Meningitis: symptoms, causes, treatment and when to call 999

The NHS says the symptoms of meningitis develop suddenly. Some of the early symptoms can look like flu, a stomach bug or a hangover, which is part of why meningitis can be missed at first. NHS inform adds that symptoms can appear in any order and some may not appear at all.

Meningitis Now, a UK charity, makes the same point: someone with meningitis or septicaemia can get a lot worse very quickly, so keep checking on them and do not wait for a rash to appear.

• a high temperature (fever)

• very cold hands and feet

• a stiff neck

• joint and muscle pain

• a severe headache that is getting worse

• eye pain when looking at bright lights

• seizures (fits)

• vomiting and diarrhoea

• confusion, or being very sleepy or difficult to wake

• spots or a rash that does not fade when pressed with a glass (this may be harder to see on brown or black skin)

The NHS says not everyone with meningitis gets spots or a rash. When it does appear, it usually starts as small red pinpricks before spreading quickly and turning into red or purple blotches. A rash that does not fade when you press the side of a clear glass firmly against the skin is a warning sign.

On brown or black skin the rash can be harder to see. The NHS suggests checking paler areas, such as the palms of the hands, soles of the feet, roof of the mouth, whites of the eyes or inside the eyelids.

NHS inform is clear that you should trust your instincts and not wait until a rash develops before getting help.

The NHS lists extra signs to look for in babies and children under 5 years. They may not want to feed, may have a high-pitched, unusual cry, may be stiff or floppy and unresponsive, or may have a bulging soft spot on the top of the head.

Meningitis Now notes that it is especially important to keep an eye on babies because they cannot say when they are unwell. The NHS says meningitis is more common in babies and young children, and that a child with meningitis might not have every symptom.

Meningitis is an infection of the protective membranes (the meninges) that surround the brain and spinal cord. NHS inform says it is usually caused by a viral or bacterial infection.

Viral meningitis is the most common and least serious type. Bacterial meningitis is rare but can be very serious if it is not treated quickly, because it can cause life-threatening blood poisoning (septicaemia) and permanent damage to the brain or nerves.

Meningitis Now explains that meningitis and septicaemia can happen together, and that many medical experts now use the word sepsis instead of septicaemia.

The NHS says the viruses and bacteria that cause meningitis are spread through close contact with a person who has them. Examples it gives are contact with the person's spit, such as kissing them or sharing drinks or vapes, and spending a lot of time in close contact, such as living in the same home.

NHS inform adds sneezing, coughing and sharing cutlery or toothbrushes to the list. Both services say the infection is usually spread by people who carry these germs in the nose or throat but are not ill themselves. Someone with meningitis can also pass it on, but NHS inform says this is less common.

Meningitis Now says that one in four 15 to 19 year olds carry meningococcal bacteria in the back of the throat, compared with one in ten of the UK population, which puts teenagers at greater risk.

NHS inform says the risk of someone with meningitis spreading the infection is generally low. If someone is thought to be at higher risk, they may be given a dose of antibiotics as a precaution.

This may include people who have had prolonged close contact, such as those living in the same house, pupils sharing a dormitory, university students sharing a hall of residence, or a boyfriend or girlfriend. People who have only had brief contact will not usually need antibiotics.

NHS inform advises phoning 111 or contacting your GP practice urgently if you have symptoms that could be meningitis but are unsure how serious they are, or if you think you have been exposed to someone with meningitis.

NHS inform lists several viruses and bacteria that can cause meningitis. The type matters because it decides how serious the illness is and how it is treated.

The NHS says anyone can get meningitis, but it is more common in the groups below. It is also possible to get meningitis more than once.

• babies and young children

• teenagers and young adults

• older people

• people with a weakened immune system, for example people with HIV or having chemotherapy

NHS inform says people with suspected meningitis will usually need tests in hospital to confirm the diagnosis and to work out whether the cause is viral or bacterial. These may include a physical examination, blood tests, a lumbar puncture (a sample of fluid taken from the spine) and a CT scan to check for problems such as swelling of the brain.

Because bacterial meningitis can be so serious, NHS inform says treatment with antibiotics will usually start before the diagnosis is confirmed. The antibiotics are stopped later if tests show a virus is the cause.

The NHS says treatment depends on whether the cause is bacterial or viral. You will need tests in hospital to find out which.

Bacterial meningitis must be treated in hospital because it can cause serious problems and needs close monitoring. NHS inform lists antibiotics and fluids given directly into a vein, oxygen through a face mask if there are breathing difficulties, and in some cases steroid medication to help reduce swelling around the brain.

Viral meningitis can often be treated at home. The NHS recommends plenty of rest, painkillers and anti-sickness medicine. NHS inform says severe viral meningitis may also be treated in hospital.

The NHS says viral meningitis tends to get better on its own within 7 to 10 days, and NHS inform says most people feel better within that time. Bacterial meningitis is usually treated in hospital for at least a week.

NHS inform says you may need to stay in hospital for a few days, and in certain cases treatment may last several weeks. Even after going home, it may be a while before you feel completely back to normal.

The NHS says viral meningitis does not usually cause long-term problems and most people make a full recovery. Bacterial meningitis is rarer but more serious, and NHS inform lists the following possible complications. Complications are much rarer after viral meningitis.

• hearing loss, which may be partial or total (a hearing test is usually arranged after a few weeks)

• recurrent seizures (epilepsy)

• problems with memory and concentration

• co-ordination, movement and balance problems

• learning difficulties and behavioural problems

• vision loss, which may be partial or total

• loss of limbs, because amputation is sometimes needed to stop infection spreading

• bone and joint problems, and kidney problems

The NHS says vaccines are one of the safest and most effective ways to protect you and your child against meningitis. Because meningitis has many causes, several vaccines offer some protection. NHS inform lists MenB, the 6-in-1 vaccine, the pneumococcal vaccine for babies, MMRV and MenACWY.

The NHS says the MenB vaccine is given to children at 8 weeks, 12 weeks and 1 year old, and that a child who missed doses can still have it up to the age of 2. The MenACWY vaccine is usually given to teenagers in school year 9 (aged 13 or 14), and can be given up to the age of 25 if it was missed.

The NHS also notes that the MenACWY vaccine is very effective but does not prevent all types of meningitis, so it is still important to know the symptoms even if you have been vaccinated. Students are advised to check they are up to date before starting university or college.

The NHS pages also describe a time-limited MenB offer for some young people starting university or further education in autumn 2026, with first doses available until 31 December 2026. Check the NHS page or ask your GP surgery for the current position.

The NHS says you need medical help immediately if you think you or your child might have meningitis. Call 999 or go to A&E if an adult or a child aged 5 or over has any of the following. Do not drive yourself to A&E; the person you speak to at 999 will advise you.

• a very high or very low temperature, feeling hot or cold to the touch, or shivering

• a very painful headache

• confusion, slurred speech, or not making sense

• a stiff neck and being unable to look at bright lights

• a rash that does not fade when you press it

• a seizure (fit) for the first time

• symptoms that you are worried might be meningitis

Suspected meningitis is an emergency and is managed through 999, ambulance and NHS emergency departments, which can start treatment immediately. Private services are not set up for this kind of emergency, so there is no private route to choose between when meningitis is suspected.

Private care may become relevant later, for example for follow-up hearing assessments, neurology or rehabilitation appointments, or private vaccination for travel. The NHS vaccination schedule is free for those eligible, so check your NHS vaccination record through the NHS App or your GP surgery first.

The NHS points people affected by meningitis to two UK charities: Meningitis Now and the Meningitis Research Foundation. Both provide information and support for people who have had meningitis and for their families.