General information on meningitis and septicaemia for staff and students

 

In January 2017, a student was admitted to hospital with septicaemia, probably caused by the meningococcal bacteria. The student has now completely recovered and no further cases were reported but as a part of Public Health England's guidance, an email with advice was issued to all Exeter-based students. You can read this email here - Jan 2017 - Email regarding probable case of meningitis. Further general information on meningitis and septicaemia is below.

General information

Cases of meningococcal disease amongst students in higher education establishments are relatively rare, but the effects can be extremely serious or even fatal. We recognise this may cause considerable anxiety in both students and their families.

When a student is affected by the disease at the University, we follow guidance issued by Public Health England to support the student and enable the identification of any other students who may be at risk and ensure they are offered appropriate advice. We also provide prompt information and reassurance to relevant groups of staff and students.

Please see further details below which explain the nature of meningococcal disease, the risks of contracting it and the actions taken by the University and Public Health England if one or more cases occur.

Meningitis is an inflammation of the meninges; the lining surrounding the brain and spinal cord. It can be caused by a variety of organisms such as viruses and bacteria.

Viral meningitis is the most common type. Symptoms are usually mild (like the common cold) and recovery is normally complete without any specific treatment (antibiotics are ineffective). In most cases admission to hospital is unnecessary (although it is still notifiable to the Health Protection Agency).

Bacterial meningitis is a rare disease, but it can be very serious and requires urgent treatment with antibiotics. There are two main forms of bacterium: pneumococcal and meningococcal (of which there are five groups (strains) A, B, C, Y and W135).

Pneumococcal meningitis mainly affects infants and elderly people, but people with certain forms of chronic disease or immune deficiencies are also at increased risk. There is a vaccine available to protect people at high risk. It does not normally spread from person to person and public health action is therefore not usually needed. The pneumococcal bacterium is better known as a cause of pneumonia.

Meningococcal meningitis is the most dangerous type of bacterial infection. The bacterium can give rise to meningitis and/or septicaemia. Public health action is always required to identify and arrange the provision of preventive antibiotic treatment to close contacts of a case of meningococcal disease. Meningococcal disease is fatal in about one in ten cases.

Septicaemia is a type of blood poisoning caused by bacterial meningitis. The bacteria release toxins which break down the walls of the blood vessels allowing blood to leak out under the skin and reduces the amount of blood available for vital organs. Septicaemia is often more life threatening than meningitis.

Meningococcal bacteria are carried at the back of the throat or nose by up to 10% of the general population (and up to 20% of young people). Only rarely does infection (or colonisation) give rise to disease. Illness usually occurs within seven days of acquiring the bacteria, but symptom-less carriage can persist for many months. It is not known why some people become ill and others remain healthy carriers. The bacteria do not survive for long outside the body and most people acquire infection from prolonged, close contact with a symptom-less carrier. Infection is usually acquired from a healthy carrier rather than from a person with the disease.

Most cases of meningococcal disease are sporadic. However, the risk of a second case in a close household contact is much higher than the risk in the general population. In spite of this, clusters of disease are uncommon, occurring only occasionally in households and rarely in establishments of further or higher education.

Antibiotics: Preventive treatment with oral antibiotics (a very short course of rifampicin or one dose of ciprofloxacin) are recommended for close contacts of a case of meningococcal disease in order to reduce the risk of further spread of infection. If only one case has occurred, antibiotic preventative treatment is recommended only for those who have had close prolonged contact with the case. As the infection does not easily spread from person to person there is generally no need for wide-scale preventive measures.

Immunisation: The NHS advises that young teenagers and 'fresher' students going to university for the first time are advised to have a vaccination to prevent meningitis W disease. The Men ACWY vaccine is given by a single injection into the upper arm and protects against four different causes of meningitis and septicaemia – meningococcal (Men) A, C, W and Y diseases. Other vaccines against meningitis are available and further detail can be found on the NHS website.

The University Policy on Immunisation: All first year students (aged under 25) should be immunised against groups A, C, Y and W meningococcal disease by their own General Practitioner, prior to arrival at the University. Those students (under 25) who arrive without immunisation should register with the Student Health Centre or a local General Practitioner and request this to be carried out as soon as possible. Second year students who missed their vaccination last year, are also eligible for immunisation. Based upon advice from the Department of Health, it is not considered necessary for other students or staff to receive this precautionary immunisation, but it may become necessary if a case occurs. This Policy will be continuously reviewed and amended, in accordance with recommendations from the Department of Health.

Meningitis

Meningitis is not easy to detect at first because the symptoms can be similar to those of flu. Recognising the symptoms early enough could mean the difference between life and death. Someone with meningitis will become very ill. The illness may take over one or two days to develop but it can develop very quickly with the patient becoming seriously ill in a few hours. If the patient’s condition deteriorates, do not delay … go straight to hospital.

The following symptoms may not all appear at the same time:

SymptomCheck for:
Fever/Vomiting (occasionally diarrhoea)
  • Is the patient's temperature above normal? (this may occasionally be slow to develop)
  • Is there vomiting?
Headache
  • Is it sudden and severe?
Stiff neck, aching limbs and joints
  • Can the patient touch their chin to their chest?
Dislike of bright lights
  • Does the light hurt their eyes?
Drowsiness/Impaired Consciousness
  • Is the patient confused and tending towards unconsciousness?
Rash (haemorrhagic/septicaemic rash, not always present)
  • Is there a rash? It could develop anywhere on the body. Initially pinprick red spots developing into large purple marks which will not fade when pressed.
Seizures (fits)  

The "Glass Tumbler" test: If a glass tumbler is pressed firmly against the rash, it will not fade, but remain visible through the glass. If this happens seek medical attention immediately.

Septicaemia (blood poisoning)

  • High fever (not always present initially)
  • Shivering and cold feet and hands
  • Rash of red/purple spots or bruises
  • Impaired consciousness
  • Nausea and vomiting
  • Rapid breathing
  • Severe muscle aches
  • Abdominal pain and sometimes diarrhoea

Just because meningitis patients are well enough to leave hospital, it does not always mean they are ready to return to normal life. Meningitis is often followed by a variety of after effects, which are impossible to predict. Some of these effects are permanent and cause physical disabilities, some are less obvious affecting the patient emotionally.

A range of possible side effects are:

  • General tiredness
  • Headaches
  • Finding it difficult to concentrate
  • Short-term memory loss
  • Clumsiness
  • Giddiness
  • Balance problems
  • Depression
  • Violent temper tantrums
  • Bouts of aggression
  • Mood swings
  • Learning difficulties
  • Deafness
  • Tinnitus (ringing in the ears)
  • Sore or stiff joints
  • Eyesight problems
  • Epilepsy
  • Brain damage

Consultants will normally see patients a few weeks after they leave hospital to determine if there are any complications. Further information will provided by the Student Health Centre.

If you need any medical advice about meningitis, please contact:

  • your own General Practitioner;  and / or
  • NHS 111 Service (dial 111); and / or
  • the University Health Centre, Streatham Campus (Tel: 01392 676606); 

For further general information about meningitis please contact:

  • the University’s Occupational Health Team (01392 722217);  and / or
  • Meningitis Now (0808 8010388);  and /or
  • the Meningitis Research Foundation (0808 8003344) 
  • the Public Health England Health Protection Team on 0300 303 8162