on when they were born.

More about the MMRV vaccine and when it will be offered

Meningococcal ACWY (MenACWY) vaccine

The Meningococcal ACWY (MenACWY) vaccine helps protect against meningococcal disease.

All young people are offered the vaccine at around 14 years old.

Read more about the MenACWY vaccine