Meningitis

How it Spreads

Germs that cause meningitis can be spread in many ways. This includes:

• Through coughing and sneezing. Infected people can pass certain bacteria that are normally found in saliva or mucus.
• Through kissing, sexual contact, or contact with infected blood. Viruses that cause meningitis can be passed from an infected person to another person.
• Through stool. Stool could have enteroviruses or certain types of bacteria in it. Wash your hands often. This can help prevent infection in you and your children.
• From eating certain foods. Eating food contaminated with Listeria monocytogenes bacteria can cause meningitis.
• During birth. The germs that cause meningitis can be passed to a baby during pregnancy even if the person has no symptoms.
• From infected rodents and insects. But this is rare.

What Increases Your Risk

Risk factors for meningitis include:

• Crowded living conditions. People in camps, day care centers, schools, and college dormitories are more likely to get it.
• Having other infections. This includes upper respiratory infections, mumps, tuberculosis (TB), human immunodeficiency virus (HIV), syphilis, Lyme disease, and illnesses caused by herpes viruses.
• Not staying up-to-date on vaccinations. Vaccines can help prevent some causes of meningitis. Talk to your doctor about which vaccines may be best for you.
• Age. Meningitis is more of a risk for infants, teenagers, or older adults.
• Having a weakened immune system. This makes it harder to fight off germs that cause meningitis.
• Chronic health conditions, such as liver disease, kidney disease, diabetes, or certain cancers.
• Travel to areas where the disease is common.
• Genetics. Some people may inherit the tendency to get meningitis.

Prevention

Vaccines can help reduce the risk of developing both bacterial and viral meningitis. You also can take other steps to lower your risk of getting or spreading meningitis. Here are some things you can do.

• Stay up-to-date on vaccinations. Vaccines prevent germs from causing some of the diseases that can lead to meningitis. They include shots for:
  • Measles, mumps, and rubella (MMR).
  • Chickenpox (varicella-zoster).
  • Haemophilus influenzae type b (Hib) disease.
  • Pneumococcal disease. Getting this vaccine usually protects people from the type of bacteria that is most likely to cause meningitis.
  • Meningococcal diseases. These vaccines may be recommended for those who live in shared housing and are near an outbreak. They may be recommended for people with certain medical conditions or for people who travel to where the disease is common. Booster shots are sometimes needed.
• Stay away from people who have it.
• If you come in close contact with someone who has bacterial meningitis, call your doctor. Taking antibiotics may keep you from getting the illness. If your contact is only casual—for example, at school or at work—you may not need to take antibiotics.
• Keep people with meningitis separate from other people in the home.
• Wash your hands often if you have meningitis or are taking care of someone who does. And have this person wash their hands often to reduce the spread of germs. Wash your hands after using the toilet or helping a sick child use the toilet, after changing a sick baby's diaper, and after handling used bedsheets, towels, clothes, or personal items of a sick person.
• Don't share dishes, glasses, eating utensils, or toothbrushes.
• Clean and disinfect high-touch items every day and anytime the sick person touches them.These include doorknobs, light switches, toilets, counters, and remote controls.
• If you have other health conditions that you get treatment for, be sure to talk with your doctor about steps you can take to prevent getting infections such as meningitis. For example, experts recommend that people with cochlear implants get a pneumococcal shot. Also, some people with cochlear implants have ear infections before they get meningitis, so it's important to treat ear infections right away with antibiotics.
• Avoid contact with wild animals. And take steps to prevent bites from bugs, such as mosquitoes and ticks, that might carry disease-causing bacteria or viruses.

Symptoms

The most common symptoms of bacterial meningitis most often appear all of a sudden. Symptoms of viral meningitis may appear all of a sudden or may develop slowly over a period of days. Symptoms of meningitis include:

• A stiff and painful neck, especially when trying to touch the chin to the chest.
• A fever.
• A severe headache that won't go away.
• Vomiting.
• Confusion and decreased level of consciousness.
• Seizures.

Less common symptoms include:

• Not having much energy.
• Having muscle aches, tingling, or weakness throughout the body.
• Eye sensitivity and eye pain from bright lights (photophobia).
• Dark purple and blotchy skin rash.
• Dizzy spells.

It's very important to see a doctor right away if you or your child has these symptoms. Only a doctor can tell if they are caused by viral or bacterial meningitis. And bacterial meningitis needs to be treated right away since it can be life-threatening.

