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Meningitis

Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults.

Symptoms of meningitis, septicaemia and meningococcal disease include:

  • headache
  • a stiff neck
  • a dislike of bright lights
  • a high temperature
  • cold hands and feet
  • vomiting
  • confusion
  • breathing quickly
  • muscle and joint pain
  • pale, mottled or blotchy skin
  • spots or a rash
  • being very sleepy or difficult to wake
  • fits (seizures).

There are two types of meningitis:

  • Bacterial - a serious infection that requires urgent treatment with antibiotics. Can result in long term complications.
  • Viral - generally a less serious infection which doesn't often result in long term complications. Does not need treatment with antibiotics.

Unfortunately, without tests, it can be extremely difficult to distinguish between the two.

However, following the introduction over the past few years of routine vaccinations for babies against infections such as meningococcus, pneumococcus and haemophilus, the rates of bacterial meningitis in children have more than halved. As a result, the number of children affected each year by bacterial meningitis in the UK is now less than 1 in 10,000.

When should you worry?

If your child has any of the following:

  • Has a fit / seizure
  • Becomes extremely agitated (crying inconsolably despite distraction), confused or very lethargic (difficult to wake)
  • Is pale and/or mottled and feels abnormally cold to touch
  • Is breathing very fast or going blue around the lips
  • Develops a rash that does not disappear with pressure (the ‘Glass Test’)
  • Is under 3 months of age with a temperature of 38°C / 100.4°F or above (unless fever in the 48 hours following vaccinations and no other red or amber features) 

You need urgent help.

Go to the nearest hospital emergency (A&E) department or phone 999

If your child has any of the following:

  • Is complaining of a severe headache and neck stiffness/pain
  • Complains of discomfort with bright lights (photophobia)
  • Is becoming drowsy (excessively sleepy) or irritable (unable to settle them with toys, TV, food or picking up) – especially if they remain drowsy or irritable despite their fever coming down
  • Appears to be becoming confused
  • Is finding it hard to breathe
  • Seems dehydrated (sunken eyes, drowsy or not passed urine for 12 hours)
  • Has extreme shivering or complains of muscle pain (for no obvious reason)
  • Is 3-6 months of age with a temperature of 39°C / 102.2°F or above (but fever is common in babies up to 2 days after they receive vaccinations)
  • Is not improving after 5 days
  • Is getting worse or if you are worried

You need to contact your GP surgery today

Please ring your GP surgery or contact NHS 111 - dial 111, or for children aged 5 years and above visit 111.nhs.uk

If none of the above features are present

Additional advice is also available to help young families cope with crying of well babies – click here.

Pharmacy/self-care

Pharmacists can advise and treat a range of common symptoms. No appointment is needed and most pharmacies have a private consulting area. Click on this link to find a Pharmacy near to you

If you are still concerned about your child, contact NHS 111 – dial 111 or for children aged 5 years and above visit 111.nhs.uk

This guidance has been reviewed and adapted by healthcare professionals across the Black Country Integrated Care System.

What should you do?

Only a tiny proportion of children who have a fever and are miserable have bacterial meningitis. Look closely at the symptoms in the red box. If your child has these, they need to see a doctor urgently. If not:

  • To make your child more comfortable, you may want to lower their temperature using paracetamol and/or ibuprofen. However, remember that fever is a normal response that may help the body to fight infection and paracetamol/ibuprofen will not get rid of it entirely.
  • Avoid sponging your child with tepid or cool water – it doesn’t actually reduce your child’s temperature and may cause your child to shiver.
  • Encourage them to drink plenty of fluids.

If a rash appears, do the glass test.

Where should you seek help?

For wear and tear, minor trips and everything in between.

Self-care

You can treat your child's very minor illnesses and injuries at home.

Some illnesses can be treated in your own home with support and advice from the services listed when required, using the recommended medicines and getting plenty of rest.

Sound advice

Children can recover from illness quickly but also can become more poorly quickly; it is important to seek further advice if a child's condition gets worse.

For information on common childhood illnesses go to What is wrong with my child?

Pharmacists are experts in many aspects of healthcare and can offer advice on a wide range of long-term conditions and common illnesses such as coughs, colds and stomach upsets. You don’t need an appointment and many have private consultation areas, so they are a good first port of call. Your pharmacist will say if you need further medical attention.

Sound advice

  1. Visit a pharmacy if your child is ill, but does not need to see a GP.
  2. Remember that if your child's condition gets worse, you should seek further medical advice immediately.
  3. Help your child to understand - watch this video with them about going to the pharmacy.

For information on common childhood illnesses go to What is wrong with my child?

Health visitors are nurses or midwives who are passionate about promoting healthy lifestyles and preventing illness through the delivery of the Healthy Child Programme. They work with you through your pregnancy up until your child is ready to start school.

Health Visitors can also make referrals for you to other health professionals for example hearing or vision concerns or to the Community Paediatricians or to the child and adolescent mental health services.

Contact them by phoning your Health Visitor Team or local Children’s Centre.

Sound advice

Health visitors also provide advice, support and guidance in caring for your child, including:

  • Breastfeeding, weaning and healthy eating
  • Exercise, hygiene and safety
  • Your child’s growth and development
  • Emotional health and wellbeing, including postnatal depression
  • Safety in the home
  • Stopping smoking
  • Contraception and sexual health
  • Sleep and behaviour management (including temper tantrums!)
  • Toilet training
  • Minor illnesses

For more information watch the video: What does a health visitor do?

School nurses care for children and young people, aged 5-19, and their families, to ensure their health needs are supported within their school and community. They work closely with education staff and other agencies to support parents, carers and the children and young people, with physical and/or emotional health needs.

Contacting the School Nurse

Primary and secondary schools have an allocated school nurse – telephone your child’s school to ask for the contact details of your named school nurse.

There is also a specialist nurse who works with families who choose to educate their children at home.

Sound Advice

Before your child starts school your health visitor will meet with the school nursing team to transfer their care to the school nursing service. The school nursing team consists of a school nursing lead, specialist public health practitioners and school health staff nurses.

They all have a role in preventing disease and promoting health and wellbeing, by:-

  • encouraging healthier lifestyles
  • offering immunisations
  • giving information, advice and support to children, young people and their families
  • supporting children with complex health needs

Each member of the team has links with many other professionals who also work with children including community paediatricians, child and adolescent mental health teams, health visitors and speech and language therapists. The school health nursing service also forms part of the multi-agency services for children, young people and families where there are child protection or safeguarding issues.

If you’re not sure which NHS service you need, call 111. An adviser will ask you questions to assess your symptoms and then give you the advice you need, or direct you straightaway to the best service for you in your area.

Sound advice

Use NHS 111 if you are unsure what to do next, have any questions about a condition or treatment or require information about local health services.

For information on common childhood illnesses go to What is wrong with my child?

A&E departments provide vital care for life-threatening emergencies, such as loss of consciousness, suspected heart attacks, breathing difficulties, or severe bleeding that cannot be stopped. If you’re not sure it’s an emergency, call 111 for advice.

Sound advice

  1. Many visits to A&E and calls to 999 could be resolved by any other NHS services.
  2. If your child's condition is not critical, choose another service to get them the best possible treatment.
  3. Help your child to understand – watch this video with them about going to A&E or riding in an ambulance
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