Menengitis comes in different forms
by: Jessica Woodward, M.D.
Meningitis is inflammation of the protective tissues (meninges) and sometimes the fluid surrounding the brain and spinal cord.
There are five types of meningitis - viral, fungal, bacterial, parasitic and non-infectious - but the three most common are bacterial, fungal and viral. Meningitis can be acute or chronic; mild or severe. The incubation period after exposure ranges from two to 10 days, with an average of four days.
Meningitis is a serious condition that should be treated as an emergency as death can occur. If diagnosed and treated quickly, a full recovery can usually be expected.
Viral, fungal and bacterial meningitis all have similar symptoms. Early symptoms are: severe headache, high fever, sweating, stiff neck and back, sensitivity to light, sensitivity to sound and a resistance to leg extension when lying down. Later symptoms include: nausea, vomiting, irritability, altered mental status, lethargy, stupor, seizures and coma. Certain types of meningitis may cause a rash.
Viral meningitis is caused by a virus and is typically a less severe form of the disease, with recovery occurring within seven to 10 days after onset of symptoms. The Center for Disease Control estimates that there are 25,000 to 50,000 inpatient hospitalizations due to viral meningitis in the U.S. each year. Babies less than a year old are at greatest risk, and incidence drops with age.
While outbreaks of viral meningitis are rare, the infection is contagious. The most common causes of viral meningitis - enteroviruses (intestinal viruses) - are most often spread through fecal contamination. Other forms of viral meningitis are spread through droplets of respiratory or throat secretions often through coughing, sneezing and close contact.
There are no vaccines for the most common causes of viral meningitis, however there are vaccines for certain diseases that can lead to viral meningitis. Vaccination against them is important. They include: measles, mumps and chickenpox. In addition prevention measures include normal infection control practices you would use to prevent viral infections. This includes: hand washing, cleaning of contaminated surfaces and avoiding sharing food, drinks or eating utensils with others.
Fungal meningitis is rare and results when inhaled fungus spores spread from the blood to the spinal cord. The disease was recently in the news when a strain of fungal meningitis spread through tainted steroid injections. According to the CDC 12 identified cases occurred in Minnesota.
People with weakened immune systems are at higher risk for fungal meningitis. An infection is typically treated with intravenous antifungal medications at a hospital. Length of treatment varies depending on the type of fungus and status of a patient's immune system.
There is no vaccine against fungal meningitis. Preventative measures include avoiding soil and other environments that are likely to contain fungus or bird droppings known to cause meningitis.
Bacterial meningitis is caused by several types of bacteria. It is usually severe and is the type of meningitis most likely to make headlines. Recovery is possible, but severe complications such as brain damage, hearing loss or learning disabilities can occur. According to the CDC, between 2003 - 2007 in the United States, about 4,100 cases of bacterial meningitis, resulting in 500 deaths, occurred each year.
Several risk factors are associated with bacterial meningitis. Community and living environment puts some groups at risk. Infectious diseases tend to spread more quickly when large groups occupy small spaces. College students living in dormitories and military personnel are at increased risk. Age is a factor; infants are at greater risk. Certain medications, medical conditions and surgical procedures increase risk. Traveling to certain countries increases the likelihood of infection. These areas include portions of Africa and Mecca in Saudi Arabia.
Bacterial meningitis is contagious, and is spread through the exchange of respiratory and throat secretions. The bacteria are not spread by casual contact or by breathing the air where a person with meningitis has been. One form of bacterial meningitis (Listeria monocytogenes) can be passed through contaminated food.
Treatment includes antibiotics and is most effective when started as soon as possible after symptoms appear.
Vaccination is the best way to prevent bacterial meningitis; there are vaccines for three types of bacteria that can cause meningitis. The current vaccination schedule recommends an initial vaccine at age 11 or 12, with a booster at age 16. If you are over age 16, one vaccination without a booster is recommended. Because of the increased risk, students headed for college dormitory living or those going into the military who have not been previously vaccinated should do so.
Other healthy lifestyle habits can assist with prevention. Avoid cigarette smoke, get ample sleep and rest and avoid people who are sick - especially if you are part of an at-risk population.
Meningitis can be a serious condition. Your best defense is to be immunized for certain types of meningitis and be aware of the risk factors and symptoms of others. If you suspect you or someone you know has meningitis, it is important to seek medical care immediately. The sooner treatment is started, the better the outcome.
Dr. Woodward is a board certified family practice physician at Raiter Clinic in Cloquet.