Health Insights · Urgent & acute
Meningitis: recognising it fast and acting straight away
Meningitis is inflammation of the lining around the brain and spinal cord; septicaemia is blood poisoning from the same infection. Both can kill a previously healthy person within hours. The most dangerous misconception is that you should wait for a rash — many people never develop one, and when it appears it is a late sign.
Call 999 immediately if there is
- a rash that does not fade when a glass is pressed firmly against it
- a stiff neck, severe headache, or dislike of bright light
- fever with cold hands and feet, or mottled, pale or blue skin
- drowsiness, confusion, or difficulty waking
- a fit or convulsion
- in a baby: a bulging soft spot, a high-pitched cry, floppiness or refusing feeds
Trust your instinct over any checklist. Someone deteriorating rapidly needs an ambulance whether or not the classic signs are present. Do not delay for a GP appointment or a phone assessment. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
The rash is a late sign, and often absent
The glass test — pressing a clear glass against the rash and looking for spots that do not fade — is useful when there is a rash. But septicaemia can kill before any rash appears, and meningitis frequently causes none at all. If someone is seriously unwell, act on how they look, not on whether you can find a rash. Waiting to see whether one develops is how time is lost.
How it starts
Early symptoms are indistinguishable from flu: fever, headache, aching, feeling generally unwell, sometimes vomiting. What distinguishes meningitis is the speed — deterioration over hours rather than days — and the appearance of any of the emergency signs above.
- In babies and toddlers: refusing feeds, vomiting, irritability especially when picked up, a high-pitched or moaning cry, floppiness or stiffness, a bulging fontanelle, and unusual drowsiness.
- In older children and adults: severe headache, neck stiffness, dislike of light, confusion, and rapid deterioration.
- Leg pain, cold hands and feet, and abnormal skin colour are early features of septicaemia and often precede everything else.
Vaccination
Several forms are preventable and the NHS childhood schedule covers MenB, MenC (within combined vaccines) and Hib, with a MenACWY vaccine offered to teenagers and to students starting university. Pneumococcal vaccination protects against another common cause.
- Students are at higher risk in their first term. Check MenACWY has been given before they go.
- Travellers to certain regions, and pilgrims to Hajj and Umrah, need MenACWY — it is a visa requirement for Saudi Arabia.
- People without a working spleen, or with certain immune conditions, need additional vaccination and often long-term antibiotics.
- No vaccine covers every cause, so vaccination does not remove the need to recognise the signs.
If you have been in close contact
Household and very close contacts of someone with meningococcal disease are usually offered preventive antibiotics and sometimes vaccination. Public health teams identify and contact them. If you believe you were a close contact and have not been contacted, seek advice the same day rather than waiting.
Afterwards
Most people who receive prompt treatment recover fully. Some are left with hearing loss, tiredness, headaches, memory and concentration difficulties, or emotional after-effects, and a hearing test is routine after bacterial meningitis. Meningitis Now (0808 80 10 388) and the Meningitis Research Foundation (080 8800 3344) both run free helplines.
Call 999 for the emergency — come to us for the protection. We provide MenACWY and other meningococcal vaccination for students, travellers and Hajj and Umrah pilgrims, pneumococcal vaccination for those at risk, and catch-up vaccination for children and adults whose schedule is incomplete. We are open 7 days a week, no referral is needed, and we can usually see you the same day.
Meningitis awareness and urgent assessment in East London
Meningitis can develop quickly and become life-threatening, so acting fast matters. A high fever with a severe headache, a stiff neck, dislike of bright light, drowsiness or confusion, or a rash that does not fade under a glass needs emergency care — call 999 or go to A&E now, and do not wait for a rash to appear. For milder illness or if you are unsure, our urgent care service and a private GP in East London can assess you the same day, and our paediatric team can see children. We can also advise on vaccinations that protect against some types. Tower Bridge Hospital is on Whitechapel Road in East London, a short journey from Canary Wharf and the City, with same-day appointments and no referral required.
Meningitis in London: common questions
What are the warning signs of meningitis?
Fever with severe headache, a stiff neck, dislike of light, drowsiness or confusion, and a rash that does not fade under pressure — any of these needs emergency care.
Should I wait for a rash?
No — the rash is a late sign and does not always appear. If meningitis is suspected, seek emergency help immediately.
Can meningitis be prevented?
Several types are covered by vaccines, including some given before travel or university; we can advise and vaccinate.
What if I'm not sure how serious it is?
If in doubt, treat it as an emergency and call 999. For milder illness we can assess you the same day and safety-net carefully.
MenACWY and travel vaccination, same day
7 days a week, no referral needed. In an emergency call 999.