Babies, young children, older adults, and people with other medical conditions may not have the usual symptoms of meningitis.

• In babies, the signs of it may be a fever, crankiness that's hard to calm, decreased appetite, a rash, vomiting, and a shrill cry. Babies also may have a stiff body and bulging soft spots on the head that aren't caused by crying. Babies with meningitis may cry when handled.
• Young children with meningitis may act like they have the flu. Or they may cough or have trouble breathing.
• Older adults and people with other medical conditions may have only a mild headache and fever. They may not feel well and may have little energy.

What Happens

How sick you get from meningitis often depends on your age, general health, and the organism causing the infection. The illness can range from mild to severe.

Viral meningitis is more common in the late summer and early fall. It usually doesn't cause a serious illness and goes away on its own. Home treatment may be all you need. You may get some antiviral medicines from your doctor. You may get better within 2 weeks. But some people may feel lightheaded and tired for several months after the illness.

Bacterial meningitis occurs most often from late winter to early spring. It usually causes a more serious illness. The symptoms usually develop suddenly and may last for 2 to 3 weeks. A person with bacterial meningitis is treated with antibiotics and other medicines in a hospital since this can be a life-threatening illness.

When to Call a Doctor

Call 911 or other emergency services immediately if:

• You or your child has symptoms of severe meningitis, such as fever, seizures, and confusion.
• Your baby has signs of severe meningitis, such as trouble breathing or a fever with a bulging soft spot on the head not caused by crying.

Contact your doctor now if:

• You or your child has symptoms of meningitis, such as severe and persistent headache, stiff neck, fever, rash, nausea, and vomiting.
• You or your child has viral meningitis and does not get better with home treatment after 3 days.
• You or your child is being treated for viral meningitis and has signs of complications, such as a fever that lasts longer than 3 full days and does not go down during home treatment.
• Your baby has a fever that comes and goes, diarrhea, vomiting, a swollen belly, and a shrill cry.

Contact a doctor soon if you think you may have been exposed to meningitis. You can be treated with medicines. This may keep you from getting the illness.

Watchful waiting

Watchful waiting is a wait-and-see approach.

It's not a good choice if you think that you or your child has meningitis, because you can't tell what type of meningitis it may be. Call your doctor as soon as symptoms appear.

Exams and Tests

Your doctor will ask questions about your health, do an exam, and do one or more tests.

The doctor will almost always do a lumbar puncture, or spinal tap, to check the spinal fluid for meningitis.

Other tests that may be done include a:

• Complete blood count. This checks if your immune system is fighting an infection.
• Blood culture. This checks for the cause of an infection.
• Urine test. This checks for infection in the urinary tract.
• Chest X-ray. This looks for lung infections.
• CT scan or MRI. These tests can look for swelling of brain tissue or for complications such as brain damage.
• Special tests to check for other health problems, such as tuberculosis (TB), human immunodeficiency virus (HIV), syphilis, Lyme disease, and illnesses caused by herpes viruses.

Treatment Overview

With mild cases of viral meningitis, you may only need home treatment. This includes drinking extra fluids and taking medicine for pain and fever.

Bacterial or severe viral meningitis may require treatment in a hospital. This includes:

• Medicines such as antibiotics, antivirals, steroid medicines, and medicines to reduce fever.
• Oxygen therapy. This is done if you have trouble breathing. If people are too sick to breathe on their own, they may need a machine called a ventilator.
• Treatments to remove mucus from the bronchial tubes.

Most healthy adults who have recovered from meningitis don't need follow-up care. But babies and children always need follow-up care after they get better. This is to check for long-term problems caused by the illness.

Self-Care

Home treatment is usually all that is needed for most people who have viral meningitis.

• Get plenty of rest. Rest helps with healing and provides relief from symptoms such as a headache. Quiet activities, such as reading books, playing board games, watching videos, or listening to music, help pass the time.
• Take steps to lower your fever. Cool washcloths to the forehead, cool baths, and medicines such as acetaminophen (Tylenol) or ibuprofen (Advil) can be used to reduce fever, if needed. Be safe with medicines. Read and follow all instructions on the label.
• Use medicine to relieve headaches and muscle aches. Mild pain usually can be relieved with medicines such as acetaminophen (Tylenol) or ibuprofen (Advil).
• Prevent dehydration. Drink plenty of fluids. Choose water and other clear liquids.
• Be sure to contact your doctor if you have any problems during your recovery.