Meningitis in Children
Dr Joseph Mizzi MD MRCP MRCPCH
Meningitis is a rare but serious disease. There are about ten reported cases every year in Maltese children. Every effort should be made to protect our children from meningitis because it can result in permanent neurological problems, such as hearing loss and seizures, and even death in about 5% of cases.
There are two lines of defence; firstly, children can be protected by immunisation; secondly, parents should learn how to recognize the signs of meningitis so that the ill child is brought immediately to medical attention. Early treatment results in a better outcome, usually with full recovery.
Meningits can be caused by viruses and bacteria. Viral meningitis is more common, but it is usually not serious. Many cases of viral meningitis manifest flu-like symptoms and often remain undiagnosed. Previously polio and mumps were significant causes of meningitis. These diseases have been practically eradicated by routine immunisation.
Bacterial meningitis is less common, but it is a more serious infection. There are three types of bacteria that commonly cause meningitis in infants and children after the first month of life: HiB, pneumococcus and meningococcus.
Effective vaccines for pneumococcus and meningococcus (B and A, W, Y and Y) are available locally in the private sector, and can be given from 2 months of age.
The symptoms of bacterial meningitis and septicaemia can develop rapidly, often within a few hours. The signs of meningitis are fever, severe headache, neck stiffness, vomiting, dislike of bright light and drowsiness. Infants and young children may not manifest the typical signs of meningitis. An infant may simply feed poorly, dislike being handled or become very lethargic. A shrill cry or unusual moaning should alert parents to the possibility of meningitis. Seizures (abnormal jerking movements and loss of consciousness) are rarely associated with meningitis and, in fact, most seizures in young children are simply the result of a high fever (‘febrile fit’).
A rash is an important sign to look for when a child is unwell with fever. It may start as tiny spots that looks like small pin pricks; may spread quickly and develop into large dark red blotches. These spots do not blanch – in other words, they don’t fade if a transparent glass is pressed against the skin.
Parents should seek immediate medical advice in the following circumstances.
1. Infant less than 3 months with fever irrespective of the
June 2009. Update 2019.