Introduction

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
  • 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.

Read more about the symptoms of meningitis

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.

Call 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.

Call the NHS 24 '111' service or your GP surgery 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

Vaccinations offer some protection against certain causes of meningitis.

These include the:

  • meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year
  • 5-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age
  • pneumococcal vaccine – offered to babies at 8 weeks, 16 weeks and 1 year old
  • meningitis C vaccine – offered at 12 weeks of age, 1 year, and to teenagers and first-time university students
  • MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months
  • meningitis ACWY vaccine – offered to teenagers, sixth formers and "fresher" students going to university for the first time

Read more about meningitis vaccinations

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

Symptoms

A classic symptom of meningitis is a blotchy rash that doesn't fade when a glass is rolled over it, but this doesn't appear in many cases.

You should get medical advice as soon as possible if you're concerned about yourself or your child. Trust your instincts and don't wait until a rash develops.

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

Call the NHS 24 '111' service or your GP surgery for advice if you're not sure if it's anything serious.

Meningitis rash

The classic rash associated with meningitis usually looks like small, red pinpricks at first.

It then spreads over the body quickly and turns into red or purple blotches.

If you press the side of a clear glass firmly against the skin and the rash doesn't fade, it's a sign of blood poisoning (septicaemia) caused by meningitis and you should get medical advice right away.

The rash can be harder to see on dark skin. Check for spots on paler areas like the palms of the hands, soles of the feet, the tummy, inside the eyelids, and the roof of the mouth.

Other symptoms of meningitis

Meningitis can have a number of other symptoms, too, including:

  • a high temperature (fever) over 37.5C (99.5F)
  • feeling and being sick
  • irritability and a lack of energy
  • headache
  • aching muscles and joints
  • breathing quickly
  • cold hands and feet
  • pale, mottled skin
  • a stiff neck
  • confusion
  • a dislike of bright lights
  • drowsiness
  • fits (seizures) 

Babies may also:

  • refuse feeds
  • be agitated and not want to be picked up
  • have a bulging soft spot on their head (fontanelle)
  • be floppy or unresponsive
  • have an unusual high-pitched cry
  • have a stiff body

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

Causes

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 is 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

Treatment

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:

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 7-10 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
  • university students sharing a hall of residence
  • a boyfriend or girlfriend

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

Complications

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 one person in every two or three who survives bacterial meningitis is left with one 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.

The Meningitis Research Foundation's guide to recovering from childhood bacterial meningitis and septicaemia (PDF, 6.73Mb) has more information about meningitis after effects and aftercare.

Prevention

Meningitis can be caused by a number of different infections, so several vaccinations offer some protection against it.

Children should receive most of these as part of the NHS vaccination schedule. Speak to your GP if you're not sure whether your or your child's vaccinations are up-to-date.

Meningitis B vaccine

The meningitis B vaccine is a new vaccine that offers protection against meningococcal group B bacteria, which are a common cause of meningitis in young children in the UK.

The vaccine is recommended for babies aged eight weeks, followed by a second dose at 16 weeks, and a booster at one year.

5-in-1 vaccine

The 5-in-1 vaccine, also known as the DTaP/IPV/Hib vaccine, offers protection against diphtheria, tetanus, whooping cough, polio, and Haemophilus influenzae type b (Hib).

Hib are a type of bacteria that can cause meningitis.

The vaccine is given on three separate occasions, when babies are 8, 12 and 16 weeks old.

Pneumococcal vaccine

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

Babies receive the pneumococcal vaccine as three separate injections, at 8 weeks, 16 weeks and one year old.

Read more about the pneumococcal vaccine

Hib/Men C vaccine

The meningitis C vaccine offers protection against a type of bacteria - meningococcal group C bacteria - that can cause meningitis.

Babies are offered a combined Hib/Men C vaccine at one year of age.

Teenagers and first-time university students are also offered vaccination against meningococcal group C bacteria as part of the combined meningitis ACWY vaccine (see below).

MMR vaccine

The MMR vaccine offers protection against measlesmumps and rubella. Meningitis can sometimes occur as a complication of these infections.

The vaccine is usually given to babies at one year of age. They'll then have a second dose when they're three years and four months old.

Read more about the MMR vaccine

Meningitis ACWY vaccine

The meningitis ACWY vaccines offers protection against four types of bacteria that can cause meningitis – meningococcal groups A, C, W and Y.

Young teenagers, sixth formers and "fresher" students going to university for the first time are advised to have the vaccination.