MENINGITIS B: SYMPTOMS, VACCINES AND HOW TO TREAT IT
Meningitis is an infection of the protective membranes that surround the brain and spinal cord. It is contagious and can be transmitted by asymptomatic carriers, infecting anyone of any age, but is most common in babies, children and young adults, particularly university-age students.
While the condition is relatively rare, the dangers of an infection became apparent in March this year, when two people died and 21 were hospitalised following an outbreak of meningitis B (MenB) believed to have started at a nightclub in Kent.
Understandably, many parents across the country are worried that their children are at risk or are unvaccinated.
Here is our expert guide to the different strains along with the key symptoms and how to protect yourself.
Skip to:
- How is MenB different to other strains?
- Why are students often affected and who is most at risk?
- Is there a vaccine for MenB?
- What are the side effects of the MenB vaccine?
- Antibiotics vs vaccines – which is more important?
- How does MenB spread?
- What are the symptoms?
- How to protect your child from meningitis
- Treatment and complications
- What to do if you think you’ve got MenB
How is MenB different to other strains?
According to the charity Meningitis Now, there are different kinds of meningitis, including bacterial, viral and fungal. Bacterial kinds, caused by bacterial infections like MenB, are more serious than viral meningitis, whilst fungal forms are rare in the UK.
MenB is the most common form of invasive meningococcal disease. It is caused by the Neisseria meningitidis bacteria, also known as the meningococcus, which usually lives harmlessly in people’s throats, but can invade the blood or spinal fluid, causing serious problems, Prof Hunter says.
When this happens, MenB can lead to sepsis or infect the protective membranes around the brain and spinal cord (the meninges), causing invasive meningitis, he adds. Bacterial meningitis can quickly become fatal if left untreated, and it can have severe consequences for survivors, such as limb amputation if sepsis results.
Pneumococcus, tuberculosis or Haemophilus bacteria may be at the root of other strains of bacterial meningitis, according to Sanders.
Meanwhile, viral meningitis “can be caused by a number of viruses including enteric, mumps or herpes viruses, although these are usually less serious”, says Sanders. Our bodies are usually quite good at fighting off the viruses that can cause meningitis, and with painkillers, rest and hydration, the body’s immune system will overcome the virus in around seven to 10 days. However, viral meningitis can still make someone feel very ill, and full recovery can take some time.
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Why are students often affected and who is most at risk?
Students at colleges and universities this year are unlikely to be vaccinated against MenB as the vaccine for this strain was added to the NHS vaccination schedule in 2015 for babies. Therefore, they are not protected against this particular strain (but are likely to have had the MenACWY vaccination in school from the age of 14, which protects against the other common types).
“When teenagers leave home and go to university, they are likely to be mixing and living in crowded environments with new people,” Prof Hunter says. “One in five people in their late teens and early 20s carry the meningococcus bacteria in the back of their throats asymptomatically, but the issue arises when they meet new people and are suddenly exposed to new strains that they’ve never encountered before or have protection against.”
The UKHSA has previously warned that school and university students can face a “particular risk” of developing meningitis because they socialise and mix closely, whilst symptoms may be confused with a hangover or bad cold.
Babies under the age of one are also at a higher risk, as their immune systems are not yet fully developed, Prof Hunter adds.
How can I get a vaccine for MenB?
The MenB vaccine was added to the NHS vaccination schedule in 2015 and is offered to babies at two, four and 12 months on the NHS, Prof Hunter says. Missed infant MenB doses can be caught up before the age of two on the NHS.
From July 13, there is a one-off vaccination programme targeting Year 13 pupils aged 17 and 18, requiring two doses administered at least 28 days apart.
A million young people are expected to be eligible for the vaccine in England, including:
- people born between Sept 1, 2007, and Aug 31, 2008;
- people born on or after July 21, 2001, and starting university for the first time this autumn;
- people born on or after July 21, 2001, who are starting at residential further education colleges for the first time this autumn.
Seventeen and 18-year-olds can book via the NHS National Booking Service if they are already registered with a GP, but you do not need to be registered with a GP surgery to use the walk-in service at participating pharmacies. You can find your nearest pharmacy on the NHS website.
