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Meningitis General Information
What is meningitis?
Meningitis is an inflammation of the linings of the brain and spinal cord caused by either viruses or bacteria.
Viral meningitis is more common than bacterial meningitis and usually occurs in late spring and summer. Signs and symptoms of viral meningitis may include stiff neck, headache, nausea, vomiting, and rash. Most cases of viral meningitis run a short, uneventful course. Since the cause is a virus, antibiotics are not effective. Persons who have had contact with an individual with viral meningitis do not require any treatment.
Bacterial meningitis occurs rarely and sporadically throughout the year, although outbreaks tend to occur in late winter and early spring. Bacterial meningitis in college-aged students is most likely caused by Neisseria meningitidis or Streptococcus pneumoniae. Because meningococcal meningitis can cause grave illness and rapidly progress to death, it requires early diagnosis and treatment. In contrast to viral meningitis, persons who have had intimate contact with a case require prophylactic therapy. Untreated meningococcal disease can be fatal.
How does meningococcal disease occur?
Approximately 10% of the general population carries meningococcal bacteria in the nose and throat in a harmless state. This carrier state may last for days or months before spontaneously disappearing, and it seems to give persons who harbor the bacteria in their upper respiratory tracts some protection from developing meningococcal disease.
Meningococcal bacteria cannot usually live for more than a few minutes outside the body. As a result, they are not easily transmitted in water supplies, swimming pools, or by routine contact with an infected person in a classroom, dining room, bar, restroom, etc.
Roommates, friends, spouses, and children who have had intimate contact with the oral secretions of a person diagnosed with meningococcal disease are at risk for contracting the disease and should receive prophylactic medication immediately. Examples of such contact include kissing, sharing eating utensils, and being exposed to droplet contamination from the nose or throat.
How many cases of meningococcal disease occur each year?
The annual incidence of meningococcal disease in the United States is about 1 case per 100,000 population. The fatality rate is approximately 12%.
Can meningococcal disease be mistaken for other health problems?
Meningococcal disease is potentially dangerous because it is relatively rare and can be mistaken for other conditions. The possibility of having meningitis may not be considered by someone who feels ill, and early signs and symptoms may be ignored. A person may have symptoms suggestive of a minor cold or flu for a few days before experiencing a rapid progression to severe meningococcal disease.
What are the signs and symptoms of meningococcal disease?
Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving.
Common early symptoms of meningococcal meningitis include fever, severe sudden headache accompanied by mental changes (e.g., confusion, lethargy) and neck stiffness.
A rash may begin as flat, red spots, mainly on the arms and legs. It may then evolve into a rash of small dots that do not change with pressure (petechiae). New petechiae can form rapidly, even while the patient is being examined.
What is the treatment for meningococcal disease exposure?
Meningococcal diseases can be rapidly progressive. With early diagnosis and treatment, however, the likelihood of full recovery is increased.
Early recognition, performance of a lumbar puncture (spinal tap), and prompt initiation of antimicrobial therapy are crucial.
Exposure treatmentThe use of such prophylactic antibiotics as ciprofloxacin or rifampin is recommended for those who may have been exposed to a person diagnosed with meningococcal disease. Anyone who suspects possible exposure should consult a physician immediately. Prophylactic antibiotics may also be prescribed for asymptomatic meningococcus carriers. A bacterial culture taken from the nose is required for confirmation of N. meningitidis carrier status.
VaccinationAs an adjunct to appropriate antibiotic prophylaxis, immunization against the meningococcus bacterium may be recommended when an outbreak of meningococcal disease has occurred in a community. It is important to note that meningococcal vaccine should not be used in place of prophylaxis for those exposed to an infected person; the protection from immunization is too slowly generated in this situation.
Meningococcal Meningitis VaccineImmunization against the bacterium N. meningitidis may be recommended for persons over 2 years of age if they are members of a population that is experiencing an outbreak of meningococcal disease, e.g., students at a university where an outbreak has occurred.
- Numerous studies have demonstrated the effectiveness of meningococcal vaccines. Although protection probably persists in schoolchildren and adults for at least 3 years, the exact timing for a booster has not been determined. As with any vaccine, vaccination may not protect 100% of all susceptible individuals. Contact your university health center to determine if vaccination is appropriate for you.
- Adverse reactions to meningococcal vaccine are mild and infrequent, consisting primarily of redness and pain at the injection site that may last 1 to 2 days. Rarely, fever of short duration may occur.
How can one reduce the risk of contacting meningococcal disease?
Maximize your body’s own immune system response. A lifestyle that includes a balanced diet, adequate sleep, appropriate exercise, and the avoidance of excessive stress is very important. Avoiding upper respiratory tract infections and inhalation of cigarette smoke may help to protect from invasive disease. Everyone should be sensitive to public health measures that decrease exposure to oral secretions, such as covering one’s mouth when coughing or sneezing and washing one’s hands after contact with oral secretions.
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This fact sheet is for information only and is not meant to be used for self-diagnosis or as a substitute for consultation with a health care provider.