ONLY half of babies with meningitis show tell-tale signs like a fever leaving doctors more likely to “misdiagnose” the condition, a charity has warned.
For decades a fever has been the trigger for further investigation of a potential infection but new research suggests meningitis should not be dismissed so soon.
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Experts from St George’s, University of London, found the classic symptoms of bacterial meningitis are uncommon in babies younger than three months.
Study author Professor Paul Heath said: “The classic features of meningitis were uncommon in many cases.
“The symptoms displayed by young infants when they are seen by doctors at first in hospital are often non-specific and only half of cases showed signs of a fever.
“Guidelines focusing on serious infections in children – including meningitis – have been introduced in the UK and the USA but all specify fever as a key feature of infection.
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“Unfortunately, neither the rates of bacterial meningitis in babies, nor the numbers of deaths, has changed since the 1980s.
“Clinicians must, therefore, still consider bacterial meningitis in the diagnosis of an unwell infant that doesn’t present with fever.”
Symptoms of meningitis usually include a fever, vomiting, a headache, a blotchy rash that doesn’t fade when a glass is rolled over it, stiffness in the neck, sensitivity to bright lights, drowsiness, cold hands and feet, seizures.
The study, funded by the Meningitis Research Foundation (MRF), looked at 263 infant patients in the UK and Ireland.
It found that a fever – a temperature higher than 38C – was only reported in 54 per cent of cases.
Other common symptoms were also only reported in a small number of cases.
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Only 28 per cent of patients suffered seizures, 22 per cent had bulging in the fontanelle or soft spot and only three per cent had stiffness in the neck.
In the UK babies under three months are 70 per cent more likely to get bacterial meningitis than adults, with newborns being the highest risk group.
MORE THAN A RASH What is meningitis, what are the symptoms of Izzy Weall’s condition, how do you get it and is there a vaccine?
Other common symptoms that doctors and parents are being urged to look for include poor feeding, lethargy and irritability.
Vinny Smith, chief executive at MRF, said: “Young babies are particularly vulnerable to bacterial meningitis.
“Meningitis and septicaemia are deadly diseases that strike without warning.
“Rapid diagnosis and treatment provides the best chance of survival.
“Based on this research, we have collaborated with the study investigators to create a teaching package aimed at doctors and health professionals to aid rapid diagnosis and treatment.
“We hope that this can ultimately improve outcomes for this vulnerable age group.”
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The key symptoms to be aware of
Meningitis can affect anyone, but is most common in babies, young children, teenagers and young adults.
It is the inflammation of the membranes that surround and protect the brain and spinal cord and can be caused by meningococcal bacteria and viral meningitis.
If it’s not treated quickly, meningitis can cause life-threatening septicaemia (blood poisoning) and result in permanent damage to the brain or nerves.
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Around 3,200 people a year get bacterial meningitis.
One in 10 die and many more are left with life-changing disabilities.
Meningitis is usually passed on from people who carry the virus or bacterial form in their throat or nose, but aren’t ill themselves.
It can be spread through kissing, sneezing, coughing and sharing household items such as toothbrushes or cutlery.
MORE ON MENINGITIS
The symptoms of meningitis develop suddenly and include:
- A high fever over 37.5 degrees – the average human temperature
- being sick
- a headache
- a blotchy rash that doesn’t fade when a glass is rolled over it
- stiffness, especially in the neck
- sensitivity to bright lights
- drowsiness, irritability or lack of energy
- cold hands and feet
- seizures
The charity warned the symptoms can easily be mistaken for a hangover.
If you, or someone you know, is experiencing these symptoms you should speak to a GP immediately.
WHO IS ELIGIBLE FOR MENINGITIS VACCINES?
There are several vaccinations that offer protection against meningitis.
They can be given to babies and young adults.
They are:
- The Meningitis B vaccine: this is for babies aged eight weeks, followed by a second dose at 16 weeks and a booster at one year. It will protect your baby against infection by meningococcal group B bacteria, which is responsible for more than 90 per cent of infections in young children.
- 5-in-1 vaccine: this is offered to babies at eight, 12 and 16 weeks of age. This won’t just protect against meningitis, but will also protect against diphtheria, tetanus, whooping cough and polio.
- Pneumococcal vaccine: this is offered to babies at eight weeks, 16 weeks and one year. It will protect against pneumonia, septicaemia and meningitis.
- Meningitis C vaccine: This is offered at 1 year of age, and to teenagers and first-time university students. The success of this vaccine means there are almost no cases of that strain of meningitis in the UK anymore.
- MMR vaccine: This is offered to babies at one year and a second dose at three years and four months. It protects against measles, mumps and rubella, which can lead to meningitis and septicaemia.
- Meningitis ACWY vaccine: This is offered to teenagers, sixth formers and “fresher” students going to university for the first time. The vaccine protects against four different causes of meningitis and septicaemia – meningococcal A, C, W and Y diseases.
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