Meningitis in children

What is meningitis?

Meningitis means inflammation of the meninges — the lining around the brain and spinal cord. It is usually caused by a bacterial or viral infection.

Meningitis is a serious condition that can develop suddenly and can be life-threatening. It’s important to seek immediate medical attention if your child has symptoms of meningitis so that it can be treated promptly.

There are vaccines available that can help protect your child from many types of meningitis.

What are the symptoms of meningitis?

The symptoms of meningitis in babies and young children include:

  • very high body temperature (fever) or very low body temperature;
  • loss of interest in food;
  • drowsiness and lethargy;
  • irritability and fretting;
  • vomiting;
  • diarrhoea;
  • red or purple skin rash;
  • becoming 'floppy' or unusually stiff;
  • irregular breathing;
  • have a bulging or tight fontanelle (soft spot on top of a baby’s head); and
  • sensitivity to light (disliking light as it hurts the eyes).

Symptoms in older children may also include:

  • headache;
  • sensitivity to light;
  • neck stiffness;
  • sore throat;
  • joint pains;
  • vomiting;
  • irritability and confusion; and
  • seizures.

Meningitis can develop suddenly and become serious very quickly, so urgent medical attention must be sought if you suspect a baby or child has meningitis.

Sometimes the early signs of meningitis are not obvious, and neck stiffness is often absent in infants. Parents are usually very instinctive about their children. If you believe there is 'something not quite right' with your child, you should take him or her to your doctor to exclude a serious illness.

What causes meningitis?

Meningitis in children is usually caused by a viral or bacterial infection. Bacterial meningitis is generally more severe than viral meningitis.

Bacterial meningitis

Most cases of bacterial meningitis in children in Australia are caused by one of 3 different types of bacteria:

  • Neisseria meningitidis - commonly known as the meningococcus bacterium;
  • Streptococcus pneumoniae - commonly known as the pneumococcus bacterium; and
  • Haemophilus influenzae type B.

These bacteria can also cause septicaemia, where the bacteria invade the bloodstream. This is also a medical emergency and can be life-threatening.

Since immunisation against Haemophilus influenzae type B (Hib) became part of the National Immunisation Program Schedule in 1992, Hib meningitis has become rare.

The National Immunisation Program Schedule now also includes vaccines against several strains of pneumococcus and the group C strain of meningococcus, leading to a significant reduction in cases of pneumococcal and meningococcal meningitis as well.

Viral meningitis

Meningitis can also be caused by viruses, including enteroviruses, influenza virus and herpes simplex virus (HSV). Measles, chickenpox and mumps viruses can also lead to viral meningitis, but thanks to immunisation these infections are now rare in Australia.

How is meningitis spread?

Bacteria and viruses can be spread from person to person by close contact, or by breathing in tiny droplets sprayed into the air when an infected person coughs or sneezes. Kissing is another way that germs can be spread from one person to another.

Bacteria that can cause meningitis live in the nose and throat of some adults and children without affecting them or causing them to be unwell. In fact, about one in 10 Australians carries the meningococcus bacterium in their respiratory tracts without suffering any disease themselves. This carriage rate may be higher in groups of people living in crowded conditions. People who smoke are more likely to be carriers than non-smokers. Carriers can infect others by coughing or sneezing on or near them.

Diagnosis and treatment of meningitis in children

Your doctor will ask about your child’s symptoms and perform a physical examination looking for signs of meningitis. If your doctor suspects meningitis, they may recommend tests for your child, such as:

  • blood tests; and
  • a lumbar puncture (a procedure where a sample of cerebrospinal fluid - the fluid that surrounds the brain and spinal cord - is taken from the lower back and tested for infection).

In cases of suspected bacterial meningitis, your doctor may start treatment with antibiotics before any tests are done, so that your child will have the best chance of recovery. They may also give an injection of corticosteroids.

Children with meningitis usually need to be treated and closely monitored in hospital. Medicines and fluids are usually given via a drip into a vein (intravenously).

Bacterial meningitis needs treatment with antibiotics and corticosteroids to treat the infection and help prevent complications. Pain relievers are also given. Some types of viral meningitis can be treated with antiviral medicines, but in many cases there is no specific treatment for viral meningitis and children get better with rest, fluids and pain relief.

Can meningitis be prevented by a vaccine?

Haemophilus influenzae type B

As mentioned earlier, the Haemophilus influenzae type B (Hib) vaccination programme has drastically reduced the incidence of meningitis due to Hib in Australia. Several doses are needed to protect your child from Hib infection - these are all included as part of routine childhood vaccinations.

Meningococcus

There are several different serogroups, or strains, of meningococci – those that most commonly cause disease are groups A, B, C, W and Y.

