Meningitis; Usually Mild, Sometimes Fatal
What is meningitis?
Meningitis is an inflammation of the meninges, which are the membranes that cover and protect the brain and spinal cord. Most cases are viral and are relatively mild. Bacterial meningitis is more severe and can be deadly. Rarely, meningitis is results from non-infectious causes.
How is meningitis transmitted?
Meningitis is a contagious disease, but it does not spread easily. It is transmitted through respiratory secretions, such as through kissing or coughing. Casual contacts are not at risk. However, family members, roommates, day care contacts may need antibiotics if they were in close contact with a meningitis patients.
What are the symptoms?
Classic symptoms are fever, headache, stiff neck, confusion and lethargy. Patients can also be intolerant to light and loud noises. A generalized rash with small raised red and purple nodules could signify the presence of meningococcal meningitis, the most deadly form of the disease. Physicians have been trained in medical school to recognize this characteristic rash and to consider it a warning that the patient’s life is in danger.
How is meningitis diagnosed?
The symptoms and the physical examination often suggest the disease. The diagnosis is usually confirmed with a lumbar puncture, when a physician aspirates spinal fluid through a needle inserted into the patient’s back. Although this procedure sounds gruesome, it is quickly done and well tolerated. Analysis of this fluid can often determine the cause of meningitis.
Is treatment available?
If bacterial meningitis is suspected, physicians will begin antibiotics even before the results of the spinal fluid analysis are completed. In bacterial meningitis, particularly with meningococcal disease, every hour counts. In general, there are no medicines to treat viral meningitis, with a few rare exceptions. Patients with meningitis often need support care to manage complications of the disease, such as low blood pressure, breathing difficulty, seizures, brain swelling and coma. Fortunately, these events are uncommon.
Can meningitis be prevented?
Childhood vaccinations against Haemophilus influenzae, Streptococcus pneumoniae and mumps have dramatically reduced childhood meningitis. There are also two meningococcus vaccines to protect against certain strains of this lethal form of meningitis. Finally, antibiotics are considered for close contacts of meningitis patients as prophylaxis.
Do international travelers need to be protected?
Meningitis is a threat to international travelers, depending on their itineraries. Bacterial meningitis occurs in sub-Saharan Africa, known as the meningitis belt, as well as in parts of South America and Asia. Your travel doctor may advise certain vaccines to protect you. Saudi Arabia requires vaccination against meningococcus for pilgrims traveling to Mecca or Medina to perform the religious Hajj.