Information on Meningitis
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About Meningitis
Meningitis is an infection of the fluid that surrounds the spinal cord and brain, usually caused by a viral or bacterial infection. Viral meningitis is generally less severe and resolves without specific treatment. Meningococcal disease is the most common cause of bacterial meningitis in the U.S. for children, adolescents and young adults. Although rare, meningococcal disease is dangerous because the disease progresses rapidly, and within hours of the onset of symptoms it may cause permanent disability or death.
Health officials now recommend routine meningococcal vaccination for certain age groups. The guidelines call for the quadrivalent meningococcal vaccine (MCV4) for:
- Young adolescents (11-12 years of age)
- Adolescents at high school entry or 15 years of age (whichever comes first) for those who have not previously been vaccinated
- All college freshmen living in dormitories
- Other groups at high risk, such as those with underlying medical conditions or travelers to areas with high rates of meningococcal disease.
Symptoms of Meningitis
High fever, headache, and stiff neck are common symptoms of meningitis. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. As the disease progresses, seizures may occur.
Meningococcal meningitis doesn’t always include the classic meningitis symptoms of headache and stiff neck. It can start like the flu and progress to organ failure and tissue damage requiring amputation.
Although meningococcal meningitis affects only about 3,000 people nationwide each year, it kills a fifth of adolescents who get it. Lifestyle factors thought to contribute to the disease include direct contact with an infected person, such as exchanging saliva, often through kissing; crowded living conditions, including dormitories; and active or passive smoking.
How Meningitis Spreads
The bacteria are spread through the exchange of respiratory and throat secretions such as by coughing or kissing. Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with an infected person. People in the same apartment or dormitory, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection.
Management of Students Potentially Exposed to Meningitis
For meningococcal meningitis, household contacts and others who have had close personal contact with infected persons are recommended to receive a preventive antibiotic, often rifampin, which kills bacteria living in nose and throat secretions. Even if rifampin or another preventive antibiotic is taken, close contacts should be observed for any signs of disease and should be promptly evaluated by a physician if symptoms occur.
Early diagnosis and treatment are very important. If symptoms occur, see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. Identification of the type of bacteria responsible is important for selection of correct antibiotics.
Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.
Note: if you live in a dormitory, report your illness to the residency hall director.
Infection Control Recommendations
Vaccination is the best method of preventing meningococcal disease (see information on vaccines above).
Transmission of viral and bacterial meningitis can be prevented by raising the level of hygiene among persons at risk of infection and among those who might be spreading the disease. Of primary importance is proper handwashing technique. Wet hands with soap and warm water. Rub hands for 10 to 20 seconds, making sure you clean under fingernails. Rinse under warm running water. Dry hands on a paper towel or your own clean towel. When paper towels are available, use a paper towel to turn off the water faucet and throw the towel away.
Cover your nose and mouth when sneezing or coughing and discard used tissues promptly. Wash hands thoroughly following exposure to respiratory secretions, including handling of soiled tissues and handkerchiefs. Do not share straws, cups, glasses, water bottles used during sports or recreation, eating utensils, cigarettes, etc. Eating and drinking utensils should not be shared and should be used by others only after they have been washed. Avoiding kissing an infant, toddler or child on the mouth also can help prevent the spread of illness.
Preventing viral meningitis also requires proper handwashing to remove fecal contamination after toileting, changing diapers, assisting toddlers with toileting and so forth.
Although large epidemics of meningococcal meningitis do not occur in the United States, some countries experience large, periodic epidemics. Overseas travelers should check to see if meningococcal vaccine is recommended for their destination. Travelers should receive the vaccine at least 1 week before departure, if possible. Information on areas for which meningococcal vaccine is recommended can be obtained by calling the U.S. Centers for Disease Control and Prevention at (404) 332-4565.