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Because of the wide range of possible symptoms, the infection is often hard to identify at first, and you may not realise how sick you really are. To add to the difficulty, not everyone gets the same set of symptoms, and they don’t come in any particular order. In fact, some of the much talked about symptoms, such as a stiff neck or purple rash, may not appear at all.

Meningitis or septicemia?

Often – but not always – the early symptoms are similar to that of the flu, gastroenteritis, or even a hangover – a severe headache, fever, sore throat, lack of energy. Alternatively, it could start with a sore arm or leg, an aching joint, or pains in the chest or stomach, depending on whether the illness starts off as meningitis or septicemia (see The disease).

If you're watching out only for the commonly talked about symptoms of meningitis (severe headache, stiff neck, sensitivity to light), then you run the risk of overlooking symptoms relating to the more deadly septicemia.
This is why it’s critically important to be aware of all the possible symptoms, to be painstakingly watchful, and to use your gut feelings to decide whether the illness seems in any way strange, different or more rapidly progressive and severe, than you’d normally expect.

Don't wait for a rash to appear

This may be one of the later symptoms, but it may not even appear at all. If it does, it may be too late to stop the disease causing irreparable damage or even death.

Be vigilant if someone is ill

Check the sick person's body regularly for any sign of strange spot, blister or scratch mark, a faint pink or a red or purple pinpricks. If a rash in any form does appear, together with some of the following symptoms, then treat it as a medical emergency.

Remember, not all of the following symptoms will appear – there may only be a few. And symptoms differ from person to person. See a doctor if several or more of these symptoms occur and the patient is looking or feeling very unwell or deteriorates rapidly.

Symptoms in children and adults:

A. Symptoms common to meningitis and septicemia:
– fever (which may not go down with medication)
– nausea or vomiting
– lack of energy
– tiredness or drowsiness
– confusion or disorientation
– dizziness
– irritability or agitation
– a sore throat

B. Specific meningitis symptoms:
– severe headache
– backache
– stiff or painful neck
– sensitivity to light
– twitching or convulsions

C. Specific septicemic symptoms:
– fever with cold hands and feet
– cold shivers
– pain in muscles or joints
– pain in chest or abdomen
– pale, grey or blotchy skin
– rapid breathing
– diarrhoea
– a rash, which may start off as a spot, scratch mark or blister, as a faint pink rash or as red or purple pinpricks on the skin, then develop into the distinctive purple bruising.

Symptoms in babies

– fever
– fever with cold hands and feet
– vomiting
– diarrhoea
– pale or blotchy skin
– poor feeding
– moaning/highpitched cry
– blank, staring expression
– dislike of being handled
– fretful
– floppy or lethargic
– difficult to wake
– arching of body/ neck
– bulging fontanelle (soft spot on top of the head)
– pink, red or purple rash
(See The rash)