Meningitis in babies and children: symptoms and vaccinations

Doctor vaccinating a baby

Meningitis is the leading infectious cause of death in early childhood and unsurprisingly, a major source of anxiety for parents

Meningitis is the name given to the inflammation of the membranes that enclose the brain and spinal cord. Those most at risk include:

  • Babies
  • Children under five
  • Young people aged 14 to 24
  • Elderly people

There are specific symptoms, but in children and young people it can be difficult to distinguish the symptoms of meningitis from those of other common viral infections.
Here, we list the possible signs and symptoms of meningitis, so you know what to look out for if your baby, child or teenager is ill.

Which symptoms of meningitis should you look out for?

It's important to remember that symptoms can appear in any order or at the same time, and some symptoms may not appear at all. You should look out for

  • Stiff neck (caused by inflammation in the spinal cord area)
  • Aversion to bright lights (photophobia)
  • Stiff or jerky movements (owing to inflammation of the meninges around brain and spinal cord)
  • Confusion or altered mental state – delirium, drowsiness, impaired consciousness
  • A red rash which doesn't fade when a glass is rolled over it (see test below)

NB: Don't wait for the rash to appear if you suspect meningitis – it's a late symptom and you need to get medical attention for your child as quickly as possible.

Symptoms of meningitis to look out for in babies

  • Blotchy or pale skin tone, turning blue
  • Poor feeding
  • A tense or bulging fontanelle on head
  • High-pitched crying, irritability (especially when touched)

General symptoms

These are part of the body's response to an infection and are easy to confuse with the symptoms of other common illnesses:

  • Vomiting and/or diarrhoea
  • Severe joint or muscle pain
  • Headache
  • Breathing difficulties
  • Irritability and restless behaviour
  • Fever
  • Severe lethargy and tiredness
  • Refusing food or drink

What does the meningitis rash look like?

Meningococcal septicaemia appears as a rash that varies from small, pinprick-sized marks to larger red or purple bruises.

The rash can appear anywhere on the body but only 40% of patients with meningococcal disease will develop the rash. It usually appears between six and 12 hours after the first symptoms.

How to do the glass test Meningitis glass test

  • Press a clear glass firmly against the skin
  • If the rash doesn't fade when the glass is pressed against it, seek medical help immediately as this could be a sign of septicaemia
  • If the rash fades, keep checking because in rare cases the rash can change from fading to non-fading
  • On dark skin, check for a rash on lighter skin eg palms of hands, soles of feet, finger tips.

What to do if you suspect meningitis

Do NOT wait for a rash to appear. If you're concerned about any symptoms, seek medical help immediately. Meningitis Now, the UK's largest meningitis charity, has a 24-hour nurse-led helpline; if you have questions you can call 0808 80 10 388 or visit their website.

What causes meningitis?

Meningitis can be viral or bacterial. In the UK, the most common bacterial forms are meningococcal and pneumococcal, and babies and children under five years of age are most at risk of developing bacterial meningitis. Viral meningitis is more common, but less serious than bacterial meningitis.

The meningococcal bacteria are present in the back of the throat and spread by coughing, sneezing and kissing. The bacteria can't live outside our bodies for very long, so it isn't a highly contagious disease and around 10% of the population carries the bacteria.

What is meningococcal septicaemia?

Meningococcal septicaemia is blood poisoning caused by the organisms that can also cause meningitis.

What are the long-term effects of meningitis?

Children and older people with viral meningitis usually make a full recovery, but sadly about half of all children with bacterial meningitis will experience lasting effects, such as scarring, limb-loss, brain damage or deafness.

Is there a meningitis vaccination?

Children receive vaccines to help prevent cases of viral and bacterial meningitis. These include:

  • Men C vaccine (for babies, with a booster at 12-13 months)
  • Men ACWY vaccine (for teenagers and students)
  • Men B vaccine (for babies, three doses between two and 12 months – from September 2015)
  • Measles, mumps and rubella (MMR) – the same virus that causes mumps is a common cause of meningitis (given to babies and a second dose for young children)
  • Hib vaccination (four doses given between two and 13 months)
  • Pneumococcal conjugate vaccine (PCV) (three doses given to babies)

These are all offered as part of the NHS childhood vaccination programme and your GP will know if your child's vaccinations are up to date.

The available vaccines don't prevent all types of meningitis, so it's important you know the signs and symptoms even if your child has been vaccinated against some forms of meningitis.

A new Men B vaccine to prevent meningitis is now being offered to babies in the UK as part of the routine NHS childhood vaccination programme.

This vaccine protects against the meningococcal group B bacteria, responsible for more than 90% of meningococcal infections in young children.
Babies born before March 2015 will not have received the vaccination.

It is currently only available to older children privately.

What Mumsnetters say

  • “Definitely don't wait for a rash; if I'd done this my son would be dead. He was very sleepy and not really rousable, didn't want milk, moaned every time he was moved and felt very warm to touch but actually didn't have a high temperature to start off with. His feet got cold once he was in hospital.”
  • “As a children's nurse and a parent I would say if you can afford it, then get your children vaccinated. We have. Be aware of the symptoms. It's not necessarily meningitis but the symptoms of sepsis.”
  • “My teenage daughter had viral meningitis: unbearable headache, neck stiffness, photophobia and fever. No D&V though. It took her several weeks to fully recover, and she was exceptionally tired.”
  • “My daughter developed septicaemia and it was only when she got a non-fading rash that the medical professionals realised how ill she was, despite seeing doctors twice within the previous 36 hours. For anyone reading, always trust your instinct and get a further opinion if you have ongoing doubts about how your child is.”