A meningitis outbreak believed to be linked to Canterbury club night has left two young dead and more than a dozen seriously ill, in an incident experts have called ‘extremely concerning’.
The victims, thought to be aged between 17 and 21, are understood to include a University of Kent student and a sixth-form pupil at Queen Elizabeth’s Grammar School in nearby Faversham.
Several others were hospitalised after reportedly developing symptoms days after attending Club Chemistry in Canterbury – a large student nightclub where the group had gathered to celebrate a birthday.
The UK Health Security Agency (UKHSA) has now alerted more than 30,000 students and staff in the area, and is offering precautionary antibiotics to some who may have been exposed.
Meningitis – a condition that causes swelling of the brain and spinal cord – is most often triggered by viral or bacterial infections.
Symptoms can at first mirror those of a bad cold, flu, or even a hangover. But without treatment, the condition can worsen quickly and become deadly.
Outbreaks of meningitis like these are ‘extremely rare’, say experts. Yet when several linked cases appear in the same place – such as a university community – it becomes a serious public-health concern.
So, who should be concerned for their safety, and what can you do if you think you’ve been exposed to the infection? Read on for expert answers to your most pressing meningitis questions…
Students wearing face masks walk through the University of Kent campus in Canterbury today
How can you catch meningitis?
Causing inflammation of the membranes that surround the brain and spinal cord, meningitis can be caused by either viruses or bacteria.
The most dangerous outbreaks are usually caused by the bacterial version – which is less common but much more deadly.
Both variants of the infection are largely spread in the same way, however – through direct contact with infected mucus or saliva.
It can be passed on through kissing, coughing and sneezing as well as sharing utensils or cigarettes.
And not everyone who passes on the infection on will be visibly ill, says Dr Simon Clarke, associate professor of cellular microbiology at the University of Reading.
‘The bacteria that cause meningococcal meningitis are often carried harmlessly in the nose and throat; around 10 per cent of the general population carry them without ever becoming ill,’ he explained.
‘In adolescents and young adults, carriage can be higher, with large UK studies showing rates between 7 per cent and 18 per cent.
‘Transmission requires close, prolonged contact such as coughing, sneezing or kissing, and even among carriers only a very small proportion ever develop invasive disease.’
While viral meningitis will likely resolve on its own within seven to 10 days, bacterial meningitis is a medical emergency that is severe and often fatal if not treated.
Several victims developed symptoms days after attending Club Chemistry in Canterbury – a large student nightclub where the group had gathered to celebrate a birthday
How does meningitis spread?
Teenagers and young adults are known to be at higher risk for the disease due to living in close contact with each other in university dorms and boarding schools, says Dr Zina Alfahl, bacteriology professor at the University of Glasgow’s School of Medicine.
‘University environments — halls of residence, parties, and large social networks — create conditions where the bacteria can spread more easily,’ she said.
‘People in this age group carry the bacteria in the nose or throat without symptoms, and it spreads through close contact such as coughing, kissing, or sharing drinks.
‘That’s why vaccination programmes and rapid public-health responses often focus on students and young adults when clusters occur.’
It’s rare for the condition to be passed on through more casual contact, however, say experts, such as sitting next to someone in a classroom or passing them in a shop.
Adds Dr Alfahl: ‘For the general public in Kent or across the UK, the overall risk remains very low.
‘The people at highest risk are usually close contacts of cases — people living together, close friends, or those sharing social spaces with prolonged contact.
‘So while this is a serious cluster that requires urgent investigation and control measures, it does not mean there is a widespread risk to the whole population.’
How can I tell the difference between a meningitis infection and a cold?
Early meningitis symptoms can be frustratingly vague, say experts, often resembling those of much more commonplace ailments.
Like flu, the illness often begins with a sudden fever, shivering, exhaustion, muscle aches and a general sense of feeling very unwell.
Children and teenagers may complain of severe headaches, nausea, vomiting or sensitivity to light.
In babies, the signs can be even harder to spot. They may refuse feeds, become unusually irritable or lethargic, have a weak high-pitched cry or be difficult to wake.
As the infection worsens, however, the more recognisable symptoms of meningitis may appear.
These include an intense headache, vomiting, a stiff neck and sensitivity to bright light.
People may also become drowsy or confused, struggle to concentrate or develop seizures.
In babies, the soft spot on the head – known as the fontanelle – may bulge, and they may seem unusually floppy or stiff.
Doctors stress that symptoms do not always appear in the same order – and not everyone develops all of them.
But if you or a loved one does develop any of these warning signs of meningitis, it’s important to seek help straight away, says Dr Clarke.
‘With prompt medical care, outcomes are generally good and long‑term complications are far less common than they once were,’ he said.
Does the glass test really work?
One of the key signs of meningitis is a rash of tiny red or ‘pinprick’ marks which can turn into larger red or purple areas resembling bruises.
Parents have long been advised to seek urgent treatment if a red or purple rash on their child doesn’t fade when a glass or tumbler is pressed on it – a trick known as the glass test.
Most rashes will fade under pressure, as blood supply is restricted and the skin whitens. But meningitis rashes occur when blood starts to leak into the skin. This means that even as a glass is pressed into the skin, the rash will remain.
