Download UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet

UNIVERSITY STUDENT HEALTH SERVICES • Fact Sheet
MENINGITIS
WHAT IS IT?
Meningitis is caused by an infection of the fluid that surrounds the brain and spinal cord. This infection
leads to inflammation and swelling of the meninges, which is the lining of the brain and spinal cord. While
meningitis can be a serious infection, most cases last for a short time and cause no long-term
complications.
WHAT CAUSES IT?
Meningitis can be caused by bacteria, viruses, protozoa, fungi, and other agents. Many of the viruses
and bacteria that cause meningitis are fairly common and often associated with routine illnesses, such as
respiratory infections. Viral meningitis is more common and tends to be less severe, while bacterial
meningitis is much less common but may result in severe complications (such as brain damage, seizures,
hearing loss, and learning disabilities) or death. Therefore, it is extremely important to identify and treat
bacterial meningitis early!
■ Viral Meningitis
Enteroviruses are the most common cause of meningitis. They are responsible for 85-95% of all
cases of meningitis. Infections by enteroviruses most frequently occur in the summer and fall.
Less common causes of viral meningitis include infection by the varicella virus (chickenpox), the
measles virus, the mumps virus, the herpes 2 virus, the influenza virus, and HIV.
Arboviruses (such as the West Nile virus and viruses that cause Yellow Fever and Dengue Fever)
can be transmitted by ticks, mosquitoes, and fleas. Infections by arboviruses occur year round but
are more common during warm weather. Travel to the southern and southwestern parts of the
United States and to tropical climates is a risk factor for infection with one of the arboviruses.
In rare cases, exposure to rodents infected with LCMV (lymphocytic choriomeningitic virus) can
also cause viral meningitis.
■ Bacterial Meningitis
One of the leading causes of bacterial meningitis in young adults living in the U.S. is Neisseria
meningitides. Most of these cases occur in late winter or early spring.
Other causes of bacterial meningitis include Treponema pallidum which causes syphilis and
Borrelia burgdorferi which causes Lyme disease in the U.S.
Tuberculosis can also be a cause of meningitis.
■ Amoebic Meningitis
Meningitis caused by the amoeba Naegleria fowleri is very rare and often fatal. This amoeba is
transmitted by exposure to soil and fresh water, such as rivers, hot springs, ponds, and lakes.
Infection occurs from diving into infected fresh water. The amoebae enter the brain by travelling up
the nasal passages.
HOW IS IT TRANSMITTED?
Most cases of viral and bacterial meningitis result from infections that are spread by respiratory
droplets from the throat and nose. These drops become airborne when the infected person coughs,
sneezes, laughs, or talks. They are also spread by sharing food, eating utensils, tissues, and towels.
Fortunately, the bacteria that cause meningitis are not as contagious as viral infections like the
common cold or flu. Therefore, the chance of getting bacterial meningitis after a possible exposure is
actually quite low. In addition, bacterial meningitis cannot be spread by casual contact or by simply
breathing the air where a person with meningitis has been.
Although enteroviruses can be spread through respiratory secretions, they are more commonly
spread through fecal contamination. This can occur when changing a diaper or not washing the
hands after using the toilet. Contact with an infected person can increase the chance of becoming
infected with the same virus; however, the chance of developing meningitis from the infection is quite
small.
HOW CAN IT BE PREVENTED?
Good respiratory hygiene is important. Wash your hands, cough or sneeze into a tissue or your
elbow, and avoid individuals who are sick.
Insect repellents (28% - 35% DEET or non-DEET) should be applied when you are outside,
especially in high-risk areas.
Avoid swimming in fresh water that may have been contaminated with amoebae, such as rivers into
which sewage treatment plants empty.
Immunize yourself against vaccine-preventable viruses, such as chickenpox, mumps, measles, and
influenza.
Immunize yourself against bacterial meningitis. The meningococcal vaccine is 85-100% effective
against four strains of Neisseria meningitides. Two-thirds of bacterial meningitis infections in college
students are caused by one of these four meningococcal strains.
WHAT ARE THE SYMPTOMS?
Symptoms can develop over several hours (as in a bacterial or amoebic infection) or over one to two
days. Common symptoms include:
Nausea/vomiting
High fever (101°F or higher)
Confusion
Headache
Extreme sleepiness
Neck stiffness
Seizures
Photophobia (sensitivity to light)
■ Bacterial meningitis caused by Neisseria meningitides can progress very rapidly, within a few hours of
infection. A history of a mild sore throat or flu-like illness may precede initial symptoms. Research
indicates that 70% of patients with a Neisseria meningitis infection present with the following triad of
symptoms: fever, neck stiffness, and altered mental status. If the bacteria enter the bloodstream, a
characteristic red, blotchy rash develops on the trunk and legs and can progress rapidly to large areas of
deep purple bruising and blackened skin. Coma can occur 24 hours after infection.
■ Viral meningitis usually lasts seven to ten days and resolves without specific treatment. Patients with
normal immune systems usually recover completely and without complications. Early symptoms may be
similar to that of bacterial meningitis. Therefore, it is important to seek medical care as soon as possible.
HOW IS IT DIAGNOSED?
Early diagnosis and treatment are very important. If symptoms occur, the patient should seek medical
care immediately. A lumbar puncture (or spinal tap) is usually performed in the emergency room or
hospital to confirm the diagnosis. This procedure involves inserting a needle into the lower back to
remove a small amount of spinal fluid for testing.
WHAT IS THE TREATMENT?
■ Viral meningitis usually responds to supportive care, including rest, medications for fevers and
headaches, and hydration. Hospitalization is required in severe cases and in people with weakened
immune systems. Antiviral medications can improve recovery in cases caused by the herpes or varicella
virus.
■ Bacterial meningitis, with its 10-15% fatality rate, requires hospitalization and treatment with
intravenous (IV) antibiotics. It is important to start treatment early to prevent complications.
WHAT IF I AM EXPOSED TO BACTERIAL MENINGITIS?
The Neisseria meningitides bacterium that causes bacterial meningitis is not easily transmitted. In fact,
up to 25% of the U.S. population harbors the bacteria in their nose or throat. During outbreaks of
bacterial meningitis, up to 95% of the population can carry the bacteria, but only 1% will become ill.
Casual contact with an infected individual is not usually a high risk. However, because of the severity of
the illness, close contacts and people in the same household of the infected person are advised to take
antibiotics for preventive purposes. This is called prophylaxis and is offered to reduce the chance of
developing an infection, even in close contacts who have received the meningitis vaccine. Students
enrolled in the Health Sciences programs who have contact with a hospitalized patient diagnosed with
bacterial meningitis may also be offered an antibiotic to prevent infection.
RECOMMENDED WEBSITES: www.musa.org, www.cdc.gov
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Published by VCU Division of Student Affairs and Enrollment Services
University Student Health Services
(804) 828-8828 - Monroe Park Campus; (804) 828-9220 - MCV Campus
Wellness Resource Center
(804) 828-9355 - 815 S. Cathedral Place
Reviewed 7/11