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Don't wait for a rash

All too often people with suspected meningitis will wait for a rash to appear before calling a doctor - and this extra waiting time can lead to tragedy, the Meningitis Trust warned  ( January 15 2003 ).

Linda Dawson's son 22 year old David died from meningitis just 11 hours after the first symptoms of the disease appeared because vital early treatment may have been unnecessarily delayed.

Linda said: "I called the doctors out twice to see David but they said he didn't have meningitis because he didn't have the rash. I know now that we should never have waited for the rash. It cost my son his life. And I urge everyone to act as soon as they suspect meningitis so that more lives can be saved. Just trust your instincts."

The rash which starts as red or purple spots anywhere on the body is a symptom of septicaemia or blood poisoning. Septicaemia is often closely associated with meningitis, both of which are caused by bacteria entering the bloodstream.

However, the rash often appears much later and sometimes it doesn't appear at all. The key early symptoms of meningitis are headache, stiff neck and dislike of bright lights; though it is important to note that these may not all appear at once and may be accompanied by other symptoms as listed below.

Today the Meningitis Trust is warning parents and health professionals alike not to wait for the rash but to take action as soon as meningitis is suspected especially during the winter months when incidents of meningitis are at their highest.

Anyone who wants to know more about meningitis, should call the Trust's 24 hour nurse-led Helpline day or night on 0845 6000 800 or visit
http://www.meningitis-trust.org

Meningitis and meningococcal septicaemia may not always be easy to spot at first, because the symptoms can be similar to those of flu. They may develop over one or two days, but sometimes develop in a matter of hours. The incubation period is between two and ten days.

Symptoms of meningitis do not appear in any particular order and some may not appear at all. It is important to remember that other symptoms may occur.

In babies:

* High temperature, possibly with cold hands and feet
* Difficult to wake or lethargic
* Vomiting, or refusing feeds
* High pitched moaning, whimpering cry
* Blank, staring expression
* Pale, blotchy complexion
* Baby may be floppy, may dislike being handled,
  or may be fretful
* Fontanelle (soft spot on their head) may be tense
  or bulging

In children and adults:

* High temperature, possibly with cold hands and feet
* Vomiting, sometimes diarrhoea
* Severe headache
* Neck stiffness (unable to touch the chin to
  the chest)
* Joint or muscle pains, sometimes stomach cramps
  with septicaemia
* Dislike of bright lights
* Drowsiness
* Fitting
* Patient may be confused or disoriented

  Both adults and children may have a rash.

http://www.meningitis-trust.org
Helpline: 0845 6000 800

We are indebted to the National Meningitis Trust for their help in compiling this section.