Meningitis

Meningitis is an inflammation (swelling) of the protective membranes (meninges) covering your brain and spinal cord. The swelling from meningitis typically triggers symptoms such as headache, fever and a stiff neck. Get medical help immediately if you suspect someone might have meningitis.

Key points

  1. There are many causes of meningitis, the most common being viral or bacterial infection.
  2. Bacterial meningitis can develop very rapidly over a few hours and can cause serious complications or even death.
  3. Those most at risk are babies and young children under 5 years, teenagers and young adults, older adults, those with weakened immune systems or those living in shared accommodation.
  4. Common symptoms of meningitis include a sudden high fever, headache, sleepiness, joint and muscle pain.
  5. If you suspect someone might have meningitis contact your doctor without delay. Bacterial meningitis can be treated with antibiotics, but early treatment is important.
  6. A number of vaccinations are available that offer some protection against meningitis.

What are the symptoms of meningitis?

People with meningitis may have some or all the following symptoms:

Babies and children Teenagers and adults
  • fever
  • crying, unsettled, irritable
  • refusing drinks or feeds
  • vomiting
  • sleepy, floppy, harder to wake
  • stiff neck, dislike of bright lights
  • reluctant to walk
  • rash 
  • fever
  • headache
  • vomiting
  • sleepy, confused, delirious, unconscious
  • joint pains, aching muscles
  • stiff neck
  • discomfort looking at bright lights 
  • rash 
If you suspect someone might have meningitis contact your doctor without delay (or call Healthline free on 0800 611 116 at any hour of the day or night) even if you have already been seen by a health professional.

What causes meningitis?

Meningitis is usually caused by a viral or bacterial infection. Viral infection is more common but less severe than bacterial infection, which can be life-threatening.

The viruses and bacteria that cause meningitis may live in your nose and throat. People of any age can carry them without becoming ill, but can infect others through close contact (ie, coughing, sneezing, sharing utensils).

Some of the viruses and bacteria that can cause meningitis include:

There are a number of different vaccines that help provide protection against the infections that can cause meningitis.

Less common causes of meningitis include cancer, lupus, some medications, head injury or brain surgery.

Who is at risk of meningitis?

Anyone can get meningitis, but some groups of people have a higher risk of getting it, for example:

  • anyone who hasn't completed the recommended childhood or adult vaccination schedule
  • children younger than 5 years old have a higher risk of viral meningitis
  • babies and toddlers under the age of 2, and adults over the age of 50 have a higher risk of bacterial meningitis. Meningococcal meningitis tends to occur mostly in adolescents and young adults, as well as young children.
  • people living in a community setting such as students living in dormitories, people on military bases, children in boarding schools and child care facilities, and those living in overcrowded housing.
  • people with a weakened immune system such as people with diabetes, alcoholism, or AIDS, or anyone who has had their spleen removed or who has a poorly functioning spleen.

How is meningitis diagnosed?

Meningitis can be very difficult to diagnose because the early symptoms are often similar to influenza (the flu). Your doctor also needs to determine whether meningitis is viral or bacterial or has some other cause. They may order several tests or seek specialist advice. Diagnosis may include:

  • taking a detailed history of signs and symptoms
  • clinical examination
  • blood tests
  • a lumbar puncture, which may be done in hospital (spinal fluid is removed using a needle and examined for bacteria).

How is meningitis treated?

Treatment of meningitis depends on the cause:

  • Bacterial meningitis is treated immediately with intravenous (into your veins) antibiotics. This helps to ensure you recover and reduces the risk of complications, such as brain swelling and seizures.
  • Viral meningitis is usually mild and often clears on its own. Treatment may include supportive care such as resting, keeping warm and comfortable and drinking plenty of fluids. Viral meningitis cannot be treated with antibiotics.
  • Non-infective meningitis may be treated with corticosteroids. In some cases, no treatment may be required, because the condition can get better on its own. Cancer-related meningitis requires therapy to manage the cancer.

Prevention

  • Get vaccinated against certain bugs that cause meningitis & other childhood diseases
 – read more about vaccines that protect against meningitis
  • Wash hands regularly & don’t share personal items.
  • Keep your distance from infected people if you are well and from healthy people if you are sick.
  • Take care of your general health and immune system by eating plenty of fruit and vegetables and exercising regularly. Avoid recreational drugs, excessive alcohol and cigarette smoke.
  • Get prompt treatment if you are concerned.

Read more about preventing meningitis

Learn more

The following links provide more information on meningitis. 

What is meningitis? The Meningitis Foundation, NZ
Meningitis Patient. Info UK
Meningitis Mayo Clinic

Credits: Editorial team. Reviewed By: Dr Katie Walland, Advanced Trainee, Infectious Diseases, Waikato Hospital Last reviewed: 17 Jan 2019