The heartbreaking pictures of four-year-old Harley Slack, who has lost both arms and legs after developing meningitis, will have filled all parents with fear.

As both a grandparent and a doctor, seeing the pictures of Harley in a hospital bed, his body entirely bandaged with a tube leading into his nose, was a harsh reminder to me of the devastating effects of this disease.

We all - parents and doctors alike - need to be on red alert for potential meningitis symptoms when a child is ill.

Harley has done well to survive - bacterial meningitis kills one in 10 sufferers a year.

It also leaves up to a quarter of the 2,000 people who get the bacterial form of the disease with serious complications, including loss of hearing or sight - or loss of limbs as in this little boy's case.

What exactly is it?

Meningitis is an infection of the protective membranes that surround the brain and spinal cord, known as the meninges, and can be caused by several bacteria or viruses.

The more common viral form isn't life-threatening though it can result in hearing loss, recurring headaches and long-term tiredness.

However, the bacterial form can kill within hours. In the UK, the most common bacterial culprit is meningococcal group B, the type that Harley had, and there's no vaccine.

However, there are jabs available to protect kids from other forms so it's vital to make sure your child doesn't miss out (see 3 ways to protect your child).

Why it's so dangerous

Meningitis is difficult to diagnose, as early symptoms often seem like flu or a bad cold but it can damage the brain and kill in hours, which is why it needs urgent treatment. It often starts as a sore throat but the bacteria can get into the blood through tissue.

Most of the time our immune systems kill off these bugs before they do too much damage but if large numbers get into the blood, the immune system may not be able to cope, especially in a child.

That's when septicaemia, or blood poisoning, can set in. Ironically, it's the body's own immune system's attempts to fight the bacteria that cause the most damage.

Swelling of the meninges and widespread inflammation due to septicaemia leads to tissue damage, which can cause gangrene and loss of limbs as well as damaging vital organs like the heart or kidneys.

It can happen fast, which is why it's vitally important to get antibiotics into the bloodstream to prevent as much damage as possible.

I recently suffered from septicaemia - though not as a result of meningitis - and can testify as to how quickly symptoms develop.

I was extremely ill in hospital for a fortnight and am still recovering at home several weeks later but I know that I got off very lightly compared with this little boy.

Most at risk are underfives, teens and young adults, especially those living in close proximity to each other - for instance college students or army recruits.

WHAT TO LOOK OUT FOR...

Babies and toddlers

• Fever with cold hands and feet
• Refusing food
• Vomiting
• Pale, blotchy skin
• Fretful and disliking being handled
• Floppy, listless and not responding
• Drowsy and difficult to wake
• Unusual high-pitched cry or moaning
• Headaches
• Rapid breathing or grunting
• Spots or a rash that doesn't go away when you press a glass on it

Children and adults

• Fever with cold hands and feet
• Vomiting
• Drowsy and difficult to wake
• Feeling confused and irritable
• Severe muscle pain
• Severe headache
• Stiff neck
• Disliking bright lights
• Stomach cramps and diarrhoea
• Spots or a rash that doesn't go away when you press a glass on it

NOTE: Symptoms can happen in any order and some may not appear at all. If in doubt, get immediate medical advice.

The glass test

A purplish spotty rash that doesn't fade under pressure is a sign of meningococcal septicaemia.

One way to test for this is to press a glass on to the rash to see if it fades. However, it's vital not to wait for the rash if there are other worrying symptoms.

The rash doesn't always appear or may appear late.

Also if the spots initially fade and the rash remains, keep doing the glass test - sometimes they fade at first.

...3 WAYS TO PROTECT YOUR CHILD

(1) Make sure your child gets all of the jabs offered in the child immunisation programme

MenC jab, which protects against The meningococcal group C is free for anyone aged between two months and 24 years, as well as for first-year university students.

It's automatically offered to babies at two, three and four months with a booster at 12 months. This jab has been enormously successful since its introduction 10 years ago, having reduced cases caused by this type of bacteria by 90%. However, it's also important to have all the jabs in the programme, as several others give protection against other bacteria and viruses that can lead to meningitis.

But remember, even if your child has had all their jabs, there's no protection against meningococcal group B meningitis.

(2) Keep eyes and ears open 

If you hear that there have been cases of meningitis in your area, be extra alert to possible symptoms. Meningitis can be spread through sneezing, coughing and sharing utensils or personal possessions such as toothbrushes.

(3) Act quickly

If your child has a temperature and is off their food, be alert look out for the possible symptoms (see What to Remember, if you're worried, don't wait for the rash to appear - it may not.

Don't hesitate to seek a second opinion if you feel something is really wrong.

I learnt as a junior doctor that a mother knows a child best and is often the first to spot when something is seriously wrong with that child.

Source: Daily Mirror

Pic: Joseph Hoban