Overview

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 sepsis 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)
• being sick
• a headache
• a rash that does not fade when a glass is rolled over it (but a rash will not always develop)
• a stiff neck
• a dislike of bright lights
• drowsiness or unresponsiveness
• seizures (fits)

These symptoms can appear in any order. You do not always get all the symptoms.

When to get medical help

Call 999 for an ambulance or go to your nearest  A&E immediately if you think you or someone you look after could have meningitis or sepsis.

Trust your instincts and do not wait for all the symptoms to appear or until a rash develops. Someone with meningitis or sepsis can get a lot worse very quickly.

Call NHS 111 Wales for advice if you're not sure if it's anything serious or you think you may have been exposed to someone with meningitis.

If you've had medical advice and are still worried or any symptoms get worse, get medical help again.

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

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

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

Vaccinations against meningitis

Vaccinations offer some protection against certain causes of meningitis.

These include the:

• menB vaccine - offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year
• 6-in-1 vaccine - offered to babies at 8, 12 and 16 weeks of age
• pneumococcal vaccine - 2 doses offered to babies at 12 weeks and 1 year, and a single dose offered to adults aged 65 and over
• Hib/Men C vaccine - offered to babies at 1 year of age
• 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

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.

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 up to 1 in every 10 cases of bacterial meningitis is fatal.

Symptoms

Symptoms of meningitis can appear in any order. Some may not appear at all. In the early stages, there may not be a rash, or the rash may fade on pressure.

You should get medical help immediately if you're concerned about yourself or your child.

Trust your instincts and do not wait for all the symptoms to appear or until a rash develops.

Symptoms of meningitis and sepsis include:

• a high temperature
• cold hands and feet
• vomiting
• confusion
• breathing quickly
• muscle and joint pain
• pale, mottled or blotchy skin (this may be harder to see on brown or black skin)
• spots or a rash (this may be harder to see on brown or black skin)
• headache
• a stiff neck
• a dislike of bright lights
• being very sleepy or difficult to wake
• fits (seizures)

Babies may also:

• refuse feeds
• be irritable
• have a high-pitched cry
• have a stiff body or be floppy or unresponsive
• have a bulging soft spot on the top of their head

Someone with meningitis, or sepsis can get a lot worse very quickly.

Call 999 for an ambulance or go to your nearest A&E if you think you or someone you look after could have meningitis or sepsis.

Call NHS 111 Wales for advice if you're not sure if it's anything serious.

If you've had medical advice and are still worried or any symptoms get worse, get medical help again.

Meningitis rash

The rash usually starts as small, red pinpricks before spreading quickly and turning into red or purple blotches.

It does not fade if you press the side of a clear glass firmly against the skin

The rash can be harder to see on brown or black skin. Check paler areas, such as the palms of the hands, soles of the feet , roof of the mouth, tummy, whites of the eyes or the inside of the eyelids.

If a rash does not fade under a glass, it can be a sign of sepsis (sometimes called septicaemia or blood poisoning) caused by meningitis and you should call 999 straight away.

Who can get it

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

The infection is usually spread by people who carry these viruses or bacteria in their nose or throat, but are not 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.

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:

• 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 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-sickness medicine for any vomiting

If you feel unable to manage your symptoms at home or you feel worse, get further medical help.

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's 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 will not 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 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 
• 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 and Meningitis Now for support and advice about life after meningitis.

The Meningitis Research Foundation has information on the after effects of meningitis in children.

This includes a guide to recovering from childhood meningitis and septicaemia.

Vaccination

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.

MenB vaccine

The menB vaccine 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 8 weeks, followed by a second dose at 16 weeks and a booster at 1 year.

Find out more about the MenB vaccine.

6-in-1 vaccine

The 6-in-1 vaccine, also known as the DTaP/IPV/Hib/Hep B vaccine, offers protection against diphtheria, tetanus, whooping cough, hepatitis B, polio and Haemophilus influenzae type b (Hib).

Hib are a type of bacteria that can cause meningitis.

The vaccine is given on 3 separate occasions, when babies are 8, 12 and 16 weeks old.

Read more about the 6-in-1 vaccine.

Pneumococcal vaccine

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

Babies are offered the pneumococcal vaccine as 2 separate injections at 12 weeks with a booster given at 1 year of age. A single dose is offered to adults aged 65 or over.

Read more about the pneumococcal vaccine.

Hib/Men C vaccine

The meningitis C vaccine offers protection against a type of bacteria called meningococcal group C bacteria, which can cause meningitis.

Babies are offered a combined Hib/Men C vaccine at 1 year of age.

MMR vaccine

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

The vaccine is usually given to babies at 1 year of age. They'll then have a second dose when they're 3 years and 4 months old.

Read more about the MMR vaccine.

Meningitis ACWY vaccine

The meningitis ACWY vaccines offers protection against 4 types of bacteria that can cause meningitis: meningococcal groups A, C, W and Y.

The vaccine is offered to teenagers aged 14 years old. It is also offered to people up to the age of 25 who have never had a vaccine containing MenC.

Read more about the meningitis ACWY vaccine.