Experts are hesitant to confirm exactly how long the MenB vaccine provides protection for. According to Dr Eliza Gil at the London School of Hygiene and Tropical Medicine: “students aren’t offered MenB vaccination as part of a routine schedule because their risk has typically been low in comparison to young children and babies, and also because the protection the vaccine offers is imperfect and is thought to only last a few years.” MenB boosters are not offered by the NHS.
What are the side effects of the MenB vaccine?
According to the NHS, not everyone will experience side effects, but they can include:
- Redness, swelling or tenderness where they had the injection
- Being a bit irritable and not as hungry as usual
- Sleepiness
- A fever
- Sore joints
- A rash (more common in children aged 12 to 23 months)
- Diarrhoea or vomiting
- A sore head
Fever can be expected after any immunisation, but is more common when the MenB vaccine is given with the other routine vaccines at eight and 12 weeks.
Are there vaccines for the other types of meningitis?
The meningococcal ACWY (MenACWY) vaccine is offered to young people between the ages of 14 and 25 on the NHS. Boosters are also available privately at pharmacies and travel health clinics, typically for students, travellers or those seeking extra protection. At Superdrug, the service costs £57 and typically provides protection for at least five years.
Pneumococcal bacteria can also cause meningitis and septicaemia. A pneumococcal conjugate vaccine (PCV) protects against the 13 strains that most commonly cause disease, and is offered to babies at 12 weeks and 12 to 13 months.
A pneumococcal polysaccharide vaccine (PPV) is offered to anyone aged 65 years and over. While it protects against more strains than the PCV (23 rather than 13), it is only effective for a limited period and isn’t effective in children under the age of two.
Other vaccines available include Haemophilus influenzae type b (Hib), which is given as part of a combined “6-in-1” vaccine in four doses. This protects against Haemophilus influenzae type b bacteria, which, prior to the introduction of the vaccine, were once the most common cause of bacterial meningitis in children under the age of 5. Meanwhile, the BCG vaccine offers protection against tuberculosis meningitis. The MMRv vaccine, while protecting against measles, mumps and rubella, is also important as mumps was a common cause of viral meningitis in children before this vaccine became available.
Antibiotics vs vaccines – which is more important?
“It is important to remember that the vaccine offers long-term protection,” Dr Clarke says. “It is the primary and most effective strategy for preventing bacterial meningitis.”
When someone is diagnosed with meningitis, preventative antibiotics are recommended for those they have recently been in close contact with, such as partners and people they live with. Within 24 hours of diagnosis, a short two-day course of prescribed antibiotics is recommended, often ciprofloxacin or rifampicin.
“If you are a carrier and have the bacteria in the back of your throat, the antibiotics will almost certainly clear them completely, assuming you take the course properly,” explains Dr Clarke. This will prevent you from becoming sick or passing the bacteria on to others.
How does MenB spread?
MenB is not highly contagious and the infecting organism can live harmlessly in people’s noses or throats. According to Meningitis Now, “around 10 per cent of the population carry meningococcal bacteria in the back of their throat at any one time”. This rises to around one in five among teenagers and young adults.
This “carrier state” can last for several months before disappearing, but in this time these asymptomatic carriers can transmit the illness via airborne “droplets”, through sneezing, coughing or intimate kissing. It can also be transmitted by sharing the same cup, cutlery or vape as a carrier.
Following the outbreak in Kent, scientists are investigating whether vapes could act as an “accelerant”, allowing bacteria that would usually require direct contact to travel further.
MenB is not as easily transmissible as many common respiratory viruses, such as flu or Covid-19, and in most cases, the carriage of the bacteria does not cause illness. It is only rarely that the bacteria overcome the body’s defences and cause meningitis.
“Meningitis can also be caught from someone else with the illness,” says Dr Safia Debar, a GP executive health at Mayo Clinic Healthcare in London. “Whether the infection takes hold will depend on the susceptibility of the individual.” In other words, if your immunity is high, you can be in contact with someone who has or carries meningitis but not get it.
