Meningitis is an infection of the covering layers of the brain (meninges). Meningitis can be caused by various sorts of infection, with a virus, with bacteria, and even with fungi.

• Viral meningitis is usually considered to be benign, and is a fairly common complication of virus infections. There is no specific treatment.

• The three main causes of bacterial meningitis have been:

  • Haemophilus Influenzae type b (Hib)
  • Meningococcus
  • Pneumococcus

  The introduction of a Hib vaccination has led to a virtual eradication of Hib meningitis in countries with vaccination programs. The other two are left as the major causes of bacterial meningitis.

The patient usually begins to feel vaguely unwell and may develop a headache and a raised temperature (fever). There may also be vomiting. Unfortunately many ordinary germs start in this way, and certain other features can help to alert us to the possibility of meningitis.

It is important not to be over anxious, but if in doubt it is better to consult your doctor. More suspicious symptoms include:

• neck and back stiffness
• over-sensitivity to light (photophobia)
• severe headache
• drowsiness

Occasionally, in meningococcal meningitis, diarrhea or a rash occur. Sometimes a fit or seizure may take place.

The rash

If there is a rash it is worth trying the "glass test" as you may have seen on the television. This involves pressing a glass tumbler against the rash to see if the red spots disappear under pressure. The rash of meningococcal meningitis does not disappear on application of pressure.

If in doubt about a child or other member of the family, it is better to call the doctor and do mention your concerns to the doctor or his answering service. If the doctor has been consulted, but the patient seems to be deteriorating rapidly in a way not predicted by the doctor, it is worth ringing again.

Should your doctor consider that this is a case of meningitis he is likely to give an injection of penicillin and arrange emergency admission to hospital.

People who have been in contact with a confirmed case of meningitis will be offered treatment to protect them. This will mean antibiotic tablets, possibly with the addition of an injection if the infection is the sort for which there is a vaccine. It is likely that the public health doctors will arrange this, but if you are in doubt, ask your doctor.

If prospective students have not received a meningitis vaccination, they should check with their doctor in good time, so that they can have the vaccination, if that is required, before they enjoy their long summer vacation.

Students living in communal residences should be aware of the above symptoms in themselves or their friends, and call the doctor or student health service if worried.

• Medinfo Meningococcus C vaccination information
• Meningitis Trust
• Meningitis Research Foundation
• World Health Organization Meningitis information