Health officials in Reading have confirmed a fourth case of meningitis, with a junior school pupil now "recovering well" from the illness.
The patient has "links with the same wider social network" as the other cases in the outbreak, which has left one college student dead.
All four infections have been identified as meningitis B, according to the UK Health Security Agency (UKHSA).
The latest confirmed case follows the death of student from meningitis in Reading.
But what is meningitis B? And why are young people at risk?
What is meningitis?
Meningitis is an infection of the protective membranes that surround the brain and spinal cord. It is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis.
It can affect anyone but is more common in babies, children, teenagers and young adults.
Meningitis can be very serious if not treated quickly, and can lead to life-threatening sepsis and permanent damage to the brain or nerves.
How does meningitis B differ?
One of the bacteria which causes meningitis is called meningococcus, which can live harmlessly in people’s throats but can cause serious illness if it gets into the blood or spinal fluid.
There are different types of this bacteria and the most common is known as type B – what is often referred to as meningitis B, or MenB.
According to Meningitis Now, MenB is one of the most common causes of meningitis in the UK.
What are the symptoms of meningitis?
Symptoms of meningitis and sepsis can include:
- a high temperature
- cold hands and feet
- vomiting
- confusion
- muscle and joint pain
- pale
- mottled or blotchy skin
- spots or a rash
- a headache
- a stiff neck
- aversion to bright lights
- being very sleepy
- seizures
Symptoms can appear in any order and some may not appear at all.
Is there a vaccine?
There are multiple meningitis vaccines available in the UK.
But the majority of young people born before 2015 are not protected against meningitis B unless they have had the jab privately.
It was introduced on the NHS for babies in 2015.
The MenB jab offers protection against meningococcal group B bacteria and is recommended for babies aged eight weeks, followed by a second dose at 12 weeks and a booster at one year.
Other routine childhood jabs, including the 6-in-1 and pneumococcal vaccines, can protect against meningitis.
Elsewhere, the MenACWY vaccine is a single dose jab that protects against four strains of meningococcal bacteria. It was also introduced in 2015.
It is offered to teenagers in school and is also available to those entering university, up to the age of 25.
Can young people get the MenB jab?
Meningitis Now has called for teenagers and young people to be vaccinated against meningitis B on the NHS.
It launched a new campaign – No Plan B for men B – calling for men B jabs to be given to those most at risk plus a booster programme to protect adolescents from 2030.
The charity also says men B jabs should be available on the high street “at a fair price”.
The jab is available privately, costing around £110 per dose, with a minimum of two doses required.
Why are young people at risk?
According to Meningitis Now, one in four 15 to 19-year-olds carry meningococcal bacteria in the back of their throats, compared with one in 10 of the UK population.
People can carry this harmlessly without becoming unwell but it can be passed from person to person by coughing, sneezing and kissing.
Increased social interaction in this age group means the bacteria can be passed on more easily.
In universities, students can be more vulnerable because of living in more “cramped” housing or halls of residence. Young people also come together from all over the world to live, study and socialise.
How is meningitis treated?
Hospital treatment is recommended by the NHS for all cases of bacterial meningitis.
Treatments include antibiotics and fluids administered directly into a vein, oxygen if there are breathing difficulties, and in some cases steroid medication to prevent swelling around the brain.
Patients may need to stay in hospital for a few days or weeks.
In cases of mild meningitis, patients may be sent home if tests confirm it is viral, which usually gets better on its own. Most patients start to feel better within seven to 10 days.
But severe viral meningitis may also be treated in hospital.
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