Health

When meningitis strikes

Meningitis strikes fear in the hearts of many parents. It happens quickly – often in the early winter months ­– and it may be hard to diagnose, with potentially serious after-effects. Discover how you can help to protect your child, and how to spot the signs and react when it does occur.

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People often use ‘meningitis’ as an umbrella term, but it has two very different aspects. The first is inflammation of the meninges. Think of the meninges like clingfilm – a couple of very thin layers wrapped around the brain and the spinal cord. When viruses and bacteria get in there, they cause inflammation and swelling. That’s meningitis.

The other aspect of the illness is septicaemia. This is blood poisoning caused by bacteria which get into the bloodstream and may also invade the cerebro spinal fluid (CSF) and cause meningitis.

Organisms that can cause meningitis and meningococcal septicaemia live in the back of the nose and throat. Some bacteria which can cause meningitis also live in the gut. One in 10 of us carry bacteria or viruses which could lead to meningitis.

There are many different kinds of viruses and bacteria that can cause meningitis. In general, viral meningitis is less serious than bacterial meningitis. However, the complications of viral meningitis can be life-threatening, so always seek medical attention if you suspect meningitis. Bacterial meningitis is regarded as a medical emergency and can be fatal. Meningitis can lead to complications, including hearing problems and brain damage. In very severe cases, septicaemia may lead to loss of digits or limbs.

Anyone of any age can get meningitis. But children under five make up half of all cases, as their immune systems aren’t fully developed, making them more susceptible to infections. It can strike at any time, anywhere, but it’s more common in the first months of winter and the transition between winter and spring.

It can strike at any time, anywhere, but it’s more common in the first months of winter and the transition between winter and spring.

How can I protect my child?

A healthy diet and lifestyle and following good hygiene practices are important, but will not protect your child.

Various infections can cause meningitis and there are several vaccinations that can protect your child against it. These vaccinations form part of the NHS vaccination schedule and babies and children are offered them for free.

  • Meningitis B vaccine was introduced in 2015 to protect against meningococcal group B bacteria, a common cause of meningitis in young children. Your baby will probably be offered this vaccine at eight weeks old, with a second dose when they’re 16 weeks, and a booster when they’re one year old.
  • Pneumococcal vaccine protects your baby from serious infections that pneumococcal bacteria can cause, and this includes meningitis. Your baby will get this vaccine as three separate injections, at eight and 16 weeks and at one year old.
  • Hib/meningitis C vaccine protects your baby from meningococcal group C bacteria, which can cause meningitis. Babies are offered a combined Hib/Men C vaccine at one year of age.
  • MMR vaccine protects against measles, mumps and rubella, from which meningitis can sometimes be a complication. Your baby will normally get the vaccine when they are one year old, with a second dose when they reach three years and four months.

When should I get medical help?

Go with your gut. Parents’ stories are all so different. But they always say they had this gut feeling that this time there was something more seriously wrong with their child. Sometimes there isn’t a symptom you can put your finger on, but you should take this instinct seriously. If you want another opinion, go to A&E. If you get sent home and you are still worried, go back. You are the expert on your child.

Monitor your child. Take a note of temperature, breathing, alertness, a new rash or changes in behaviour. If you are worried about something, then check every half an hour so you pick up changes quickly. Most importantly, be aware.

Children with meningitis are often hospitalised, and the length of stay will depend on the seriousness of the case and whether there are complications. Bacterial meningitis is treated with antibiotics. Antibiotics aren’t effective against viral meningitis but they can be given as a safeguard, before a definite diagnosis is made.

It can take months, rather than weeks, for a child to recover from meningitis, even when there have been no obvious after-effects. Children could have problems with sleeping and eating and there may be behavioural issues, mood changes, tantrums, or even personality changes. Don’t expect everything to go back to normal as soon as you’re home from the hospital. It may be quite some time before your child is ready to go back to school, for example. In some cases, children may need extra support with schooling after meningitis.

Monitor your child. Take a note of temperature, breathing, alertness, a new rash or changes in behaviour.

SYMPTOM CHECKLIST

Temperature A rise in temperature is seen in most cases. It’s not always extremely high, so follow your instincts. If you feel there is something wrong with your child, seek medical advice.

Rash The rash we associate with meningitis is a sign of septicaemia, which occurs with bacterial meningitis. Most parents who have had a child with meningococcal septicaemia would describe it as ‘dark purple/deep red spots or marks’ rather than a rash. It can start anywhere on the body so it is important to examine your child’s body carefully if you are worried.

Irritability This is a common sign. Babies may refuse to feed or they may vomit. Your child may have a ‘moaning’ cry and picking them up to comfort them may not help.

Muscle aches and pains Be aware that children often complain of pain in their muscles or joints. Neck stiffness may not be seen in all children.

Headache and sensitivity to light With babies, this can go along with irritability. Light may not cause children great pain but they may show a marked preference for being in a very dark room.

‘We were told it was a throat infection’

Amanda Perry’s daughter Cassie, now three, deteriorated quickly

‘Cassie was just a year old when she was sick one day - I didn’t think anything of it as she had reflux. But her complexion was a really strange, pale grey and she had a mottled effect on her legs so I took her straight to the GP. I was told she had a throat infection. I asked about the mottled colour and he just lifted her vest and looked at her tummy. He said the colour wasn’t anywhere else and gave me antibiotics. But when I got home, I found the septicaemia rash on her back and arms.

My neighbour drove us to A&E and Cassie was admitted straight away. Soon afterwards, she lost consciousness. Within two hours, her whole body was swollen and purple. She was on life support and under sedation. For the first 48 hours, we didn’t know whether she would live or die. But on the third day, one of the surgeons said: “I think she’s going to pull through.”

After she had stabilised, she went down with pneumonia and had to go back on life support in intensive care for three days. She then had to have a series of operations to take skin grafts and remove two fingertips, her left foot and her right leg below her knee.

Cassie has prosthetic legs. She had a frame but now she doesn’t use it and runs around like nobody’s business! One of her kidneys is slightly damaged, and her hearing may have been affected. But she’s an incredibly happy, smart little girl. She’s just amazing.’

‘Sam had no after-effects at all’

Chloe and her son Sam, now five, were lucky to get a prompt diagnosis

‘When Sam was eight weeks old, he seemed very sleepy and floppy and wasn’t feeding well. Whenever I tried to rouse him, he would make a very strange crying noise. It didn’t sound like his typical cry, and normally he was a hungry baby.

I noticed that he had a rash on his back and his tummy and thought it might be a heat rash. My husband Jonathan is a GP so I asked him to look at it. At first, he didn’t think it was anything serious. But next morning, when Sam wasn’t any better, we took him to hospital.

He was admitted right away. They did a lumbar puncture and found he had meningitis and septicaemia. He was given intravenous antibiotics and he soon started to improve: in the end, he was only kept in hospital for a week. We were very lucky. He didn’t have any after-effects at all. Whenever he was due to reach a milestone, like talking or walking, I’d worry about him achieving it. But he’s reached them all and done everything at the right stages.’

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