How to prevent meningitis?

Meningitis

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What Is Meningitis?

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord.

People of any age can get meningitis, but because it can spread easily among those living in close quarters, teens, college students, and boarding-school students are at higher risk for infection.

If dealt with quickly, meningitis can be treated successfully. So it’s important to get routine vaccinations, know the signs of meningitis, and get medical care right away if you think that your child has the illness.

What Causes Meningitis?

Most cases are caused by bacteria or viruses, but some can be due to certain medicines or illnesses.

Many of the

and that cause meningitis are fairly common and cause other routine illnesses. Both kinds of meningitis spread like most other common infections do — someone who’s infected touches, kisses, or coughs or sneezes on someone who isn’t infected.

Bacterial meningitis is rare, but is usually serious and can be life-threatening if not treated right away.

In some cases of bacterial meningitis, the bacteria spread to the meninges from a severe head trauma or a severe local infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis).

Many different types of bacteria can cause bacterial meningitis. In newborns, the most common causes are group B strep, E. coli, and less commonly, Listeria monocytogenes. In older kids, Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are often the causes.

Viral Meningitis

Viral meningitis (also called aseptic meningitis) is more common than bacterial meningitis and usually less serious.

Many of the viruses that cause meningitis are common, such as those that cause colds, diarrhea, cold sores, and the flu.

What Are the Signs & Symptoms of Meningitis?

Meningitis symptoms vary, depending on the person’s age and the cause of the infection. The first symptoms can come on quickly or start several days after someone has had a cold, diarrhea, vomiting, or other signs of an infection.

Common symptoms include:

  • fever
  • lack of energy
  • irritability
  • headache
  • sensitivity to light
  • stiff neck
  • skin rash

Meningitis in Infants

Infants with meningitis might have different symptoms. Babies might be cranky, feed poorly, and be sleepy or hard to wake up. It may be hard to comfort them, even when they’re picked up and rocked. They also may have a fever or bulging fontanelle (soft spot on head).

Other symptoms of meningitis in babies can include:

  • jaundice (a yellowish tint to the skin)
  • stiffness of the body and neck
  • a lower-than-normal temperature
  • a weak suck
  • a high-pitched cry

How Is Meningitis Diagnosed?

Bacterial meningitis can be very serious. So if you see symptoms or think that your child could have meningitis, it’s important to see the doctor right away.

If meningitis is suspected, the doctor will order tests, probably including a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This test will show any signs of

and whether the infection is due to a virus or bacteria.

How Is Meningitis Treated?

Most cases of viral meningitis end within 7 to 10 days. Some people might need to be treated in the hospital, although kids usually can recover at home if they’re not too ill. Treatment to ease symptoms includes rest, fluids, and over-the-counter pain medicine.

If bacterial meningitis is diagnosed — or even suspected — doctors will start

(IV) antibiotics as soon as possible. Fluids may be given to replace those lost to fever, sweating, vomiting, and poor appetite.

What Problems Can Happen?

Complications of bacterial meningitis might need extra treatment. Someone with shock or low blood pressure might get more IV fluids and medicines to increase blood pressure. Some kids may need extra oxygen or mechanical ventilation if they have trouble breathing.

Bacterial meningitis complications can be severe and include neurological problems, such as hearing loss, visual impairment, seizures, and learning disabilities. Because impaired hearing is a common complication, those who’ve had bacterial meningitis should have a hearing test after they recover.

The heart, kidneys, and

also might be affected, depending on the cause of the infection. Although some kids develop long-lasting neurological problems, most who get a quick diagnosis and treatment recover fully.

Can Meningitis Be Prevented?

Vaccinations

Routine immunization can go a long way toward preventing meningitis. The Hib, measles, mumps, polio, and pneumococcal vaccines can protect against meningitis caused by those germs.

Kids also should get the meningococcal conjugate vaccine when they’re 11 or 12 years old, with a booster shot at age 16. Kids older than 11 who haven’t been vaccinated also should be immunized, particularly if they’re going to college, boarding school, camp, or other settings where they’ll live in close quarters with others.