In Australia, vaccines available against meningococcus include:

  • Meningococcal C vaccines (against meningococcal disease caused by a type of meningococcus called group C). This vaccine is routinely given in childhood, and has significantly reduced the number of cases of group C meningococcal disease.
  • Meningococcal B vaccine. A vaccine against group B meningococcus is available on prescription in Australia, but is not currently available on the National Immunisation Program Schedule. It is recommended for infants and young children, especially those younger than 2 years of age. It is also recommended for adolescents aged 15-19 years.
  • Quadrivalent vaccines (effective against 4 serotypes of meningococcus: A, C, W-135 and Y). Quadrivalent vaccines are used in people who have conditions that put them at risk of meningococcal disease. They are also recommended for people travelling to parts of the world where these 4 serogroups of meningococcus are common — particularly pilgrims attending the annual Hajj in Saudi Arabia. Due to increasing rates of type W and (to a lesser extent) type Y meningococcal disease, several States in Australia have recently introduced school-based immunisation programmes for teenagers, aimed at immunising against these 4 serotypes.

Pneumococcus

There are at least 90 different subtypes of Streptococcus pneumoniae that have been identified. Most of them cause disease, but only some cause serious infections. Vaccines against the pneumococcus that are available in Australia include:

  • the 13-valent pneumococcal conjugate vaccine (13vPCV), which offers protection against the 13 serotypes that cause the majority of invasive pneumococcal disease in young children in Australia; and
  • the 23-valent pneumococcal polysaccharide vaccine (23vPPV), which offers protection against the 23 most common or most disease-causing types of pneumococcus.

The pneumococcal conjugate vaccine (13vPCV) is recommended for all children, and is given as part of the National Immunisation Program Schedule. Vaccination with 23vPPV may also be recommended for certain children who are at increased risk of pneumococcal disease.

Viral meningitis

While there is no vaccine for enteroviruses (now the most common cause of viral meningitis), there are vaccinations available against many viral infections that can lead to meningitis. These include measles, mumps and chickenpox vaccinations, which are part of the National Immunisation Program Schedule. Influenza vaccination is also available and recommended each year for children older than 6 months.

Antibiotics to prevent meningitis

If you or your child has been in close contact with someone who has developed bacterial meningitis, your doctor may recommend that you take antibiotics to help prevent infection. Talk to your doctor if you are concerned about a possible exposure to bacterial meningitis.

Meningitis: what the words mean
BacteriumSingular of bacteria, a type of germ.
MeningitisInflammation of the membrane covering the brain and spinal cord.
MeningesMembrane covering brain and spinal cord.
Meningococcal infectionThis can result in meningitis or septicaemia or both.
MeningococcusCommon name for a type of bacterium called Neisseria meningitidis.
PneumococcusCommon name for a bacterium called Streptococcus pneumoniae.
SepticaemiaBlood poisoning. Invasion of the bloodstream by disease-causing bacteria, viruses or fungi.
SerotypeA subdivision of a particular species of bacterium or virus based on characteristic proteins it possesses.

 

Last Reviewed: 12 April 2017
myDr

References

1. Australian Government Department of Health. The Australian Immunisation Handbook 10th Edition (updated Mar 6 2017). http://immunise.health.gov.au/internet/immunise/publishing.nsf/Content/Handbook10-home (accessed Mar 2017).
2. Centers for Disease Control and Prevention (CDC). Meningitis (updated 15 Apr 2016). https://www.cdc.gov/meningitis/ (accessed Mar 2017).
3. Royal Children’s Hospital Melbourne. Clinical Practice Guidelines. Meningitis - encephalitis (updated Sep 2012). http://www.rch.org.au/clinicalguide/guideline_index/Meningitis_Guideline/ (accessed Mar 2017).
4. Meningitis (published March 2016). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2016 Nov. http://online.tg.org.au/complete/ (accessed Feb 2017).
5. Immunise Australia Program. Meningococcal disease (updated Apr 2015). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-meningococcal (accessed Mar 2017).
6. Immunise Australia Program. Pneumococcal disease (updated Apr 2015). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-pneumococcal (accessed Mar 2017).
7. Immunise Australia Program. Haemophilus influenzae type B (Hib) (updated Apr 2015). http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/immunise-hib (accessed Mar 2017).
8. Australian Government Department of Health. National Immunisation Program Schedule from November 2016. http://www.immunise.health.gov.au/internet/immunise/publishing.nsf/Content/nips (accessed Mar 2017).
myDr

myDr

myDr provides comprehensive Australian health and medical information, images and tools covering symptoms, diseases, tests, medicines and treatments, and nutrition and fitness.