Meningitis and the fear factor

Meningitis is perhaps the illness that instils most fear into any parent. The speed with which it takes hold and the damage it can cause is horrifying. As someone who was taken to hospital with suspected meningitis as a youngster I am well aware of the urgency required. As it happens I didn’t have meningitis but there’s nothing like a good health scare to keep your parents on their toes.

So what is it? Meningitis is the inflammation of the meninges, the membranes that line the brain and spinal cord, and can be caused by either a viral, bacterial or (very rarely) a fungal infection. While all three are extremely serious, it is the bacterial infection that is more dangerous, the most common of which is meningococcal bacteria.

In a worst case scenario, meningitis can kill. Even assuming survival, damage to brain tissue can lead to disabilities such as brain damage or deafness; and septicaemia (blood poisoning) as a result of the bacteria may require limbs to be amputated. Meningitis is a medical emergency, if you’re in any doubt then get the patient to hospital. Not so long ago most patients would die, now it's about 10%. It’s still high but the chances of survival are so much better.

So how would you recognise meningitis? The initial symptoms can sometimes be confused with those of the flu, especially in cases of viral meningitis. The speed with which meningitis occurs is often the biggest clue. If flu symptoms appear rapidly, get the patient to hospital.

The symptoms include fever / vomiting, a severe headache, a stiff aching neck, an aversion to bright light, drowsiness, confusion a rash and seizures. If the patient is a baby then there could also be bulging of the soft spot on top of their skull. With septicaemia the symptoms can also include limb or joint pain, cold hands / feet, shivering, pale or blotchy skin and the breathing rate would increase. These symptoms may not all appear, and if they do they may not be in that order.

It is the rash and glass test that I’m sure most people will be familiar with when thinking of meningitis. If the patient has a rash then press a glass against it and the rash will normally go away as long as the pressure of the glass is applied. In the case of meningitis, as the rash is caused by burst blood vessels, the rash will not go away when a glass is placed against it. That said, if you do suspect meningitis, do not wait for a rash to appear as it may not appear until later, if at all.

As for treatment, the patient needs to get to hospital urgently. There is very little that can be done outside of hospital other than to make them comfortable. In hospital they will be able to give antibiotics to fight against bacterial infection, and keep the patient under close observation. A lumbar puncture (extraction of fluid from the spinal cord using a syringe) may be performed so fluid can be tested for infection and therefore confirm meningitis. If it's viral meningitis then antibiotics are of no use so the patient would be given rest, hydration and pain relief.

Meningitis can be quite a complicated illness so I’ve tried to make this as unscientific as possible so it is understandable. Instead I’ve concentrated on the symptoms and emphasised the urgency of getting the patient to hospital. If you would like more information on meningitis then visit the websites of either the Meningitis Research Foundation or the Meningitis Trust.

Meningitis Awareness Week runs from the 19th to 25th September 2011.