Kids 2 months to 11 years old are at higher risk for infection should get the meningococcal conjugate, including those who:

  • live in or travel to countries where infection is common
  • have certain immune disorders
  • are present during an outbreak

A newer type of meningococcal vaccine called MenB (which protects against a type of meningococcal bacterium not covered by the older vaccine) can be given to teens and young adults at the discretion of their doctor. Kids 10 and older at high risk for infection should get the MenB vaccine.

Avoiding Germs

Kids and adults should wash their hands well and often, particularly before eating and after using the bathroom, and if they work closely with kids (as in a daycare). Avoid close contact with someone who’s obviously ill and don’t share food, drinks, or eating utensils.

In some cases, doctors may give antibiotics to anyone who has been in close contact with a person who has bacterial meningitis to help prevent infection.

When Should I Call the Doctor?

Get medical care right away if you think that your child has meningitis or you see symptoms such as vomiting, headache, tiredness or confusion, neck stiffness, rash, and fever. A baby who has a fever, is irritable, and isn’t feeding well also should be seen right away by a doctor.

If your child has been near someone who has meningitis, call your doctor to ask whether preventive medicine is recommended.

Reviewed by: Marcella A. Escoto, DO Date reviewed: January 2019

How Can I Avoid Getting Meningitis?

Overview

Meningococcal meningitis is a potentially serious infection that can result in brain damage or even death. It’s fairly uncommon, but it can be highly infectious. Read on to learn how the disease spreads, how to prevent it, and what precautions you can take to avoid it.

How meningitis spreads

Meningococcal meningitis is most often caused by a type of bacteria called Neisseria meningitidis. About 1 in 10 people carry this germ in their nose or throat without any signs or symptoms of disease. These people are called carriers.

Carriers can infect other people through activities like:

  • open-mouthed kissing
  • sharing food or utensils
  • coughing
  • sneezing

Susceptible people can develop an infection after exposure to the bacteria that cause meningitis.

The infection affects the delicate tissue that encases the brain and spinal cord. This thin tissue is called the meninges. Meningococcal meningitis is a serious infection of the meninges and cerebrospinal fluid. Inflammation and swelling in these tissues can exert dangerous pressure on the brain or spinal cord.

Prompt diagnosis and treatment are essential. But the symptoms of meningitis can be similar to symptoms of other illnesses. As a result, medical attention is often delayed.

Meningococcal meningitis can be treated with antibiotic drugs. Even with rapid antibiotic treatment, a person with meningitis may have serious consequences that can last a lifetime. Affected people may experience a loss of hearing, loss of limbs, or loss of the ability to think clearly.

Preventive measures

With the introduction of new vaccines, avoiding a meningitis infection is a lot easier today. Most children receive the meningococcal conjugate vaccine routinely. The first dose is usually given between the ages of 11 and 12 years old. A booster shot is given about five years later. An older vaccine known as the meningococcal polysaccharide vaccine can be given to people who are older than 55. Young people ages 16 to 21 are considered most at risk for contracting meningitis.

The vaccination teaches the immune system to recognize proteins on the bacteria that cause meningococcal meningitis. The immune system then targets the bacteria. There are several strains of the bacteria, however, and vaccines aren’t available for all of them. Current vaccines can prevent the majority of the most common strains. While children now routinely receive the vaccine, older adults may not have been vaccinated.

An unvaccinated person who has been exposed to meningitis should seek medical attention immediately. Doctors will often prescribe a course of prophylactic antibiotics. This kind of antibiotic use can prevent the disease from taking hold in a recently exposed person. Even if doctors can’t confirm exposure, they will usually prescribe antibiotics to be safe.

Practicing good hygiene can also help you avoid exposure. Meningococcal meningitis is usually spread through contact with the saliva or nasal secretions of an infected person. Try to avoid sharing drinks, eating utensils, or other items that may contain saliva. Also, don’t engage in open-mouthed kissing with an infected person.

