Looking out for meningitis

Meningitis is a word that strikes fear in the heart of any parent. And I've just heard that a child at a friend's school has died from it. Apparently another child they know died of it last year. This is the kind of news that sends me to The Meningitis Trust like I'm drilling for a test (and in a way, I am, just in case). The signs and symptoms:

* feeling unwell

* fever with cold hands and feet

* floppy, drowsy or difficult to wake

* headache

* stiff neck

* dislike of bright lights

* rash

Apparently the much-talked-about petechial rash (ie, doesn't go away when you press a glass on it) didn't show up in this case and the local hospital didn't catch it either. It's just a reminder that as parents we have to educate ourselves, be proactive and not be afraid to challenge doctors if we think they've got it wrong.

Here's a good piece from the BBC that tells more about meningitis.

 

Comments

[M]

I was away when this was posted. It brings me back to when my daughter had a suspected case of meningitis, she had a full house of symptoms, really. In fact, she was severely dehydrated, which could have caused brain damage, so she was kept in hospital for days, on a drip and I can't speak highly enough of the staff there. Better safe than sorry was the feeling.

[Weaselwords]

Thanks, Dectora. I've done some research now, to satisfy my curiosity and I see that scarlet fever is still a notifiable disease in the UK. And it's the complications such as rheumatic fever and meningitis (!) that kill people (complications which are generally avoided by treating the original disease with ABs). So, another batch of symptoms to watch out for (as I mentioned, there were several cases in local schools here last winter). And another reason to be grateful for antibiotics.

[Dectora]

Weaselwords. Scarlet fever is easily managed with antibiotics. I should know as I had it aged 22, in the Midddle East.

[Chris]

Every time my child (now 3 years) has ever had a fever, she has also had cold hands and feet. Therefore, in her case, this symptom has never been indicative of meningitis.

[Lucy]

This is such an important post. It has made me stop and take time to learn all the signs. To everyone who's had experience with meningitis, thanks for sharing. I am sure that the right thing to do is to ring 999, and that goes for adults too. It's often teenagers who catch meningitis, and because the symptoms appear similar to a hangover, it can go unnoticed in young students. Therefore, it is always worth checking up on friends or children, even if 99 times out of 100 they are just 'sleeping it off'. No doctor worth their salt should be angry with you for wanting to check up on a notoriously subtle set of symptoms.

[LizG]

My daughter had a lumbar puncture at 36 hours old as she had a Group B Strep infection and they were concerned that she'd also developed meningitis, which thankfully she hadn't.

But she had still deteriorated rapidly. I'd left her in the ward nursery as I'd been awake for 3 days and needed rest and she was fine when I left her. 2 hours later I was woken by a doctor asking my instant permission for the lumbar puncture and to give her every drug they could think of. By the time I got to SCBU she was on life support and I was given a polaroid picture by a kind nurse so I'd have 'something to remember her by'.

It happens so fast, so if you think something is wrong basically hold your ground and get a second/third/fourth opinion as soon as you can. My daughter was lucky enough to survive with nothing wrong with her but I know many children and parents who were not as fortunate.

[Amireallyamummy?]

My daughter had a lumbar puncture at 3 weeks (she had fever, mottled skin, listless) and although I was considerably freaked out (understatement), it at least showed nothing scary. We still spent 3 nights in hospital, with IV antibiotics strapped to her arm until whatever infection she had subsided. My husband thought the hospital/doctors had overreacted but to me this was the only way to deal with it (well done Royal Surrey in Guildford). At no time did I feel they or I were idiots. And even if I did, mild embarrassment is a small price to pay. Even now I cry when I think of what it could have been.

[Kitta]

A Lumbar puncuture (LP)is the ONLY reliable tool with which meningitis can be excluded. LP can also tell if it is viral or bacterial. And if it is bacterial what bug and therefore what anti-b's to give. A lumbar puncture is never a waste of time and can be used to diagnosis a vast range of illness quickly and accuratily
Here ended the lecture........
I'm in teacher mode today, could you tell?

