What is meningitis?
Meningitis is inflammation of the membranes that surround and protect the brain and spinal cord. The most common germs which cause meningitis are viruses and bacteria.
Viral meningitis is rarely life-threatening, although it can make people very unwell. Most people make a full recovery, but sufferers can be left with after-effects such as headaches, tiredness and memory loss.
Bacterial meningitis can be life-threatening and needs urgent medical attention. Most people make a full recovery, but many are left with debilitating after-effects such as deafness, epilepsy and brain damage, and one in ten will die.
Despite the availability of vaccines to prevent some types of meningitis, each year in the UK there are about 2,500 cases of bacterial meningitis and an estimated 5,000 cases of viral meningitis.
Many different bacteria can cause meningitis. The main types are meningococcal, pneumococcal, TB and Hib.
Meningococcal bacteria are the most common cause of bacterial meningitis in the UK. They can cause both meningitis and septicaemia (blood poisoning), which often happen together. It is important to be aware of all the signs and symptoms. Signs and symptoms information is available from Meningitis Now (see below).
Transmission of meningitis
The germs that cause bacterial meningitis usually live harmlessly in the back of the throat. Most of us will carry them at some stage in our lives without becoming ill, and they help us build up natural immunity (protection against the disease). Occasionally, these germs get past the body’s defences and cause infection.
The germs are passed from person to person through coughing, sneezing and intimate kissing, but they will rarely cause disease.
Meningitis and septicaemia can affect anyone at any age, but babies and young children are most at risk. Teenagers and young people are also at risk, particularly during the first year at university.
Most are isolated cases, but when there is a case of meningococcal disease, there is a small chance that further cases can happen. The local public health office may offer antibiotics to people who have been in close contact for a long period of time with someone who has meningococcal disease. This is to reduce the risk of further cases.
Vaccination is the only way to prevent meningitis. Effective vaccines are available to prevent some types of bacterial meningitis and these have dramatically reduced the number of cases in the UK. To continue this success, the number of people having the vaccines needs to remain high.
Vaccines that protect against meningococcal group C, Hib and pneumococcal bacteria are offered as part of the routine childhood immunisation programme.
But at least 90 per cent of meningococcal disease in the UK is caused by group B, and there had previously been no vaccination for this. However, in March 2014, the Joint Committee on Vaccination and Immunisation (JCVI) recommended that a new vaccine for meningitis B be included in the childhood immunisation programme. Since September 2015, all babies have been offered the vaccination.
Dealing with cases of meningitis in schools
Cases of meningitis must be notified to the local authority or health protection team’s Consultant in Communicable Disease Control (CCDC), also known as the ‘proper officer’. The CCDC is, in particular, responsible for advice on precautions to be taken in schools with regard to cases involving school pupils.
When a case of meningitis occurs, it is important that parents, pupils and staff are fully and regularly informed. It is sensible for schools to hold information on identifying the signs and symptoms of meningitis and meningococcal septicaemia, and on steps which may need to be taken if there are cases at the school. It is also sensible for each school to have a named person who will deal with this type of issue.
Meningitis is not regarded by the medical profession as highly infectious. Due to the means of transmission, only the patient’s close contacts, generally family members, are at any significant risk. Contacts are usually offered antibiotics, which are intended to reduce the risk of further cases. The use of antibiotics does not, however, guarantee that contacts will not contract meningitis. Contacts will also generally be offered vaccination if appropriate, although this offers protection only in the longer term and against only certain strains of meningitis.
Medical advice is likely to be that the risk of transmission to contacts at school is low and, therefore, that the school will not need to be closed, close contacts such as siblings will not need to be excluded, and other contacts such as teachers and fellow pupils will not need treatment with antibiotics or vaccination. In general, antibiotics and mass vaccination are offered only where at least two cases occur in a school simultaneously or very close together.
The NEU has in such circumstances generally sought to ensure that antibiotics and/or vaccination are made available to contacts who request them, at the very least to those staff and pupils who have been in close contact with the person suffering from meningitis. In the event of an outbreak, the NEU believes that provision of antibiotics and vaccination should be made available to school staff. NEU members facing difficulty in obtaining this should contact the NEU Adviceline.