Last updated:

Reviewed by:

Dr Rhianna McClymont

, Lead GP at Livi

Medically reviewed

We explain the difference between viral and bacterial meningitis, including the main signs and symptoms, how to spot a meningitis rash and when you should seek medical attention.

What is meningitis?

The lining around the brain and spinal cord is called the meninges – if this becomes inflamed, it’s known as meningitis. This can trigger symptoms like a stiff neck, headache and fever and cause severe complications, like blood poisoning, if not treated quickly.

What causes meningitis?

The leading causes of meningitis are bacteria and viruses:

  • Viral meningitis – This is the most common type of meningitis and is more likely to affect babies and young children. Some viruses that can cause viral meningitis include the herpes simplex virus (which causes cold sores, mumps and enteroviruses (that often cause mild stomach upsets)

  • Bacterial meningitis – This is rarer than viral meningitis but more serious and needs urgent hospital treatment. It can be caused by a range of different bacteria, including meningococcal, pneumococcal, TB, Group B streptococcal and E.coli

How does meningitis spread?

Meningitis is usually spread if you’re carrying viruses or bacteria but don’t have any symptoms. It can be passed on through sneezing, coughing and kissing.
Less commonly, it can also be spread if you are displaying meningitis symptoms.

Who gets meningitis?

You can get meningitis at any age, but certain groups are more likely to be affected. These are:

  • Babies and young children

  • Teenagers and young people

  • Older people

  • Those with a weak immune system

Can you get meningitis twice?

It’s possible to get meningitis twice, but it’s very unlikely.

Meningitis symptoms

There is a range of possible meningitis symptoms, but you don’t necessarily get all of them, and they can appear in any order. The main symptoms are:

  • A high temperature

  • Vomiting

  • Severe headache

  • A rash on the body

  • Stiff neck

  • Sensitivity to bright lights

  • Being vacant

  • Excessive sleepiness

  • Feeling confused or delirious

  • Seizures

  • Additional meningitis symptoms in babies can also include:

  • Difficulty feeding

  • Floppy or stiff body

  • Bulging fontanelle (soft spot on their head)

  • Difficulty waking up

  • Constant crying

Meningitis rash

The meningitis rash generally starts with tiny, red pinpricks, which can spread and appear like red or purple blotches.

The meningitis glass test involves placing a clear glass firmly against the skin on top of the rash. If the rash does not fade under the glass, it could be a sign of septicaemia, which is blood poisoning caused by meningitis.

When to seek medical attention

Call 999 and ask for an ambulance if you have a rash that doesn’t fade when you carry out the meningitis glass test.

A rash isn’t always present in the early stages of meningitis. If you or your child has other symptoms of meningitis, don’t wait for a rash to develop if you’re concerned.

Meningitis vaccine

Various vaccines help prevent some types of meningitis, but there isn’t a vaccine that prevents all types. Vaccines include:

  • Meningitis b vaccine – Offered to babies at eight weeks, 16 weeks and one year to protect against the meningococcal group B bacteria

  • Pneumococcal vaccine – Offered to babies in two doses to help protect against pneumococcal infections, which can lead to meningitis and septicaemia

  • MenACWY vaccine – Offered to teenagers in years 10 and 11 and to university students to protect against the four strains of the meningococcal bacteria, which cause meningitis and blood poisoning

  • Other vaccinations that offer some protection against meningitis include Hib/MenC, MMR, BCG and the 6-in-1 vaccine

What are the side effects of the meningitis vaccine?

Like most vaccines, meningitis vaccines can cause some mild side effects. These will depend on the vaccination you or your child is having and how old you are. Talk to the doctor about the possible side effects of each vaccine beforehand.

Meningitis diagnosis

Different tests may be needed to confirm a diagnosis of meningitis and tell whether it’s viral or bacterial meningitis. These include:

  • Blood tests

  • A lumbar puncture, which takes a fluid sample from your spine

  • A CT scan to look for swelling or other complications in the brain

  • A physical examination

Meningitis treatment

It’s vital to treat bacterial meningitis with antibiotics as soon as possible to prevent serious complications from developing. You may be given antibiotics immediately, even before bacterial meningitis is confirmed.

Bacterial meningitis treatments

This includes:

  • Intravenous antibiotics (given through a vein)

  • Intravenous fluids

  • Oxygen is given through a face mask

Viral meningitis treatment

Mild to moderate cases of viral meningitis usually get better on their own at home within seven to 10 days with plenty of rest. Painkillers and anti-sickness medication can help to improve symptoms.

If you have a severe case of viral meningitis, it will usually be treated in the hospital.

Meningitis complications and outlook

Most people with viral meningitis make a full recovery with no long-term side effects.

Some bacteria that cause meningitis can also cause septicaemia (blood poisoning). This is a life-threatening condition that can lead to permanent brain or nerve damage.

If bacterial meningitis is treated quickly, people usually recover well, but it can be fatal in up to one in 10 cases. It can also cause other long-term problems like:

  • Loss of hearing and vision

  • Seizures (epilepsy)

  • Movement problems

  • Problems with memory or thinking

Last updated:
Reviewed by:
Lead GP at Livi Dr Rhianna McClymont
Dr Rhianna McClymont, Lead GP at Livi