Video: How do you get bacterial meningitis?

Playlist: Meningitis Q&A

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How do you get bacterial meningitis?

Dr Sarah Jarvis MBE, FRCGP

01:16

How do you get bacterial meningitis?

Dr. Sarah Jarvis MBE, FRCGP

01:03

Is meningitis life threatening?

Dr. Sarah Jarvis MBE, FRCGP

00:56

What is the most common cause of meningitis in children?

Dr. Sarah Jarvis MBE, FRCGP

00:56

What are the symptoms of meningitis in children?

Dr. Sarah Jarvis MBE, FRCGP

00:53

What is the meningitis glass test?

Dr. Sarah Jarvis MBE, FRCGP

01:14

Why do teenagers need a meningitis vaccine?

Dr. Sarah Jarvis MBE, FRCGP

01:15

How do you get vaccinated against meningitis?

Dr. Sarah Jarvis MBE, FRCGP

00:46

Where does your neck hurt with meningitis?

Dr. Sarah Jarvis MBE, FRCGP

How do you get bacterial meningitis?

Dr Sarah Jarvis

It’s scary to think that the germ that causes many kinds of bacterial meningitis, the so called meningococcal germ, actually lives harmlessly in the nose and throat of about one in four of us, without us knowing it. And many of us may never know. Fortunately our immune system actually does a really good job of stopping it from getting any deeper into our bodies.

But occasionally that germ can sneak past our immune system and invade deep into the body where it can cause meningitis and meningococcal blood poisoning. Now if your immune system is not working very well, it’s more likely to happen. So babies whose immune system is immature, older people whose immune system is waning, people with long-term conditions like diabetes and anyone with blood cancer or who is having cancer treatment that affects the immune system, are more risk.

You are also at more risk if you live in very close contact, which is one of the reasons we think university students are more likely to get it. The good news is that for meningitis several forms and for strep pneumonia which can also cause meningitis, there are immunisations available free on the NHS for babies and for over-65s.

Is meningitis life threatening?

Dr Sarah Jarvis

Meningitis is the inflammation of the meninges - that is, the tissues that lie in the brain and the spinal cord. If these get inflamed, they can squash the brain. If you think about how many of your life’s vital functions depend on your brain you can understand that that alone can be dangerous enough, but the meningococcal germ can also get into your bloodstream, causing blood poisoning, and that can have an effect on your whole body system.

So, for instance, your red cells can get broken down and you can get clots where they shouldn’t happen deep inside your body and that which often lead to children who have had meningococcal meningitis needing amputations. It can affect your kidneys so your kidneys can’t filter the fluid properly, and you can get an impact on your heart causing fluid to build up around your heart.

All of those things can be life-threatening, but with early treatment the outlook is better. That’s why it’s so important, if ever you suspect meningitis not to delay for a second.

What are the symptoms of meningitis in children?

Dr Sarah Jarvis

Classic signs of meningitis in children are headache, not liking the light and a stiff neck and worsening headache if they move their head. But, children - especially toddlers - can also get severe muscle pain, and they may be boiling hot all over but may have freezing cold hands and feet. Later on, they may develop a rash that can spread very quickly and if you press a glass against it, it doesn’t go pale underneath the glass.

They may be breathing very fast, become disorientated and even become drowsy, have convulsions and become unconscious. If you have any suspicion that your child might have meningitis, always seek help immediately. With the right treatment early enough the outlook for many children with meningitis is still good, but that means getting treatment immediately, which could make the difference between life and death.

What is the meningitis glass test?

Dr Sarah Jarvis

The glass test is to check the rash that appears, if the meningococcal germ that causes one kind of meningitis spreads to the rest of your body and causes blood poisoning! If you take a glass and press it firmly (but not too firmly so that you break it, obviously!) against the skin, if the rash goes pale it’s probably nothing to worry about, but if the rash doesn’t get paler you should seek medical help immediately.

That rash usually starts off looking like tiny red or round pin pricks but can spread with terrifying speed anywhere in the body. So you must check the whole body. When it spreads it often starts to look like red or purplish blotches and there may be blood blisters. If you think that there is any chance that you have had a positive glass test, do seek help immediately.

Why do teenagers need a meningitis vaccine?

Dr Sarah Jarvis

All infection with meningococcal germs is horrible, but there is one code named Men-W which is even worse than most. Most cases of meningitis caused by men disease, or meningococcal disease, kill about 1 in 10 to 1 in 20 people who get it. Men-W kills up to one in 7 and it’s on the rise.

7 years ago only 1 in 100 cases of meningitis caused by men disease were due to Men-W, but last year that was 1 in 4. And what’s worse, there are ten times more cases reported last year than over 6 years ago.

Teenagers seem to be particularly vulnerable, whether it’s because they spend a lot more time in contact with each other, living in close quarters with new people, we don’t know. But we do know that there is now a new meningitis vaccine; it was introduced in 2016 and any teenager or young person about to go off to university is eligible a Men-ACWY vaccine, free on the NHS. Since that introduction not a single person who has been vaccinated has died from Men-W.

How do you get vaccinated against meningitis?

Dr Sarah Jarvis

When we think about vaccines for meningitis we tend to think about the Men vaccines which protect against the meningococcal germ, but actually, it's not just that that can cause meningitis. So for instance, every baby in the UK is now eligible for vaccine with Men-B and against pneumococcus at 8 and 16 weeks and again with the booster at one year.

Then of course there is Men-C, and babies are offered a booster against that and against HIB, which is haemophilus influenza, at one year as well. But as part of the standard 2, 3 and 4 month vaccines, babies are also offered the HIB vaccine, as well as other vaccines, and at one year they also get MMR vaccine. Now we forget that before the introduction of MMR vaccine, mumps used to be one of the most common causes of meningitis.

All teenagers - anyone from 6th form going to university or up to the age of 25 - in case they have missed it, are also to eligible to receive the Men-ACWY, which protects against 4 different kinds of meningitis, including the Men-W.

Where does your neck hurt with meningitis?

Dr Sarah Jarvis

Meningitis is the inflammation of your meninges - those are the tissues that lie in your brain and your spinal cord that run down the back of your neck into the whole of your spine. If you think about it, anything that’s inflamed hurts when you stretch it.

So when you bend your neck forwards like this and put your head down on your chest then your meninges are going to be stretched and that will cause worse pain. If you take it one step further, as well as putting your chin on your chest, if you bring your knee right up to your chin you are stretching your spinal cord both at the top and at the bottom and that can make the pain worse still. If you think that there is any chance that you might have meningitis always seek medical help immediately.