Precautions

You should seek vaccination before traveling to certain regions where the disease is common. For example, the disease frequently causes outbreaks of illness in sub-Saharan Africa.

Certain groups are also more likely to get the infection, including:

  • U.S. military recruits
  • college freshmen living in dormitories
  • people with a damaged or missing spleen
  • laboratory workers who regularly work with N. meningitidis
  • people with a disorder called complement component deficiency

By getting vaccinated and practicing good hygiene, you can avoid exposure to meningococcal meningitis.

Bacterial Meningitis

What is bacterial meningitis?

Meningitis is an infection of the membranes (meninges) that protect the spinal cord and brain. When the membranes become infected, they swell and press on the spinal cord or brain. This can cause life-threatening problems. Meningitis symptoms strike suddenly and worsen quickly.

What causes bacterial meningitis?

Bacteria or a virus can cause meningitis. Viral meningitis is more common, but bacterial meningitis is more serious. It can lead to brain damage, paralysis, or stroke. In some cases, it can be fatal.

Many different types of bacteria can cause meningitis. Vaccines are available that target many of these bacteria. For this reason, it’s important to know what’s causing meningitis. Even though all types affect the same area of the body, they can have different outcomes and need different treatments.

What are the risk factors for bacterial meningitis?

Experts don’t always know why meningitis happens. Some people get it when their immune system is weak or they’ve recently been sick. A head injury may also increase risk.

Bacterial meningitis is more common in infants under 1 year of age and people ages 16 to 21. College students living in dorms or other close quarters are at increased risk. Also at risk are adults with certain medical problems, including those without a spleen.

What are the symptoms of bacterial meningitis?

The most common symptoms of bacterial meningitis are:

  • Painful, stiff neck with limited range of motion
  • Headaches
  • High fever
  • Feeling confused or sleepy
  • Bruising easily all over the body
  • A rash on the skin
  • Sensitivity to light

These are symptoms to look for in children:

  • Irritability
  • Vomiting from a high fever
  • Frequent crying
  • Swelling of the head
  • Lack of appetite
  • Seizures (sometimes also seen in adults if the meningitis is advanced)

Symptoms typically come on quickly, in as little as a couple of hours or up to a day or two. If you think you or your child may have meningitis, go to an emergency room right away.

How is bacterial meningitis diagnosed?

To diagnose this condition, a healthcare provider will do a spinal tap (also called a lumbar puncture) to take a sample of fluid from around the spinal cord. The fluid is then tested for bacteria. The healthcare provider will also ask about your symptoms and do a physical exam.

Other tests may include:

  • Brain imaging (CT scan)
  • Blood and urine testing
  • Swab of fluids from your nose or throat

How is bacterial meningitis treated?

Prompt treatment of bacterial meningitis is crucial. It can save your life. Once the type of bacteria has been identified, you’ll start taking antibiotics.

Antibiotics are given through a needle placed into a vein (usually in the arm or hand). They may also be given along with a corticosteroid to help reduce inflammation and swelling. Treatment also includes plenty of fluids to prevent dehydration.

What are the complications of bacterial meningitis?

With quick treatment, many people with bacterial meningitis don’t have any permanent problems. However, even with prompt treatment, some may battle seizures, brain damage, hearing loss, and disability for the rest of their lives. Meningitis can be fatal and some people with this infection will die.

Can bacterial meningitis be prevented?

Vaccines are available to help prevent bacterial meningitis. Children now routinely get a meningitis vaccine around ages 11 to 12. A booster shot is given at age 16. Ask your healthcare provider if you or your children should be vaccinated.

Bacterial meningitis is contagious. If you’ve been around someone who has it, call your healthcare provider to talk about how to keep from getting sick.

