Bacterial meningitis and viral meningitis are serious, potentially deadly diseases that can progress extremely fast. Meningitis is an inflammation of the membranes that surround the brain and spinal cord. The bacteria that cause meningitis can also infect the blood. There are treatments available for persons exposed to or infected with the bacteria that cause meningitis.

Note: The following information was obtained from material posted on the meningitis website maintained by the Centers for Disease Control and Prevention (Atlanta) at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm .

What is meningitis?

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 (also called H.influenzae or “Hib”) was the leading cause of bacterial meningitis, but new vaccines 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. These bacteria are also referred to as S.pneumoniae and N.meningitidis.

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 a person experiences these symptoms, he/she should see a doctor immediately. A 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 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 of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, sneezing, spitting, and kissing). Fortunately, the bacteria that cause meningitis are not 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 person with meningitis caused by Neisseria meningitidis (also called “meningococcal meningitis”) or caused by H.influenzae. People in the same household or dormitory 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 H.influenzae meningitis disease are no longer recommended if all contacts four years of age or younger were previously fully vaccinated against H.influenzae disease. (See the following information, below.)

Are there vaccines against meningitis?

Yes, there are vaccines against H.influenzae as well as against some serogroups of N.meningitidis and against many types of S.pneumoniae. The vaccines against H.influenzae are very safe and highly effective and are now administered to children as part of their routine childhood immunizations plans.

There are two vaccines against N.meningitidis available in the USA. Meningococcal polysaccharide vaccine (MPSV4 or Menomune^®) has been approved by the Food and Drug Administration (FDA) and available since 1981. Meningococcal conjugate vaccine (MCV4 or MenactraT) was licensed in 2005. Both vaccines can prevent four types of meningococcal disease, including two of the three types most common in the USA. (serogroup C, Y, and W-135) and a type that causes epidemics in Africa (serogroup A). Meningococcal vaccines cannot prevent all types of the disease. They do, however, protect many people who might become sick if they did not get the vaccine. Meningitis cases should be reported to state or local health departments to assure follow-up of close contacts and to recognize outbreaks.

MenactraT is recommended for all children at their routine preadolescent visit (11 to 12 years of age). For those who have never gotten MenactraT previously, a dose is recommended at high school entry. Other adolescents and young adults (such as college students) who want to decrease their risk of meningococcal disease can also get the vaccine.

Other people at increased risk for whom routine vaccination is recommended are college students living in dormitories, microbiologists who are routinely exposed to meningococcal bacteria, U.S. military recruits, anyone who has a damaged spleen or whose spleen has been removed; anyone who has terminal complement component deficiency (an immune system disorder), anyone who is traveling to the countries which have an outbreak of meningococcal disease, and those who might have been exposed to meningitis during an outbreak.

MenactraT is the preferred vaccine for people 11 to 55 years of age in these risk groups, but Menomune^® can be used if MenactraT is not available. Menomune^® should be used for children 2 to 10 years old, and adults over 55, who are at risk.

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 1-404-332-4565.

There are vaccines to prevent meningitis due to S.pneumoniae (also called “pneumococcal meningitis”) which can also prevent other forms of infection due to S.pneumoniae. The pneumococcal polysaccharide vaccine is recommended for all persons over 65 years of age and younger persons at least 2 years old with certain chronic medical problems. There is a newly licensed vaccine (pneumococcal conjugate vaccine) that appears to be effective in infants for the prevention of pneumococcal infections and is routinely recommended for all children older than two years of age.

Source: Centers for Disease Control and Prevention, www.cdc.gov

See http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm for additional information.

Where can WCJC students get a vaccination against bacterial meningitis?

Vaccination against bacterial meningitis is available from a student’s health care provider and at several convenient locations in the WCJC service area. These include the following:

HEB in Wharton, Texas (cost: $115)
Tel.: 1-979-282-2773 (for an appointment and directions) 

Immunization Clinic/Southwest in Stafford, Texas (cost: $125)
Tel.: 1-281-313-7468 (for an appointment and directions) 

U.S. Health Works in Sugar Land, Texas (cost: $210)
Tel.: 1-281-277-7997 (for an appointment and directions) 

Want more information?

For more information about meningitis and about vaccination against bacterial meningitis, WCJC students can contact their own health care providers.

For additional information, WCJC students can view the meningitis website posted by the Centers for Disease Control and Prevention at http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm.

WCJC students can also contact a local or regional office of the Texas Department of State Health Services for information. Tel.: 1-888-456-7114 or 1-979-733-8453.

WCJC meningitis website updated by:  Bruce Kieler, DrPH