[Lazy Mummy]

J - yes, you're right about the lumbar puncture, that's what I was alluding to earlier when talking about my brother (I said spinal tap - too much time dealing with US medics - but it was lumbar puncture & that's why they did it).

[j]

Another thing I am told by my medic friends is that young children go from being OK-ish to being nearly dead very very quickly- much faster than adults. So haning about is not a good idea- and cerrtainly we hear many stories of people who hit the hospital a bit too early and are sent home, then the child gets worse. Has to be worth gong back.

Caroline, I think the lumbar puncture is to get a sample of the bug itself, as there are lots of different strains, so you can use the right antibiotic and hit it efficiently. The infection is rushing round the system carried in the cerebrospinal fluid as I understand it, and you dont want to be getting it out of the brain.

[Caroline]

Also, one symptom is aching legs prior to the onset of meningitis. I was at a wedding reception and told one of the guests that my son was unwell and one of the symptoms were aching (my son had come home from school, lay on the sofa and complained of both legs aching) and he said ' I hate to say this but that is one of the symptoms of meningitis' As it turned out he was right. I would also add that do not take them to the doctors surgery if you think it may be meningitis, take them straight to the hospital, many doctors do not have experience of this disease. I would also like to know why time is wasted doing a lumbar puncture.

[mumoftwo]

It seems that so many of us know people who have had meningitis or lost children to meningitis. It's so sad.

I also think it's really important to take direct action if you believe your children to be really ill and never to worry about what people might think. I know that phoning NHS Direct, or waiting til the next day to see a doctor, whilst fine if they really only have a cold or a minor infection, can waste valuable time if children are very ill. If I thought the children were seriously ill/had meningitis, I would just phone 999 or drive straight to A and E and worry about looking like an idiot later (I have had to do this recently over a different illness, when my family were dithering, not sure at what point to call the ambulance). Plus I have to say that ambulance men and women are just the nicest people in the NHS, but that's probably because I'm usually looking up at them thanking god they are there and they seem almost heroic (or is that the gas and air...?)

[j]

Apologies for descending into cut'n'post but I can never get links to work:

"Oxford researchers are part of a team reporting encouraging results in a clinical trial of a new meningitis vaccine at a conference in Austria this week.

The new vaccine developed by the pharmaceutical company Novartis offers hope that infants could be protected against the B strain of meningococcal disease. The trial involved 150 babies from the Oxford area and was set up with help from Andrew Pollard and colleagues at the Oxford Vaccine Group.

After a series of three immunizations starting when the babies were 2 months old, 85 per cent, 89 per cent and 96 per cent of the infants showed an immune response that would protect them against three different strains of meningitis B. Now that the extent of protection against different strains of the disease has been shown, the group is starting a large-scale trial of the vaccine.

Meningitis is a particularly frightening contagious disease because it takes hold fast, mostly strikes the young, and can be hard to diagnose. Each year there are approximately 500,000 cases of meningococcal disease worldwide, causing about 50,000 deaths. The B strain of the disease is a leading cause of bacterial meningitis, particularly in Europe where it was responsible for 72 per cent of the cases in 2006.

The vaccine was developed using a new approach based on decoding the genetic makeup of meningococcal strain B. With this information, a number of new proteins were discovered and a vaccine produced with those that showed the greatest ability to stimulate the immune system against meningitis B. "

link is http://www.ox.ac.uk/media/news_stories/2008/080516.html but dont hold your breath, they never work when I do them.. They hope to go to market in 3 years apparently.

[Lazy Mummy]

Here in the US, Hib is a standard vaccine these days & according to our paediatrician, is the main reason deaths from one strain of meningitis have plummeted over the last few years in the US (since it was introduced).

