Meningococcal septicaemia (meningococcaemia): signs, emergency care and prevention

Meningococcal bacteria can cause two main forms of serious illness: meningitis, infection of the protective layers that cover the brain and spinal cord, and septicaemia, infection of the bloodstream. Meningitis Now explains that meningitis and septicaemia can happen together and that the term sepsis is increasingly used in place of septicaemia.

The NHS describes meningitis as an infection of the protective layers that cover the brain and spinal cord which can be very serious and even life-threatening if not treated quickly. In meningococcal septicaemia the infection is in the bloodstream, and the NHS and Meningitis Now both describe a rash that does not fade as one of its signs.

The NHS lists symptoms of meningitis that develop suddenly, and Meningitis Now adds symptoms specific to septicaemia. Symptoms can appear in any order and some may not appear at all. Some of the early symptoms can be similar to flu, a stomach bug or a hangover, according to the NHS.

• A high temperature, often with very cold hands and feet.

• Vomiting, and sometimes diarrhoea.

• Severe muscle and joint pain.

• Being very sleepy, hard to wake, confused or irritable.

• Pale, blotchy skin, spots or a rash that does not fade when pressed with a glass.

• A severe headache, stiff neck, dislike of bright lights and seizures, when meningitis is also present.

• In babies and under-5s: refusing feeds, a high-pitched or unusual cry, a stiff or floppy body, or a bulging soft spot on the head.

The NHS says the rash usually starts as small red pinpricks before spreading quickly and turning into red or purple blotches, and that not everyone gets spots or a rash. Press the side of a clear glass firmly against the skin: a rash that does not fade under pressure is a sign of meningococcal septicaemia, according to Meningitis Now.

On brown or black skin the rash can be harder to see. The NHS advises 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.

Meningitis Now is clear that you should not wait for a rash. If someone is ill and getting worse, trust your instincts and get medical help immediately.

The NHS says to call 999 or go to A&E if an adult or child aged 5 or over has a very high or very low temperature, a very painful headache, confusion or slurred speech, a stiff neck and cannot look at bright lights, a rash that does not fade when pressed, a first seizure, or symptoms you are worried might be meningitis. For a baby or child under 5 it lists a very high temperature (38C or more in babies under 3 months, 39C or more in babies 3 to 6 months), a very low temperature (below 36C) or feeling cold to touch, a weak, high-pitched or continuous cry, a non-fading rash, not responding normally, not feeding, or being floppy, hard to wake or more sleepy than usual.

It stresses that you should not drive yourself to A&E, and that a person with meningitis might not have every symptom listed. Trust your instincts and get immediate medical help if you are unwell and think there is something seriously wrong.

The NHS says bacterial meningitis needs to be treated in hospital, usually for at least a week, with antibiotics given directly into a vein, fluids into a vein, and oxygen through a face mask. The sources used here describe the treatment of bacterial meningitis; for septicaemia the principle of urgent hospital care applies and the hospital team will decide on the details.

The NHS says viral meningitis tends to get better on its own within 7 to 10 days, whereas bacterial meningitis is rarer but more serious and can be fatal. Tests in hospital are used to find out which type of infection it is.

The NHS says bacterial meningitis may cause long-term problems such as hearing or vision loss, seizures, problems with movement and co-ordination, and problems with memory and concentration. It points families to Meningitis Now and the Meningitis Research Foundation for information and support services, including information on the after-effects.

The sources used here do not describe the after-effects of septicaemia specifically, so questions about recovery and rehabilitation are best put to the hospital team.

The NHS says vaccines are one of the safest and most effective ways to protect against meningitis. Children and teenagers are offered vaccines that protect against the main causes of meningitis as part of the NHS vaccination schedule, such as the MenB, MenACWY, pneumococcal, 6-in-1 and MMRV vaccines. A MenB vaccine is also being offered, until March 2027, to some young people starting university or further education in autumn 2026 who were born in specified date ranges, with two doses important for protection.

Meningitis Now notes that one in four 15 to 19 year olds carry the bacteria in the back of their throats, compared with one in ten of the UK population, which puts them at greater risk. The NHS adds that meningitis is spread through close contact, such as kissing or sharing drinks or vapes, usually by people who carry the bacteria but are not ill themselves.

Suspected meningococcal disease is always an emergency and is managed by NHS ambulance and hospital services. There is no role for waiting for an appointment or for private referral before emergency treatment.

Charity helplines provide information and support afterwards, including the Meningitis Now helpline listed on the NHS page.