Spotting The Signs Of Meningitis


Meningitis is a rare, but serious illness that affects the membranes, also known as meninges, which cover the brain and spinal cord. You or your children can be infected as it can spread from person to person. Those most at risk are babies, elderly people and anyone with a compromised immune system.

It’s not easy to spot the symptoms of meningitis and possible infections should not be taken lightly. Considering that the symptoms often appear in any order and some not at all, pharmacy teams must pay careful attention to anything out of the ordinary and know what to look out for.


How Dangerous Is Meningitis?

There are essentially three types you could be infected with – bacterial, viral or fungal meningitis. While all are dangerous, bacterial meningitis can potentially be life threatening and fungal meningitis typically affects people with an already compromised immune system.

Did you know that 90% of children and teenagers who die of bacterial (meningococcal) meningitis die within 24 hours? On a global scale, meningitis affects more than 5 million people and 1 in 5 people are left with an impairment caused by the dreaded disease (source:


Bacterial Meningitis 

Bacterial meningitis is extremely serious and as previously mentioned, can be deadly. While most people recover from meningitis, in some cases, death can occur in as little as a few hours. There is also a risk of permanent disabilities among survivors, including brain damage, hearing loss and learning disabilities.

The types of bacteria that can cause meningococcal meningitis, and lead to sepsis, are:

  • Streptococcus pneumoniae
  • Group B Streptococcus
  • Neisseria meningitides
  • Haemophilus influenzae
  • Listeria monocytogenes

These bacteria are spread in several different ways from coughing, sneezing, kissing, living together for an extended period of time and during childbirth.

Recommended: ‘Pharmacy Training: Symptoms And Early Detection Of Sepsis


Viral Meningitis

This is the most common and often not as severe or as dangerous as bacterial meningitis. While most people get better without treatment, it is advisable to see a doctor as soon as you notice any signs or symptoms. Only a doctor will be able to accurately determine whether someone has meningitis, what is causing it and the best treatment options.

Several viruses can cause viral meningitis including:

  • Mumps
  • Herpesviruses, including Epstein-Barr, herpes simplex, and varicella-zoster virus (responsible for chickenpox and shingles)
  • Measles
  • Influenza
  • Arboviruses (West Nile virus)
  • Lymphocytic choriomeningitis virus


People in close contact with someone who has viral meningitis can become infected with the virus that made that person sick in the first place. However, these people are unlikely to actually develop meningitis. In fact, only a small number of people who get infected with the meningitis-causing virus will develop the condition. 

General Signs And Symptoms

Pharmacists and their entire team must be aware of the signs and symptoms as they are starting to see more people referred from NHS111 or their local GP Practice as a result of the NHS Community Pharmacist Consultation Service (NHS CPCS).

People should seek immediate medical assistance if they are concerned about themselves, a family member or their child. They shouldn’t wait until there’s a rash as it doesn’t always appear or it could fade when applying pressure. The first symptoms of meningitis usually involve the following:

  • Fever and / or vomiting
  • Severe headache
  • Limb, joint and muscle pain
  • Cold hands and feet, shivering
  • Rash
  • Pale skin
  • Breathing fast, breathless
  • Stiff neck
  • Disliking of bright lights
  • Very sleepy, difficult to wake and being vacant
  • Confused, delirious
  • Seizures (fits)


Meningitis Symptoms In Babies And Toddlers

Babies and toddlers can get sick very quickly so it’s best to check on them often. Once again, they may not experience the same symptoms, or in any order but the most common symptoms are as follows:

  • Tense or bulging soft spot
  • High temperature (Be aware that it could be normal or low in babies under 3 months)
  • Very sleepy and too tired to wake up
  • Breathing fast or difficulty breathing
  • Extreme shivering
  • ‘Pin-prick’ rash (marks or purple bruises in any location on the body)
  • Diarrhoea can also occur
  • Unusual grunting sounds
  • Vomiting and refusal to feed
  • Irritable when picked up with a high pitched or moaning cry
  • Blotchy skin, getting paler or turning blue
  • A stiff body with jerky movements or floppy and lifeless
  • Pain and irritability from aching muscle or severe limb or joint pain
  • Cold hands and feet


What Is The Tumbler Test?

If you, or someone you know, suffer from any of the above-mentioned symptoms, seek medical advice as soon as you can. When there is a rash or even just a few small spots, use the tumbler test get a better view.

All you have to do is press a clear glass tumbler firmly against the rash. If the marks are clearly visible through the glass, you should seek urgent medical assistance. Remember to check the entire body and look out for tiny red or brown pin-prick marks. These can change into larger red or purple blotches and blood blisters.

meningitis tumbler test

On darker skin, it may be more difficult to see a rash so check lighter areas like the palms of hands and soles of feet. Alternatively, look inside the eyelids and at the roof of the mouth.

Final Thoughts

In support of the Community Pharmacist Consultation Service, pharmacy teams need to understand the serious impact of meningitis. They must be able to identify the early signs and know how to assist and when to refer patients to a GP.

If you need to access online training courses to help your pharmacy team, VirtualOutcomes have developed several. These range from diabetes, sepsis and strokes to fall prevention, asthma attacks and our coveted Health Champion Training. Please visit our website for more information and remember to follow our blog for all the latest updates.