A recent survey suggested that more than 40 per cent of mothers believe the glass test is the best way to identify meningitis – but experts warn that it cannot be relied on to give an early warning of the deadly disease.
This is because once a rash appears, it may already be too late to get help, as it means the infection has advanced and sepsis, a potentially fatal condition, has taken hold.
Dr Jolanta Bernatoniene, a consultant paediatrician and expert in paediatric contagious diseases, says waiting for a rash to develop before seeking help is a mistake.
She told The Mail on Sunday last year: ‘Instead, be aware of the other symptoms, such as a worsening headache, spiking temperature, aversion to bright light, or, with babies, dislike of being held or cuddled.
‘Not everyone will develop a rash – and if they do, it’s often an indication the disease has got much worse, meaning the patient requires urgent treatment to survive. And with an illness that progresses as quickly as meningitis, there’s no time for delay.’
Will masks and hand-washing help prevent me from catching it?
Vaccination is the most effective protection against meningitis, say experts.
But as with all respiratory viruses, there are some precautions people can take to reduce the risk of transmission, particularly in crowded, enclosed spaces.
As meningitis is often spread through direct contact with respiratory droplets from the mouth and nose, wearing a surgical mask can act as a barrier – limiting the spread of these droplets.
Hospital staff in the emergency department at Kent and Canterbury Hospital are being told to wear face masks, the Daily Mail understands, in light of the recent outbreak.
But whilst masks do reduce risk, they’re not a complete solution, as meningitis bacteria doesn’t spread as easily as the common cold.
Frequent handwashing, and avoiding sharing items like cups and utensils can also help reduce the risk of transmission.
Who needs preventative antibiotics, and how can I get them?
Another preventative measure are antibiotics, which can be used to kill off any bacteria in the nose and throat of close contacts of meningitis patients.
The drugs, which are often either taken as a twice daily pill or single-dose tablet, must be taken as soon as possible to be most effective – ideally within 24 hours of identifying the case.
Preventative antibiotics are currently being handed out to some students in Canterbury. But not everyone will be eligible for the drugs, says professor in medicine at the University of East Anglia, Dr Paul Hunter.
‘Close contact is defined as prolonged close contact with the case in a household type setting during the seven days before onset of illness,’ he said.
‘Antibiotics may also be offered to someone who “had transient close contact with a case only if they have been directly exposed to large particle droplets or secretions from the respiratory tract of a case around the time of admission to hospital”.’
In the case of the current outbreak, more people than usual may be offered antibiotics – and vaccinations – however.
Says Prof Hudson: ‘When we see multiple linked cases of invasive disease, antibiotics are given to a wider circle of contacts.
‘If the infecting bacteria is a group other than B we would usually offer the MenACWY vaccine to the same people offered antibiotics.
‘If as is most usual the infection was a group B meningococcus, vaccination with a group B vaccine may be offered unless the data suggests that the infection would not be covered by the vaccine.’
If you think you may be eligible for preventative meningitis antibiotics, contact your GP immediately, or call NHS 111.
How do I know if I’ve already been vaccinated?
Whether you’ve previously received a vaccine for meningitis will depend on your age, location and childhood vaccination history, say experts.
Vaccinations against certain strains of meningitis are offered during childhood by the NHS.
‘In the UK, adolescents are routinely offered the MenACWY vaccine, and infants receive the MenB vaccine,’ says Dr Alfahl.
Both of these jabs were only introduced in the last few decades, however, so older adults may not have received them.
Babies aged eight weeks began receiving the MenB vaccine, which protects against Meningcoccal B, in September 2015, while the MenACWY, which targets strains A, C, W and Y, was introduced for teenagers in August of that year.
Babies born after November 1999 will also have been offered the MenC vaccine, which has now been replaced by the MenACWY jab.
The jab was also offered to young adults under 25 as part of a catch-up campaign in 2002.
While it’s not yet known what strain of meningitis is behind the outbreak in Kent, many current university students will not have been offered the MenB vaccine, as they were born before 2015, says Dr Alfahl.
‘Uptake of the ACWY vaccine among adolescents is around 73 per cent, so there are a lot of unvaccinated students given the size of the student cohort,’ added Dr Andrew Preston, Professor of Microbial Pathogenicity at University of Bath.
British adults over 50 today are also unlikely to have received any vaccine for meningitis unless they paid for it privately or were part of a specific risk group, therefore.
If you are unsure whether or not you have received the vaccine, you can check your health records with your GP, or through the NHS app.
If my child hasn’t yet been vaccinated for meningitis, should they get a jab now?
Children and young adults who have not yet received the meningitis vaccine may still be eligible for a catch up jab.
Young people aged 25 and under who missed the MenACWY vaccine can request one from their GP.
Catch-up doses of the MenB vaccine can also be provided by your GP up until the age of two.
Older children and adults who are not eligible for either vaccine can also pay to receive them privately.
The MenB vaccine is widely available for adults and children over two at Boots and Superdrug pharmacies, as well as many travel health clinics, for around £100 a dose.
The MenACWY, meanwhile, costs around £55 a jab.
University students under 25 are strongly advised to get the MenACWY vaccine if they missed it, according to the NHS website.