Can a newborn baby have meningitis?
Professor 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
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
Paul Heath is is a Professor / Honorary Consultant in Paediatric Infectious Diseases at St George’s, University of London and Vaccine Institute in London.
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