Meningitis

What is meningitis?

Meningitis is an inflammation of the membrane covering the brain and spinal cord (meninges). Meningitis can develop very rapidly and is very serious.

Meningitis can be caused by bacteria or a virus:

• Bacterial meningitis. This is the most serious form of meningitis. It can be life-threatening and can lead to serious disabilities such as deafness or brain damage. Bacterial meningitis can also lead to blood poisoning (septicaemia) if it's untreated, as bacteria enter the bloodstream and multiply rapidly. Septicaemia causes a purple rash and is very dangerous.


• Viral meningitis. This is the most common type and can be relatively mild and seem a bit like flu. Some people who have it are not even aware that they have an infection.

How can my baby get meningitis?

Your baby can get viral meningitis when the virus is transferred into the air when someone coughs or sneezes nearby. It's also spread by poor hygiene, such as not washing your hands after going to the toilet.

The bacteria that cause bacterial meningitis don't live long outside the body. So your baby can only get it from being in very close contact with an infected person. This usually means living in the same house as someone with bacterial meningitis. Your baby can pick up the bacteria from:

• being kissed or touched;
• people sneezing and coughing close by;
• sharing eating and drinking utensils, and other personal items such as toothbrushes.

Most cases of bacterial meningitis are isolated, but clusters occasionally appear. People who share a house with someone with bacterial meningitis are usually offered antibiotics as a precaution because of the risk of infection.

What are the symptoms of meningitis?

There's no textbook pattern to meningitis. Symptoms can occur in any order or may not appear at all. You won't be able to tell if your baby has bacterial or viral meningitis unless she is tested. The early symptoms of both types of meningitis can be very similar. This is why it's important to get medical help as soon as you notice any warning signs.

If your baby shows any of the follow symptoms, take her to the nearest accident and emergency (A&E):

• unusual cry or moaning;
• grunting or rapid breathing;
• being fretful or irritable when touched;
• vomiting;
• refusing food;
• pale or blotchy skin;
• being floppy, listless or unresponsive;
• being drowsy or difficult to wake;
• having a fever with cold hands or feet;
• a bulging fontanelle (soft spot at the top of your baby's head);
• spots or a rash (see below, What should I look out for?).

Many of the symptoms commonly associated with meningitis only appear when the disease is already advanced. Lots of the symptoms are also similar other childhood illnesses, such as flu. If you are worried get medical help straight away. Don't wait.

I have heard that meningitis causes a rash. What should I look out for?

If your baby has bacterial meningitis and it has developed into septicaemia, she will get a rash. The rash will appear under her skin as a cluster of tiny spots. They look like pinpricks and can start anywhere on her body.

If your baby's septicaemia goes untreated, the spots develop a bruise-like appearance, followed by purple skin damage and discolouration. If your baby has darker skin the rash can be harder to see, so check paler areas of her body.

You can use the glass test to check for a meningitis rash. Press the side of a clear drinking glass on to the spots. A meningitis rash doesn't fade. The rash may fade at first so keep checking. If you have any doubt, get to the hospital right away.

The rash is one of the later signs of septicaemia, after which your baby's condition can rapidly become critical. Check on your baby often throughout the day if you are worried her illness is getting worse. Even if no rash develops but your baby's condition is deteriorating rapidly, take her to A&E immediately.

When should I see the doctor?

If you think your baby has meningitis, see a doctor for treatment straight away. The earlier she has antibiotics the greater the chance that she will survive, and without complications. Always trust your instincts.

How is meningitis diagnosed?

Your doctor will give your baby a blood test or a lumbar puncture to diagnose meningitis. A lumbar puncture involves inserting a hollow needle into your baby's lower spine to remove a sample of fluid from the spinal cord. This fluid will then be sent to the lab to be tested.

It's bound to be distressing to see your baby going through these tests. But the tests need to be carried out to confirm for sure whether your baby has meningitis. If your doctor suspects bacterial meningitis he will give your baby antibiotics as soon as possible, before the tests results have been confirmed.

The lumbar puncture takes less than 20 minutes and your baby may have a headache afterwards.

What is the treatment for meningitis?

Your baby's treatment will depend on what type of meningitis she has:

Viral meningitis
Viral meningitis doesn't respond to antibiotics, so your baby will just need rest and care. It often clears up quickly, though your baby may continue to have headaches and feel low and tired for some time.

In very rare cases, viral meningitis can cause inflammation of the brain (encephalitis). If this happens your baby may need antiviral treatment.

Bacterial meningitis
Bacterial meningitis requires immediate treatment with antibiotics. Your baby will need to go to hospital to an intensive care unit. She will be given antibiotics through a drip in her arm, and she will need extra oxygen through a mask.

Your baby will also be fed through a drip. It could take anything between a week and a month or more for your baby to recover, depending on how severely ill she is.

Are the any ways to prevent meningitis?

Babies now receive the Hib (Haemophilus influenzae type B) vaccine at two, three and five months, with a booster at 18 months. The Hib vaccination also offers protection against bacterial infections such as septic arthritis and cellulitis.

The pneumococcal vaccine is available as an optional vaccine. The pneumococcal bacteria is the cause of one in 10 cases of meningitis.

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. The vaccine against meningococcus groups A,C,W,Y is available for those above two years old in Malaysia.

Can newborn babies get meningitis?

It's very rare for newborns to contract meningitis. The condition is called neonatal meningitis when it affects newborns.

Neonatal meningitis is usually caused by bacteria such as E coli, group B streptococcus or listeria. Babies can come into contact with these bacteria during birth if their mums carry them in their stomach or vagina.

Premature babies born before 33 weeks and babies born with a low birth weight are more likely to get neonatal meningitis.

Neonatal meningitis can be difficult to diagnose. If you are at all worried about your newborn and she doesn't seem well, get immediate medical advice.