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Meningitis is an infection caused by the inflammation of the meninges, a membrane covering the brain and the spinal cord. It can be caused by a virus or a bacteria and death can result in a matter of hours if untreated. Acute illness may settle down into a chronic state and may lead to serious brain damage. Meningitis is one of the diseases that parents fear the most and with 50% of the cases occurring in children under the age of five, it's easy to see why. It's encouraged that parents familiarise themselves with the symptoms so that they can spot any of the telltale signs straightaway and get urgent medical help.

There are two types of meningitis, viral and bacterial. With viral meningitis, it can be caused by a variety of viruses and infections and could be spread through coughing, sneezing, poor hygiene and sewage polluted water. It is the more common and less life-threatening. Viral meningitis has the following symptoms; headache, fever and drowsiness. Rarely, it can lead to deep coma and serious cases can show muscle weakness, paralysis, speech problems, vision problems and epileptic seizures. Bacterial meningitis is caused by different types of bacteria found naturally in the back of the nose and throat in one out of 10 people. They could be spread by prolonged contact with coughing, sneezing or kissing. Sometimes bacteria can cause blood poisoning or septicaemia and it's a medical emergency that needs immediate treatment with antibiotics.

The symptoms of bacterial meningitis include flu-like symptoms, which can delay treatment, a rash or tiny blood spots which can appear and give the appearance of a bruise, which can come on in one or two days or just a few hours. Symptoms may not be there all of the time, which also confuses the diagnosis. With older children and adults, signs and symptoms include a high temperature, loss of appetite, a neck which doesn't allow the chin to touch the chest, joint pain, seizures and disorientation. With infants and toddlers, the signs and symptoms include high temperature, neck retraction, an arching back, floppiness, lethargy, convulsions, difficulty to wake up and they may be whimpering and finally, they may have a tense, bulging fontanelle, which is the soft spot on the head.

Many people know about the glass test for meningitis, but the rash we are looking for is not the first sign and comes out as the condition progresses. It's a common misconception that meningitis rash appears in every case of meningitis. This is not true.

If someone has meningitis but not septicaemia, they would not have the rash, that does not fade, but they will still be seriously unwell. Never wait for the rash to appear. The rash is caused by meningococcal bacteria multiplying rapidly in the bloodstream. They begin to release endotoxins or poisons from the outer coating. The body's natural defence has little effect on these poisons and eventually, blood vessels would become damaged. As septicaemia or blood poisoning advances, it will affect the whole body and can cause organ damage or failure. The rash associated with septicaemia is caused by the blood leaking into the tissues under the skin. It's important to know that septicaemia can also cause more specific symptoms to look out for as well as the rash. These include fever, with cold hands and feet, joint and muscle pain, rapid breathing and stomach cramps and diarrhoea.

To complete the glass test, roll the glass over the spots, if they do not disappear, this indicates meningitis. Press on the side with a clear glass firmly against the skin. The spots may fade at first, but they will still be there as you roll the glass over. If you find that the spots vanish, then this may indicate that it's not meningitis. If in doubt, seek medical assistance. Do not wait for the rash.

If someone is ill and getting worse, get medical help immediately. On dark skin, the spots or the rash can be more difficult to see. Do not wait for the rash, be aware of the signs and symptoms of meningitis. After carrying out a primary assessment, make sure the child is comfortable, lying against some cushions, keep the child cool, call the emergency services and describe the symptoms and say that meningitis is suspected. Monitor their ABCs and monitor and record their vital signs.

Finally, to recap, the glass test is where the red spots do not vanish when the glass is rolled over the skin. Meningitis is caused by inflammation around the spinal cord and the brain, and it's caused by viruses or bacteria and is easily confused with other common illnesses. A survey showed that 50% of children with meningitis were initially sent home, so you need to ensure that you get help as the condition gets worse. For more information, look on meningitisnow website and meningitisnow.org.