How to spot meningitis, and meningitis B vaccine information

Since I qualified as a doctor from University College Cork in 1997, one of the most remarkable changes I have noted has been in the reduction in the number of cases of meningitis in children. Since the first meningitis vaccine was introduced against Haemophilus Influenza meningitis in 1992, many kinds of meningitis have been reduced to a mere handful of cases, including Haemophilus Influenza, meningitis C and pneumococcal meningitis. However, meningitis B is now the most common cause of bacterial meningitis in the Ireland. In 2014, there was a total of 82 cases of all types meningococcal meningitis in Ireland, and 64 (78%) of these were caused by meningitis B.

Vaccines are an effective method to prevent meningitis and, as mentioned above, have helped to almost eliminate some other causes of this deadly disease. In the UK, from September 2015, babies are being offered a vaccine to protect against meningococcal B meningitis vaccine as part of the routine immunisation schedule. In Ireland, the National Immunisation Advisory Committee (NIAC), which advises the Irish Government, have conditionally recommended the vaccine, but we are still waiting to hear whether it will be made freely available to Irish infants. There is currently no date for the free introduction of this vaccine by the HSE in Ireland. The vaccine is available free of charge to people in Ireland who are close contacts of a patient diagnosed with meningitis B. Stocks of the vaccine are also available to buy in Ireland, so parents can elect to source the vaccine for their children through their GP privately.

If you suspect meningitis - get medical help immediately.

What are the symptoms of meningitis?

Patients with meningitis become very ill, very quickly. The classic symptoms of headache, neck stiffness and rash may not occur. One or more of the following symptoms below may occur. Note that not all symptoms may occur. Many children who are developing meningitis have non-specific symptoms such as just feeling or looking generally unwell. These symptoms may include having a high temperature, being more tired than usual, and feeling sick.

The following symptoms commonly develop early on:

Leg pains, which are often severe and prevent a child from standing or walking.
Cold hands or feet - even if the child has a high temperature.
Pale, dusky or blue colour of the skin around the lips.
Rash - commonly occurs but not always. A typical rash is common with meningococcal infection. The rash is red or purple. Small spots develop at first and may occur in groups anywhere on the body. They often grow to become blotchy and look like little bruises. One or two may develop at first, but many may then appear in different parts of the body. The spots/blotches do not fade when pressed (unlike many other rashes). To check for this, do the glass test. Place a clear glass firmly on one of the spots or blotches. If the spot/blotch does not fade and you can still see it through the glass, get medical help immediately.

Other symptoms that may occur in babies:

Excessive crying - often high-pitched or moaning and different to their usual cry.
Fast breathing or distressed breathing.
High temperature - but the baby may not look hot and the skin may look pale or blotchy, or turn blue. The hands and feet may feel cold. The baby may shiver.
Will not take feeds - sometimes, repeatedly vomiting.
Being irritable - especially when picked up and handled.
Drowsiness or sleepiness - does not wake easily.
A bulging fontanelle (soft spot on the baby's head) sometimes develops.
Jerky movements may occur and the body may appear stiff. Sometimes the opposite occurs and the body appears quite floppy. Fits or seizures sometimes develop.