Meningitis is a terrifying illness, partly because it strikes so quickly. Both my brothers had it (not at the same time), one was hospitalised, had spinal tap, the works while they were determining which strain he had & how to treat him & it was touch & go for a day or two as to whether or not he'd pull through. I think there was very little warning that they were about to be ill and it was probably one of the most stressful thing my parents encountered as parents, certainly the most serious illness they had to deal with.

The symptoms I remember were all on Jen's list and doctor friends & our family doctor have also said what Mo2 did about listlessness being the worrisome factor with children. I've also heard (since becoming a parent) that it's really important to impress on the doctors that your child's behaviour is very different from normal - worryingly so - and not to take no for an answer if you have any concerns at all that your child is more poorly than they think. Especially if you're dealing with a doctor who's not your regular GP and doesn't know your child.

Agree with Mo2 that good doctors will always squeeze in an appointment to see a child if the parents are worried (and IMO, if they won't, you should probably find a new doctor).

[Tara@From Dawn Till Rusk]

You are so right that this is one word that strikes fear into every parent's heart.
It is vital to remind parents over and over, it's so easy to become complacent and lose that vigilance.
I am going to put up a link on my own blog now (i just might go and check in on my two first though . . . )

[Weaselwords]

Just checked and the recommended age for a child to have the MMR booster is 3 years 4 months. Also, forgot to mention that the pneumococcal vaccine - which also protects against septicaemia and meningitis - is also included in the current programme of vaccinations for infants in the UK.

[Weaselwords]

It's a "pre-school" booster to be given before the child starts full-time school - so you may get a letter from your surgery any time in the next few months, I would imagine. My son won't be called in until the autumn, but I have made an appointment for him to have the MMR booster etc in the summer holidays, as I would like him to go through the winter as fully protected against bugs as he can be. As long as the correct amount of time has elapsed between the initial MMR shot (given at 13 months) and the booster, you should be able to make an appointment for your child to have the booster and Hib / Men C.

[Gipsy]

I've not been offered the MMR booster yet, and my child is 3.

[Weaselwords]

The vaccination programme for infants has changed in the last couple of years and now includes jabs for Hib and Men C to protect children against 2 types of meningitis. Children aged between 2 and 3 should be offered "catch-up" jabs with their pre-school MMR booster.

[Sue]

Interesting question about SF. I went and checked, and it's a bacterial infection (Group A Strep for those who know what that is!), and is treatable by AB, which, presumably, is why it's no longer a major child killer?

Apparently it's very contagious - "Group A streptococcal infections that cause scarlet fever are very contagious. Strep bacteria can be passed through contact with the nasal or throat fluids of someone with a strep throat infection. Strep bacteria can also be transmitted by touching the infected skin of someone who has strep impetigo, or by sharing towels, clothing or bed linen".

So, guess it's worth still being on guard for it.

[Weaselwords]

Why have deaths from Scarlet Fever declined? There is no vaccine for that, is there? And there were several cases in schools in my local area last year. Just wondering...

[Gipsy]

Jo, yes although I'm not sure if the teenage meningitis program is still being rolled out (both my step children had that one).

[Jo]

There is a vaccine for Men C but I think you only get that when you are older. I think I got it at 15.

[Sue]

Thank you for a very good thread. I too know of someone who died of meningitis, and it is terrifying to think of.

I agree that GPs/docs are usually very sympathetic to 'parental paranoia', though perhaps I've just been lucky. It must surely strike fear into any GP/doc themselves that they might mis-diagnose meningitis.

[Gipsy]

I am utterly terrified of this one too. Mostly I suspect because my cousin died of it. There's nothing like close proximity to something like that, and seeing the fallout (with my aunt and uncle and the surviving siblings and my family as a whole) to strike the fear of god into your heart.

The fever cold hands/feet tip is a good one. And thanks MoT for the reminder about fever and responsiveness. Anyone got anything else?

Son has had one meningitis jab, for the strain that is prevalent in NZ but not in any other country in the world. As soon as it is his turn here I'll be right there.