Meningitis is an inflammation of the meninges, the tissues that surround and protect the spinal cord and brain. Meningitis is a serious condition that is most commonly caused by viral or bacterial infections, and requires urgent medical attention. If you think you, or somebody else, is displaying symptoms of meningitis then you should seek medical help immediately. The symptoms of meningitis differ between ages, so it is important to know which symptoms to look out for.

What are the symptoms of meningitis?

The symptoms of meningitis in babies include:

• Crying, which is sometimes described as an unusual cry
• Cold hands and feet, even with a fever
• Pale or blotchy skin, which may turn blue
• Refusing to feed
• Fast or unusual breathing
• A bulging fontanelle (the soft spot on the head)
• Drowsiness and difficult to wake up
• Jerky movements or convulsions
• Stiff or floppy body

The symptoms of meningitis in older children and adults include:

• Severe headache
• Fever
• Stiff neck
• Nausea and vomiting
• Sensitivity to light
• Tiredness and lack of energy
• Confusion
• Seizures

The first signs of the meningitis can be hard to spot – the early symptoms of meningitis are very similar to those of the flu and other milder illnesses, so meningitis can be very difficult to identify at first. As meningitis can be potentially life-threatening, it is important to learn how to identify the early symptoms that distinguish meningitis from other illnesses.

A bad headache and a stiff neck are telltale signs of meningitis – while a number of the early symptoms of meningitis have similarities to other illnesses, a severe headache and a stiff neck are signs that the meninges in the head and neck may be becoming inflamed as a result of meningitis. These two symptoms are key to look out for to help differentiate meningitis from the flu. Sensitivity to light is also another symptom that is not commonly seen in illnesses such as the flu, which can also be indicative of meningitis.

The “tumbler test” cannot be relied on to identify meningitis – a well known symptom of meningitis is the distinctive red rash that does not fade when a glass is pressed against it (this is called the glass test or tumbler test). This rash is actually a sign of blood poisoning (septicaemia) caused by bacterial meningitis, which means that the infection has already spread and urgent medical attention is required. As the red rash is a symptom of sepsis secondary to only one type of meningitis (bacterial meningitis), lots of cases of meningitis  may not display this symptom.

How long do the symptoms of meningitis take to appear?

The first symptoms of meningitis typically happen very quickly – much like the flu, the symptoms of meningitis can come on quite suddenly and progress in a short amount of time. This is especially true for bacterial meningitis, the second most common type of meningitis in the UK, which can progress to causing serious health complications or even death in a matter of hours.

Symptoms of viral meningitis appear within a week – viral meningitis is usually milder and less aggressive than bacterial meningitis, and  the symptoms come on slower. The first symptoms of viral meningitis typically appear between 3 to 7 days after being exposed to the infection.

Symptoms of bacterial meningitis appear and progress quickly – bacterial meningitis is the most dangerous type of meningitis, and the infection progresses the fastest. Symptoms of bacterial meningitis can appear just a few hours, though in some cases may appear 1 to 2 days afterwards. Because of this, it is vital to seek treatment immediately if symptoms appear.

Fungal meningitis comes on gradually – fungal meningitis is a very rare type of meningitis in the UK, but is more common in regions of Africa. Fungal meningitis is caused by the inhalation of fungal spores in dirt and soil, which then infect the spinal cord and brain. Fungal meningitis has a very gradual onset, typically over the course of weeks or even months, which can make it even harder to detect than other forms of meningitis.

How long do the symptoms of meningitis last?

The length of time depends on the type and treatment – as there different types of meningitis that are caused by different triggers, the length of time you will be symptomatic depends on the type of meningitis that you have been affected by. Getting early treatment, particularly for bacterial meningitis, will improve the chances that you will fully recover without suffering long term after-effects. Treatment will depend on what type of infection caused the symptoms of meningitis, but typically antibiotics will be administered directly into the vein before the diagnosis has been confirmed. This is a precaution taken in case of bacterial meningitis, which can progress rapidly without treatment. If the diagnosis confirms that you do not have bacterial meningitis, then antibiotic treatment will stop.

Viral meningitis – the symptoms of viral meningitis are typically quite mild, and will usually go away in 7-10 days without requiring extensive treatment. Once diagnosed by a medical professional, most cases of viral meningitis can be recovered from at home with rest and painkillers.

Bacterial meningitis – bacterial meningitis has a sudden onset, and can cause serious health problems, or even death, within 24 hours if left untreated. If treated early, the symptoms of bacterial meningitis can improve in as little as 2-3 days.

Fungal meningitis – fungal meningitis has a gradual onset, but also takes a long time to recover from. Depending on the type of fungus that has caused this infection, symptoms can last for weeks to months even with treatment.

Parasitic meningitis – meningitis caused by a parasitic infection can progress rapidly, usually over the course of 1 to 12 days, and is fatal in almost all cases. Between 1962 and 2008, 97% of confirmed cases of meningitis caused by the parasite Naegleria fowleri the US were fatal.

Non-infectious meningitis – non-infectious meningitis, as an umbrella term for meningitis caused by a variety of non-infectious triggers, is dependant on what has lead to the inflammation. Symptoms can be expected to be relieved after the underlying cause has been diagnosed and treated.

The after-effects of meningitis can be lifelong – some survivors of meningitis will suffer lifelong health complications that may have a significant impact on their lives. For those who do experience long-term after-effects of meningitis, there are a number of organisations that can offer support and advice, for example Meningitis Now and the NHS’s counselling services, which you can talk to your GP about. Some after-effects of meningitis may be managed with the assistance of medical technology, such as cochlear implants for those who have experienced hearing loss, or prosthetic limbs for amputees.

What happens as meningitis progresses?

Meningitis can be life-threatening – all types of meningitis can cause serious health complications if they are left untreated, especially bacterial meningitis. Bacterial meningitis is fatal in up to 70% of cases when it is not treated, and is estimated to be fatal in 10% of cases where it is treated.

Meningitis can cause life-changing after-effects – meningitis, as an inflammation of the tissues around the brain and spine, can lead to long-term health complications in survivors. It is estimated that 20% of survivors of bacterial meningitis will suffer after-effects as a result.

Possible complications of meningitis include:

• Partial or total hearing loss
• Partial or total vision loss
• Neurological damage, such as memory loss and behavioural changes
• Epilepsy
• Difficulty with movement and coordination
• Loss of limbs
• Septicaemia (bacterial meningitis only)

What should I do if I think I’m having symptoms of meningitis?

Meningitis is a medical emergency – left untreated, all types of meningitis have the potential to cause death or life-altering after-effects. If you are seriously ill and suspect that it is as a result of meningitis, call 999 or go to the nearest A&E immediately for emergency care.

Do not wait to see if your symptoms improve – it’s better to be safe than sorry with meningitis, as the infection can progress rapidly and could potentially have a serious impact on your health if not treated in a timely manner. If your symptoms are mild, or even if you’re not completely sure that you’re displaying symptoms of meningitis at all, you can still call NHS 111 for advice. You’ll be put in contact with a trained adviser who will be able to offer assistance, and let you know whether or not you need to see a doctor.