Neurology
Recent cases of meningococcal meningitis in the Western Cape have understandably worried parents.
Meningitis is a serious disease, but it is quite rare, and if spotted early, it can usually be treated successfully.
What is meningitis, and why can it become dangerous so quickly?
Meningitis is an infection of the protective lining around the brain and spinal cord, known as the meninges. It can be caused by viruses or bacteria.
Dr Wayne Hough, a paediatrician at Mediclinic Louis Leipoldt, says awareness and early diagnosis is vital. “Viral meningitis can make children quite ill, but it is usually milder,” he explains. “Bacterial meningitis, however, is the form we worry about most. It can progress very rapidly, sometimes within hours, and may lead to severe complications if not treated urgently.”
Certain bacteria, including meningococcus, can also enter the bloodstream and cause sepsis, a life-threatening reaction to infection that affects the whole body. Babies and young children are particularly vulnerable because their immune systems are still developing.
Early warning signs in babies and toddlers
In young children, meningitis doesn’t always begin with obvious symptoms. Early signs can resemble common childhood illnesses, which makes careful observation important.
Parents should watch for:
- Fever
- Poor feeding
- Vomiting
- Excessive sleepiness or difficulty waking
- Irritability or high-pitched crying
- Floppiness or unusual stiffness
- A bulging fontanelle (soft spot on the head) in babies
- Seizures.
“These symptoms are often non-specific at first,” says Dr Hough, “which is why changes in behaviour or responsiveness should never be ignored.”
Symptoms in older children
Older children are usually better able to describe what they’re feeling, and their symptoms often resemble those seen in adults, such as:
- Severe headache
- Neck stiffness or pain
- Sensitivity to light
- Vomiting
- Fever
- Confusion or drowsiness
- Seizures.
When should your child go to the emergency room?
Urgent medical care is needed if a child has:
- Fever with a severe headache
- Neck stiffness
- Persistent vomiting
- Confusion or unusual drowsiness
- Seizures
- Difficulty waking
- A non-fading rash that does not disappear when pressed
- Any baby who is lethargic, feeding poorly, or difficult to rouse.
“If you’re unsure, always let a healthcare professional evaluate your child,” Dr Hough emphasises.
How is meningitis diagnosed?
Doctors diagnose meningitis using a combination of medical history, physical examination, blood tests, and sometimes a lumbar puncture – also known as a spinal tap.
“The lumbar puncture allows us to test the fluid surrounding the brain and spinal cord,” explains Dr Hough. “This helps confirm whether meningitis is present and whether it’s viral or bacterial. This is essential for deciding on the correct treatment.”
How is meningitis treated?
Treatment depends on the cause.
“Viral meningitis is generally milder, and many children recover fully with supportive care,” says Dr Hough.
Bacterial meningitis, however, requires immediate hospital admission and intravenous antibiotics. “The earlier treatment is started, the better the outcome,” he notes.
If treatment is delayed, particularly in bacterial meningitis, complications may occur. These can include hearing loss, developmental delay, seizures, brain injury, and, in rare cases, death. Early treatment dramatically reduces these risks.
Vaccines that protect against meningitis
Routine childhood vaccines in South Africa protect against some major causes of meningitis, including Haemophilus influenzae type b (Hib) and pneumococcal disease.
Other vaccines, available privately, can protect against meningococcal meningitis. There are 12 known meningococcal serogroups, but only a few usually cause illness. In South Africa, serogroup B is currently the most common cause of meningococcal meningitis.
Menactra protects against meningococcal types A, C, W and Y.
Bexsero protects against meningococcal type B and has recently become available in South Africa.
“Unfortunately, the price of these vaccines means that many families in the public sector cannot easily access them,” Dr Hough says.
Advice for parents
- Meningitis is rare, but it can be serious
- Early diagnosis and treatment save lives
- Trust your instincts if your child seems unusually ill
- Seek medical care urgently for concerning symptoms
- Discuss meningitis vaccination options with your doctor.
While recent cases can be worrying, there’s no need to panic. Dr Hough reassures parents that they shouldn’t feel guilty if they can’t afford meningococcal vaccines. These vaccines are only available privately and are not part of the routine government immunisation programme.
“The overall risk of meningococcal disease remains low,” he says. “Many children who develop meningitis have no identifiable risk factors. Awareness, vaccination where appropriate, and prompt medical care are the most effective ways to keep children safe.”