What are the Signs and Symptoms of Meningitis?

Many years ago I spent 24 hours in a meningitis ward in a London hospital.  I was writing an article on   — The Day in the Life of a Meningitis Doctor.  This was while I was still working as a journalist and before I started Safe and Sound.  I remember the doctor telling me how difficult it was sometimes to diagnose the early symptoms of meningitis. It was a harrowing experience seeing the babies and young children so sick and it had a lasting effect on me.  At the time I had 3 young boys and I became what can only be described as a little over obsessed……

“No mummy we don’t have a sore neck, our head is just fine and the lights are not affecting our eyes,” was my children’s retort to my repeated questions every time they felt a little unwell.  This was more than 25 years ago and I had thought that doctors had become much more diligent about meningitis.

Not so for Abigail Hull, the mother of seven-month old Oliver. He was sent home from Epsom General Hospital after being wrongly diagnosed with a sinus infection and two days later he died. Said Mrs Hull “to lose your son to an illness that is both preventable and treatable is a tragedy.”

Oliver was treated with paracetamol rather than antibiotics and sent home after 4 hours and it was only when his grandfather, a retired GP, noticed that his fontanelle – the soft gap in skull – was bulging that Oliver was rushed to hospital. Sadly, he couldn’t be saved and died the next day.

According to Meningitis Now, bacterial meningitis kills more UK children under the age of five than any other infectious disease. Not surprisingly it is one of the big concerns from many people on our first aid courses, particularly the parents. And we always advise, if you are at all concerned then take the child directly to A & E and don’t take no for an answer.  I have been told by A & E Centres that they would prefer parents to be over diligent and they should not worry about wasting doctors’ time.

So what is meningitis and septicaemia (blood poisoning). The two often come together?

Meningitis is an inflammation of the linings surrounding the brain and the spinal cord which is caused by bacterial or viral infections.

Possible signs and symptoms

Early symptoms may include:

  • Cold hands and feet
  • Pain in the limbs and joints
  • Abnormal skin colour (pallor or mottling)

Later signs may include:

  • Fever – high temperature and vomiting
  • Blotchy purple rash. Use the glass tumbler test (the spots don’t fade under pressure). They may however fade at first so keep checking. They are more difficult to see on darker skin, so check in paler areas.
  • Drowsiness or lower levels of consciousness
  • Severe headache
  • Stiff neck (this can be rare)
  • Dislike of bright lights (can be rare)

Meningitis in babies

The soft spot on the baby’s head may start to bulge

  • May refuse food, be irritable when picked up or have a high pitched or moaning cry
  • May be floppy and lifeless and start fitting or be too sleepy to wake up

NB the rash is a late sign and it doesn’t always occur – so don’t wait for a rash to appear.

The problem is that many of the symptoms of meningitis are very similar to less serious viral illnesses and you can see how difficult it can be to diagnose this especially in the early stages. And of course, babies are too young to tell you how they are feeling.

Most important is that you trust your instinct – you know you child and if you are concerned get medical help immediately.

Meningitis  Now is an excellent resource and help centre. The helpline is staffed by nurses.

Call 0800 028 18 28


We cover meningitis on our paediatric first aid courses. For more information about open and private first aid courses call us on 0208 445 8998 or go to