What are the symptoms to look out for?
The symptoms of MenB are not fundamentally different from other strains, Prof Hunter says.
Because some of the symptoms of meningitis are flu-like, self-diagnosis in the early stages can be tricky. According to Prof Vijay Nayar of Healthium Clinics, “the symptoms of meningitis can develop quite quickly and include a high temperature, headache, vomiting, a stiff neck and being unable to tolerate bright light. Symptoms of more severe infection include a rash that does not disappear when a glass is rolled over it, as well as drowsiness and fits. Urgent medical attention is required if some of these symptoms are present”.
If you have meningitis and your neck is stiff, you may not be able to touch your chest with your chin or lift your head up from a pillow, Prof Hunter explains.
Symptoms in babies may present differently to those in adults, according to the World Health Organisation. Infants with meningitis may exhibit unusual behaviour (like being less active or difficult to wake), be irritable, have a weak and continuous cry or feed poorly.
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How to protect your child from meningitis
“Ensure your child receives the recommended vaccinations, including those against common meningitis-causing bacteria and viruses,” says Dr Chun Tang, a GP and medical director at Pall Mall Medical, a private healthcare clinic in Manchester. “You should also encourage good hygiene to reduce the risk of viral infections and teach children proper handwashing and hygiene etiquette.” Further precautions include minimising contact with individuals who are coughing or sneezing, as meningitis can be transmitted via droplets, even from an otherwise healthy person. He also advises staying informed about meningitis symptoms, transmission and prevention strategies.
If your child exhibits symptoms, seek immediate medical attention. “If you are concerned about symptoms, you can call NHS 111 or your GP for help and advice,” says Donovan. “However, if someone is ill and getting worse, you should call 999.”
“Inform healthcare providers of your child’s symptoms and any recent illnesses,” says Tang. “Be assertive in expressing your concerns and share specific symptoms and observations. Request tests, including blood cultures and lumbar punctures – and if you feel your concerns are not being taken seriously, seek a second opinion or consult specialists.”
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How is meningitis treated?
Bacterial meningitis, including the MenB strain, needs immediate, emergency treatment, says Prof Nayar. It requires antibiotics and hospital assistance. “Bacterial infections can lead to complications, especially when not treated quickly,” he adds.
“People who are suspected of having meningitis should have tests in hospital to establish whether it is viral or bacterial.” This is done via a lumbar puncture where a needle is inserted into the base of the spine to withdraw fluid that will then be examined for an accurate diagnosis, Nayar says.
As viral meningitis is less serious, it can often be dealt with at home. It tends to get better on its own within seven to 10 days with adequate rest and fluids, plus painkillers where necessary.
Meningitis Q&A
Our health expert answered your questions
What are the complications of meningitis?
In severe cases, meningitis, including MenB, can lead to death, says Tang.
According to the Meningitis Research Foundation, the problems following meningitis can be temporary or permanent, and can encompass both physical and mental health issues, including brain damage.
“The membranes around the brain are like a bag of fluid,” explains Claire Donovan, a helpline manager at Meningitis Now. “When these become inflamed with meningitis, the intracranial pressure can press down on the brain and cause damage.”
After-effects of meningitis include memory loss and difficulty concentrating, reduced physical coordination and balance, headaches, problems with speech, sight and hearing, physical weakness and spasms, and mental health or behavioural issues. If septicaemia is brought on by meningitis, damage to the kidneys and lungs can result, as well as joint pain and stiffness. In extreme cases, amputation may be required to remove damaged tissue and prevent the infection spreading further throughout the body.
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What to do if you think you’ve got MenB
You should call 999 immediately or go to your nearest A&E if you think you or someone in your care could have meningitis, according to the NHS.
If you have been in close contact with someone who has meningitis, you may be given preventative antibiotics to reduce your risk of getting sick.
“Your symptoms may be mild at the start, similar to a flu or cold, but if you have meningitis, you can deteriorate very quickly, so it is important to trust your gut, and to tell your doctor if you believe you have encountered someone with meningitis, or was in a place where it spread,” Prof Hunter concludes.
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