DR MAX PEMBERTON: Why over 50s are at risk from meningitis outbreak

Many years ago, when I was a junior doctor, I was examining a woman patient in her mid 50s at a routine appointment when she mentioned – almost in passing – that her head was absolutely pounding.

She assumed it was the antidepressant I had recently prescribed her and inquired if headaches were a common side effect. They can be, so I might have answered her and moved on.

But something made me look at her more carefully. Something was not right. Her face was flushed, she seemed exhausted, and when I asked her directly she admitted she had been running a temperature since the previous evening.

The combination of a sudden, severe headache and a fever set alarm bells ringing immediately.

Was the light bothering her? Yes, now I mentioned it. Stiff neck? She tried to move her head and winced.

I didn’t finish the appointment and instead lost no time in advising her to go straight to A&E. Within a few hours she was in intensive care with bacterial meningitis. It is an infection of the three protective membrane layers surrounding the brain and spinal cord.

She survived, thankfully, but was left with permanent hearing loss in one ear, a lasting reminder of how close it had come. She later told me she had almost not bothered mentioning the headache at all, fully convinced it was the tablets.

I am telling you her story because meningitis is dominating the headlines following the outbreak centred around the University of Kent.

Two young people have died, and more than 30 more have been affected, and there is entirely understandable public alarm. The coverage has focused, rightly, on students.

But there are also other groups who may not realise they are also at risk – including the over-50s and those with compromised immune systems. And it’s important to understand why.

While babies and students face the greatest risk, statistically, there is also a second peak of vulnerability that receives far less attention.

Adults over 60 account for about a quarter of all serious cases of invasive meningococcal disease, a proportion that would surprise most people.

The reason for this is something that scientists call ‘immunosenescence’ – a gradual decline in immune function that is a normal part of ageing, which means that our bodies simply become less capable of mounting an effective response before a bacterial infection takes hold.

And older patients who do develop the disease often delay seeking medical help – often because they assume meningitis doesn’t represent a danger for their age group – leading to worse outcomes.

And there is also the immuno-compromised group: if you are taking long-term steroids, receiving chemotherapy, living with a condition such as lupus, HIV or rheumatoid arthritis, or if you have had your spleen removed, then you are at a significantly higher risk from any serious bacterial infection, including meningitis. And deterioration can occur rapidly for people in this group.

So what should you be on the lookout for? The early symptoms of bacterial meningitis can be deceptive precisely because they overlap with so many less serious illnesses.

A sudden and severe headache, a high temperature, sensitivity to light, a stiff neck, vomiting, confusion, or unusual drowsiness can all be dismissed as flu, especially in the early hours.

One sign to watch out for is if your symptoms steadily get worse, hour after hour.

And the symptom that requires urgent action is a rash that does not fade when you press a glass firmly against it.

Read More

DR MAX: I've spent 25 years treating patients with autism. This is the truth many don't want to hear

This non-blanching rash sometimes only occurs as the disease progresses – there may only be a few hours between it’s appearance and death – so it represents a medical emergency. You should call 999 or go immediately to A&E.

So how can you best protect yourself?

With regards to vaccines, if you are over 25 you fall outside the standard NHS vaccination schedule for both the MenB vaccine – the strain driving the current outbreak, routinely offered to babies – and the MenACWY vaccine, offered to teenagers and as a catch-up for students up to the age of 25.

However, there are options. The pneumococcal vaccine, which protects against another form of bacterial meningitis, is offered free to all adults aged 65 and over on the NHS. If you are in that group and have not had it, ask your GP.

And if you have had your spleen removed or have an immune condition, both the MenACWY and MenB vaccines can be prescribed on the NHS regardless of your age, so it is worth speaking to your doctor about whether you qualify.

For everyone else, both vaccines are available privately through travel clinics and some pharmacies, typically between £50 and £70 per dose.

As the meningitis virus and bacteria live in saliva droplets it’s important to not share glasses, bottles or vapes to avoid spreading the disease and regularly wash your hands.

And if you or someone you know becomes suddenly and severely unwell with any of those symptoms, do not wait or try to reason your way out of it.

My patient long ago almost did not mention her headache at all. I am very glad she did.

I applaud Lisa's honesty

Friends actress Lisa Kudrow recently said that her eyes were red and ‘inflamed’ and she had a ‘weird’ pattern on her forehead – she attributed it to a recent Botox injection.

The side effects meant she was ‘probably done’ with the wrinkle-smoothing neurotoxin, which she only started experimenting with after her 60th birthday.

Kudrow, 62, also told The Hollywood Reporter that she is still ‘scared’ of one day looking like her grandmother – honesty I found moving and brave.

My issue with Botox and similar procedures is that they only offer temporary respite from the fear that prompts a woman to seek treatment.

What is really needed is to build a real acceptance of the ageing process, rather than finding ever more elaborate ways to push it away.

Lisa says she is excited to take on older roles. That is someone moving in the right direction.

Most of us understand that neglecting our teeth leads to cavities. But did you also realise gum disease is linked to about 50 serious health conditions including heart disease, stroke, dementia and Parkinson’s disease.

The risks stem from chronic inflammation. A build-up of bacteria along the gum line leads the body to mount a sustained inflammatory response. Brush with fluoride toothpaste for at least two minutes twice a day and floss daily. See a hygienist regularly.

Dr Max prescribes... Sway.ly

If you worry about what your child is seeing online, then consider the new app Sway.ly. Unlike blunt parental controls that simply block content, this AI-powered app analyses your child’s social media feeds across TikTok, Instagram and YouTube, flags harmful material, and explains why a post might be damaging. It also helps families retrain the algorithm to reduce exposure to toxic content.