Meningitis is an infection of the fluid of a person’s spinal cord and
the fluid that
surrounds the brain. People sometimes refer to it as spinal meningitis.
Meningitis is
usually caused by a viral or bacterial infection. Knowing whether
meningitis is caused
by a virus or bacterium is important because the severity of illness and
the treatment
differ. Viral meningitis is generally less severe and resolves without
specific treatment,
while bacterial meningitis can be quite severe and may result in brain
damage, hearing
loss, or learning disability. For bacterial meningitis, it is also
important to know which
type of bacteria is causing the meningitis because antibiotics can
prevent some types
from spreading and infecting other people. Before the 1990s, Haemophilus
influenzae
type b (Hib) was the leading cause of bacterial meningitis, but new
vaccines being given
to all children as part of their routine immunizations have reduced the
occurrence of
invasive disease due to H. influenzae. Today, Streptococcus pneumoniae
and
Neisseria meningitidis are the leading causes of bacterial meningitis.

What are the signs and symptoms of meningitis?

High fever, headache, and stiff neck are common symptoms of meningitis
in anyone
over the age of 2 years. 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. In newborns and small
infants, the classic
symptoms of fever, headache, and neck stiffness may be absent or
difficult to detect,
and the infant may only appear slow or inactive, or be irritable, have
vomiting, or be
feeding poorly. As the disease progresses, patients of any age may have
seizures.

How is meningitis diagnosed?

Early diagnosis and treatment are very important. If symptoms occur, the
patient should
see a doctor immediately. The diagnosis is usually made by growing
bacteria from a
sample of spinal fluid. The spinal fluid is obtained by performing a
spinal tap, in which a
needle is inserted into an area in the lower back where fluid in the
spinal canal is readily
accessible. Identification of the type of bacteria responsible is
important for selection of
correct antibiotics.

Can meningitis be treated?

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.

Is meningitis contagious?

Yes, some forms are bacterial meningitis are contagious. The bacteria
are spread
through the exchange of respiratory and throat secretions (i.e.,
coughing, 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 a patient with meningitis
caused by
Neisseria meningitidis (also called meningococcal meningitis) or Hib.
People in the
same household or day-care center, 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. People who qualify as close contacts of a
person with meningitis
caused by N. meningitidis should receive antibiotics to prevent them
from getting the
disease. Antibiotics for contacts of a person with Hib meningitis
disease are no longer
recommended if all contacts 4 years of age or younger are fully
vaccinated against Hib
disease (see below).

Are there vaccines against meningitis?

Yes, there are vaccines against Hib and against some strains of N.
meningitidis and
many types of Streptococcus pneumoniae. The vaccines against Hib are
very safe and
highly effective.

There is also a vaccine that protects against four strains of N.
meningitidis, but it is not
routinely used in the United States and is not effective in children
under 18 months of
age. The vaccine against N. meningitidis is sometimes used to control
outbreaks of
some types of meningococcal meningitis in the United States. Meningitis
cases should
be reported to state or local health departments to assure follow-up of
close contacts
and recognize outbreaks. 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 Centers for Disease Control and Prevention at
(404)-332-4565.

A vaccine to prevent meningitis due to S. pneumoniae (also called
pneumococcal
meningitis) can also prevent other forms of infection due to S.
pneumoniae. The
pneumococcal vaccine is not effective in children under 2 years of age
but is
recommended for all persons over 65 years of age and younger persons
with certain
chronic medical problems.