What is meningitis?
Meningitis is inflammation of the protective layers that surround the brain and spinal cord. These layers are called the meninges.
What is septicaemia?
Septicaemia is blood poisoning and can be caused by some types of bacteria that also cause meningitis. The bacteria enter the bloodstream and multiply uncontrollably. As the bacteria die and breakdown, they release toxins (poisons) into the blood. These toxins damage the blood vessels throughout the body, causing organ damage. The rash associated with meningitis is actually caused by septicaemia.
What causes meningitis?
Meningitis can be divided into two main types; viral meningitis and bacterial meningitis. Viral meningitis is reasonably common but rarely fatal. It presents like flu and cannot be treated with antibiotics. Bacterial forms are comparatively rare, but extremely dangerous and can be fatal. The most common bacterial cause in the UK is the meningococcus. This can cause both meningitis and septicaemia (meningococcal disease). Other forms of bacterial meningitis include pneumococcal, Hib, neonatal (caused by E. coli and group B streptococcus) and TB.
What vaccines are available?
There are no vaccines to offer protection against all forms of meningitis and meningococcal disease. However, there are three vaccinations offered as part of the childhood immunisation programme:
  • Hib – Given to babies at two,three, and four months, with a booster at 12 months, protects against Haemophilus influenzae type b.
  • MenC – Given to babies at three, four and 12 months, protects against group C meningococcal disease only. This vaccine was introduced in 1999 and is available to all those aged under 25 years.
  • Pneumococcal – Given to babies at two,four and 13 months, protects against pneumococcal meningitis. This vaccine will be introduced in the summer 2006.
Other vaccines are available to people travelling to countries where there is a risk of meningococcal groups A, W135 and Y. There is also a vaccine offered those over 65 years to protect against pneumococcal disease (including meningitis)
If I get meningitis once can I get it again?
It is very unusual for anyone to have meningitis more than once, but it is possible. Most people develop immunity to the organism that has caused their disease. However, there are several different causes of meningitis and therefore it is possible, but rare, to have the disease more than once.

Meningococcal Disease is the most common form of bacterial meningitis and septicaemia in the UK. The following questions and answers relate specifically to meningococcal disease.

How is it spread?
The meningococcal bacteria are carried in the back of the throat and are spread by coughing, sneezing and intimate kissing (close prolonged contact). The bacteria are extremely fragile and cannot live outside the body for very long, therefore it is not a highly contagious disease. At any one time, around ten percent of the population are carrying the bacteria.
Can anyone get it?
Everybody carries a very small risk but certain age groups are more susceptible. The under fives are the most at risk group, particularly the under ones. Teenagers and young adults are the second most at risk group. Scientists do not yet fully understand why a few people get meningitis or septicaemia from bacteria that appear to be harmless to most of us.
Is it seasonal?
Meningococcal disease can occur at any time of the year, but the number of cases rises during the winter months i.e. October - March.
Are there different groups of disease?
Yes, meningococcal disease can be divided into several groups, including A, B, C, W135 and Y. Group B causes over 90% of meningococcal disease in the UK.
What is the difference between meningitis and meningococcal septicaemia?
The meningococcal bacteria can affect the body in several ways:
  • Meningitis is caused when bacteria enter the bloodstream and travel to the meninges, where they multiply and cause inflammation.
  • Septicaemia is caused when bacteria enter the bloodstream and multiply rapidly. They release toxins that poison the blood. If the bacteria do not reach the meninges, meningitis does not occur.
  • Commonly, the bacteria will multiply in both the meninges and the bloodstream, causing meningococcal meningitis and septicaemia to occur.
What are the main symptoms?
There are several signs and symptoms associated with meningitis and septicaemia. They may not all appear.
  • In adults and children: fever with cold hands and feet, headache, vomiting, muscle pain, dislike of bright lights, drowsiness, stiff neck, confusion.
  • In babies and toddlers: fever with cold hands and feet, refusing feeds/vomiting, pale or blotchy skin, dislike of being handled, listlessness, high pitched moaning cry, drowsy and difficult to wake.
  • A rash may appear anywhere on the body. This is caused by septicaemia (blood poisoning). Other symptoms of septicaemia include rapid breathing, stomach cramps and diarrhoea.
What is the rash?
When bacteria multiply in the blood stream, they release toxins (poisons) that damage the blood vessels. The rash is caused by blood leaking from the damaged blood vessels into the tissues underneath the skin.
The rash can start anywhere on the body. It begins as tiny red pin pricks, but may quickly develop to look like fresh bruising. “The Glass Test” can be used to see if the rash might be septicaemia. If you press the side of a clear drinking glass firmly onto the spots or bruises, they will not fade.
Are signs and symptoms different for septicaemia?
If the patient has septicaemia alone, the common signs for meningitis are not present. Early warning signs are sometimes not there or are very difficult to spot. These can include fever with cold hands and feet, vomiting, muscle pain, pale blotchy complexion, stomach cramps and diarrhoea. Very often the first sign people notice is the rash. Septicaemia can progress very quickly and a patient can suffer severe shock and death within hours. If septicaemia is suspected, urgent medical help is needed.
Is there an incubation period?
Yes, the incubation period for meningococcal disease is between two and ten days. Signs and symptoms will develop during this time if someone has contracted the disease after being exposed to the bacteria.
What should you do if someone has signs and symptoms?
If you have identified signs and symptoms, and the patient's general health is deteriorating, you need to act quickly. Seek medical help immediately, describe the symptoms as accurately as possible and mention that you think it could be meningitis.
It is best, whenever possible, to call a GP. They carry antibiotics that need to be given immediately. The antibiotics will start to destroy the bacteria even before the patient gets to hospital.
How is it treated?
Meningococcal disease requires urgent hospital care and treatment with antibiotics. The progression of the disease varies, with some people needing only a few days in hospital and others needing a longer stay with treatment in an intensive care unit.
What are the after-effects?
The majority of people will make a full recovery, but some people may be left with after- effects from both bacterial and viral meningitis. The most common after-effect of meningitis is deafness and others include:
  • learning difficulties
  • epilepsy
  • mood swings
  • disruptive behaviour
  • sight problems
  • headaches
  • tiredness
  • memory loss
  • concentration problems
The toxins that are released during septicaemia cause damage to blood vessels. This can prevent the vital flow of blood and oxygen to major organs such as the kidneys, liver and the skin. Those who have suffered septicaemia may need skin grafts and sometimes amputations.
Why are antibiotics given to some people after a case of bacterial meningitis?
Meningococcal disease carries a slightly increased risk to the household and kissing contacts of a primary case. The antibiotics are given to destroy any meningococcal bacteria (which may be carried at the back of the throat) and prevent any further transmission. These antibiotics are not a form of prevention. If someone is already incubating the disease the antibiotics will not stop them developing meningitis and/or septicaemia. It is still important to look out for signs and symptoms.