Can a newborn baby have meningitis?

Dr Paul Heath answers:

Meningitis in the first month of life (neonatal meningitis) can be a devastating condition. The most recent UK national surveillance study on neonatal meningitis, conducted between 1996-7, showed that 10% of babies died and about 50% of survivors had some form of disability at five years of age (24% with serious disability).

The bacteria responsible for neonatal meningitis have been consistent over the last two decades: Group B streptococcus (GBS) followed by Escherichia coli (E. coli), Listeria monocytogenes and Streptococcus pneumoniae.

How infection is acquired by the baby differs somewhat between them. GBS is usually transmitted to the baby from the mother’s genital or gastrointestinal tract around the time of birth, while listeria is usually transmitted to the baby across the placenta before birth.

Mothers with listeria infection generally have a flu-like illness in the week or so before the baby is delivered, although this is often not distinctive enough to recognise it as a listeria infection. It is during this time that the bacteria cross the placenta (which connects the mother's and baby’s bloodstreams) and infects the baby.

Many babies with infection are therefore unwell as soon as they are born, indeed the infection in the baby may result in an earlier (premature) birth than normal or the signs of the infection may cause the obstetrician to deliver the baby quickly.

Babies with infection can have features of septicaemia or pneumonia or meningitis. Infection occurring in the first week of life is called early onset and after the first week of life, late onset; meningitis is typically, but not always, late onset.  

Unfortunately, opportunities for prevention of neonatal meningitis are currently few – however, GBS vaccines are in development and if introduced may significantly reduce GBS, the leading cause of neonatal meningitis.

 

Our Expert

Paul Heath is a Reader in Paediatric Infectious Diseases at St George’s Hospital Medical School and Vaccine Institute in London.

His training in paediatrics and infectious diseases was at the Royal Children’s Hospital, Melbourne, the John Radcliffe Hospital, Oxford and St George Hospital, London.