Nearly half of babies with meningitis don’t display the classic warning signs of the killer bug, research has found.
Scientists noted a fever – long considered a key symptom of bacterial meningitis – was reported in only 54 per cent of cases.
The new findings, made by researchers at St George’s, University of London, have prompted an urgent warning to doctors.
Meningitis Research Foundation, which funded the study, believes they may be missing cases of bacterial meningitis in babies.
It revealed the most common signs of the deadly bug were poor feeding, lethargy and irritability – though all can be signs of much milder illnesses.
Data from 263 babies under the age of three months who had the infection – which can kill in hours – was used to make the conclusion.
Scientists noted a fever – long considered a key symptom of bacterial meningitis – was reported in only 54 per cent of cases
Estimates suggest around 350 cases of bacterial meningitis in infants under three months of age occur each year in the UK and Ireland.
In the UK, infants under three months are 70 times more likely to get it than adults. Newborn babies face the highest risk.
The study, published in the Paediatric Infectious Diseases journal, showed that just 28 per cent of cases reported seizures.
While a fifth of the incidents reported bulging fontanelle, six per cent a coma and just three per cent neck stiffness.
Of the 263 babies, 23 died – nine per cent – and 56 of the surviving babies suffered serious complications, such as amputations, hearing loss and recurrent seizures.
The authors, led by Professor Paul Heath, concluded classic features of meningitis were ‘uncommon’ among the babies studied.
He said: ‘The symptoms displayed by young infants when they are seen by doctors at first in hospital are often non-specific and only half of cases showed signs of a fever.
‘Clinicians must, therefore, still consider bacterial meningitis in the diagnosis of an unwell infant that doesn’t present with fever.’
He added that meningitis guidelines ‘have been introduced in the UK and the US but all specify fever as a key feature of infection’.
The symptoms displayed by young infants when they are seen by doctors at first in hospital are often non-specific and only half of cases showed signs of a fever
Professor Paul Heath, St George’s, University of London
Professor Heath said: ‘Unfortunately, neither the rates of bacterial meningitis in babies, nor the numbers of deaths, has changed since the 1980s.
‘Clinicians must, therefore, still consider bacterial meningitis in the diagnosis of an unwell infant that doesn’t present with fever.’
Vinny Smith, chief executive at the MRF, said: ‘Young babies are particularly vulnerable to bacterial meningitis.
‘Meningitis and septicaemia are deadly diseases that strike without warning. Rapid diagnosis and treatment provides the best chance of survival.
Mr Smith added that the charity has now created a teaching package for doctors and health professionals to aid rapid diagnosis and treatment.
It has also updated its symptoms information for parents ‘so that they know not to rely on fever alone as the main symptom to look out for in babies’.
WHAT IS MENINGITIS?
Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord.
Anyone can be affected but at-risk people include those aged under five, 15-to-24 and over 45.
People exposed to passive smoking or with suppressed immune systems, such as patients undergoing chemotherapy, are also more at risk.
The most common forms of meningitis are bacterial and viral.
Symptoms for both include:
- Pale, blotchy skin with a rash that does not fade when compressed with a glass
- Stiff neck
- Dislike of bright lights
- Fever, and cold hands and feet
- Vomiting
- Drowsiness
- Severe headache
Headache is one of the main symptoms
Bacterial meningitis
Bacterial meningitis requires urgent treatment at hospital with antibiotics.
Some 10 per cent of bacterial cases are fatal.
Of those who survive, one in three suffer complications, including brain damage and hearing loss.
Limb amputation is a potential side effect if septicaemia (blood poisoning) occurs.
Vaccines are available against certain strains of bacteria that cause meningitis, such as tuberculosis.
Viral meningitis
Viral is rarely life-threatening but can cause long-lasting effects, such as headaches, fatigue and memory problems.
Thousands of people suffer from viral meningitis every year in the UK.
Treatment focuses on hydration, painkillers and rest.
Although ineffective, antibiotics may be given when patients arrive at hospital just in case they are suffering from the bacterial form of the disease.
Source: Meningitis Now