Meningitis

Symptoms

• Fever (38°C or higher for babies under 3 months old, 38.5°C and higher for children over 3 months old)
• Extreme irritability or drowsiness
• Very bad headache
• Stiff neck (child avoids moving their neck)
• Sensitivity to bright lights
• Vomiting
• Small red or purplish spots on the skin that don’t blanch when pressed, or blue patches mainly on the limbs
• Seizures

What is meningitis?

Meningitis is an inflammation of the meninges, which are the membranes that cover the central nervous system, including the brain and spinal cord. There are different types of meningitis, depending on the infection that causes it.

Viral meningitis

This type of meningitis is caused by a virus (e.g., herpes simplex, enterovirus, parechovirus).

Meningitis caused by an enterovirus usually occurs in late summer and early autumn, and often begins with an upper respiratory tract infection. Its symptoms mimic those of a common cold (fever, dry cough, runny nose) or flu (fatigue, muscle aches, fever).

This type of meningitis is relatively benign and almost never has after-effects. However, it can cause convulsions and severe apnea (pauses in breathing) in babies.

Herpes viral meningitis, on the other hand, can be severe and must be treated urgently, especially in babies. This type of meningitis is caused by the virus that causes cold sores.

Bacterial meningitis

This type of meningitis is caused by bacteria. A child with bacterial meningitis will become ill very quickly.

Bacterial meningitis has become rarer nowadays thanks to vaccination against Haemophilus influenzae type b (Hib), pneumococcal, and meningococcal group C infection. Group B streptococcus is the bacterium most often associated with meningitis in babies under 8 weeks. After this age, meningococcus and pneumococcus are more often the cause.

Bacterial meningitis can lead to serious complications, including permanent damage to the brain and other organs. In less than 5% of cases, bacterial meningitis can be fatal.

The most frequent complication is hearing loss, which can vary in severity. Hearing loss affects one in four children with bacterial meningitis. All children who have had bacterial meningitis should have their hearing tested, even if everything seems normal.

Other serious potential complications include epilepsy, intellectual disability, limb paralysis, learning or behavioural disorders, and attention deficit disorder.

Complications can arise quickly, even with proper treatment. For this reason, consult a doctor as soon as your child shows signs of meningitis.

How can you tell what type of meningitis it is?

Only a doctor can confirm whether meningitis is caused by a viral or bacterial infection. They do this by performing a thorough examination and running diagnostic tests, including a lumbar puncture. This can often help them distinguish between viral and bacterial meningitis.

The initial results of a lumbar puncture don’t always confirm the type of meningitis on their own. Usually, children with meningitis are hospitalized until bacterial meningitis has been ruled out.

Treatment – viral meningitis

Your child can be discharged from hospital if their general condition is good, they aren’t vomiting, and their tests have ruled out bacterial meningitis. Once they’re back home, they can quickly resume their usual activities; no medical follow-up is needed.

Care and practical advice

• Encourage quiet activities. Your child doesn’t have to stay in bed all day, but they do need to rest.
• Give your child plenty of fluids (e.g., water, milk, soup).
• If your child has a poor appetite, give them smaller portions five or six times a day (e.g., cheese, Greek yogurt, eggs, oatmeal, apple sauce, or nuts if your child can eat them).
• To relieve pain and fever, give them acetaminophen (e.g., Tylenol^® or Tempra^®) or ibuprofen (e.g., Advil^®, Motrin^®) as indicated and in the doses recommended for your child’s weight. Don’t give ibuprofen to babies under 6 months, and never give acetylsalicylic acid (ASA, such as Aspirin^®) to children or teens.

Treatment – bacterial meningitis

Children with bacterial meningitis must be hospitalized. Bacterial meningitis requires treatment with intravenous antibiotics as soon as possible to prevent complications. Antibiotics are administered for 7 to 21 days, depending on the type of bacteria involved. Some complications may require longer treatment.

If meningococcal bacterial meningitis is suspected, the doctor may prescribe antibiotics for other family members to prevent them from becoming infected. In this case, the antibiotic can be prescribed as a single dose or as multiple doses to be taken every 12 hours for 2 days.

Prevention

Vaccination

Quebec’s vaccination schedule includes protection against the main bacteria that cause meningitis—Haemophilus influenzae type b [Hib], pneumococcus, and meningococcus—administered from the age of 2 months. These vaccines have significantly reduced the number of cases of bacterial meningitis. Some children who are at higher risk of contracting meningitis, such as children with a compromised immune system or who don’t have a spleen, may receive additional vaccines.

Talk to your child’s doctor to make sure they receive all these vaccines on schedule. However, because these vaccines do not target all strains of meningitis-causing bacteria, your child cannot be 100% protected against meningitis.

There is no specific vaccine for viral meningitis, but the measles, mumps, and rubella (MMR) and chickenpox vaccines offer some protection against viral meningitis, which is a possible complication of these infections.

Basic hygiene

These basic hygiene measures can help prevent infections in general:

• Wash your hands with soap after coming into contact with an infected person or after touching an object that they handled.
• Wash your child’s hands often, and show them how to wash their own hands as early as possible, especially after they cough, sneeze, or blow their nose.
• Teach your child to cough or sneeze into a tissue or, if they don’t have one, into the crook of their elbow.
• Wipe down taps and door handles thoroughly, preferably with an alcohol-based cleaner. Do the same with toys. For more information, read our fact sheet on cleaning and disinfecting toys (available in French only).

Scientific review: Dr. Isabelle Viel-Thériault, pediatrician and infectious disease specialist at CHU de Québec – Université Laval. Research and copywriting:The Naître et grandir team Updated: February 2025

Photo: BSIP/MENDIL