Key points about bacterial meningitis

  • If you feel like you’ve got the flu with unusual stiffness in your neck, it could be meningitis.
  • Get any symptoms checked out and treated as soon as possible to help ward off complications.
  • Ask your healthcare provider about vaccines that may protect you from bacterial meningitis.
  • If you’ve been around someone who has bacterial meningitis, call your healthcare provider to talk about how to keep from getting sick.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Know the reason for your visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
  • Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
  • Ask if your condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if you do not take the medicine or have the test or procedure.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.

Know how you can contact your provider if you have questions.

Bacterial Meningitis in Children

What is meningitis?

Meningitis is an infection that causes inflammation of the three thin layers of tissue, known as meninges, which cover the brain and spinal cord. Meningitis may be caused by a virus or by bacteria.

In general, bacterial meningitis is more dangerous than viral meningitis. Bacterial meningitis may cause permanent damage, including hearing loss, mental retardation or even death. Approximately 3,000 people in the U.S. or one in 100,000 are diagnosed with bacterial meningitis each year.

Typical treatment includes hospitalization and antibiotics.

What is the difference between bacterial meningitis and viral meningitis?

Symptoms:

  • Viral meningitis – Fever, headache, stiff neck, sensitivity to light, drowsiness, confusion.
  • Bacterial meningitis – High fever, severe headache, stiff neck, sensitivity to light, drowsiness, confusion. A rash, nausea, vomiting, and sore throat can also occur.

Effects:

  • Viral meningitis – Temporary, flu-like symptoms, headache, and stiff neck.
  • Bacterial meningitis – Possibility of varying degrees of brain damage, including hearing loss and mental retardation. Can be fatal if not treated in time.

Severity:

  • Viral meningitis – Goes away on its own usually within three to 10 days.
  • Bacterial meningitis – Life-threatening. Medical treatment is needed immediately.

Treatment:

  • Viral meningitis – Bed rest, Tylenol.
  • Bacterial meningitis – Hospitalization and antibiotics.

How common is bacterial meningitis?

Approximately 3,000 people in the United States — or one in 100,000 — are diagnosed with bacterial meningitis each year, most of them infants, children, college students and the elderly. Incidences of bacterial meningitis usually peak in the winter or early spring. People who show symptoms in the summer time are more likely to have viral meningitis rather than bacterial meningitis.

Preventing bacterial meningitis

The most common cause of bacterial meningitis in children, Haemophilus influenzae b (Hib), has been almost eliminated due to a vaccine that was developed at Boston Children’s Hospital in 1990.

  • Before then, approximately 10,000 children were diagnosed with meningitis each year, and 5 percent of them did not survive.
  • The Hib immunization is now a routine childhood vaccination that prevents hundreds of deaths a year.

The rate of another major cause of bacterial meningitis — the pneumococcus bacteria — also has been reduced dramatically by the widespread use of Prevnar pneumococcal vaccine.

Meningococcal vaccine, specifically for meningococcus bacteria, is recommended for students entering dormitory situations in high school or college. It is effective for three to five years, however, it does not protect against all strains of meningococcus bacteria.

How we care for bacterial meningitis

Because of the fast and severe nature of bacterial meningitis, Boston Children’s urges all parents to seek treatment immediately once you suspect bacterial meningitis. After admission, doctors will find the specific cause of your child’s meningitis and administer treatment accordingly. The ultimate goal of quick treatment is to make sure your child recovers without any permanent damage.

Meningitis in Children

What is meningitis in children?

Meningitis is a swelling (inflammation) of the thin membranes that cover the brain and the spinal cord. These membranes are called the meninges.

What causes meningitis in a child?

Meningitis is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid (CSF). CSF is the fluid that protects and cushions the brain and spinal cord. A fungus or parasite may also cause meningitis. This is more common only in children with a weak immune system.

Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis is usually more severe and may lead to long-term complications or death.

Viruses that can cause meningitis include polioviruses, the mumps virus (paramyxovirus), the flu virus, and West Nile virus.

Bacteria that can cause meningitis include group B streptococcus, E. coli, Haemophilus influenzae type b (Hib), and a strep bacteria that causes pneumonia. Syphilis, tuberculosis, and Lyme disease bacteria can also cause meningitis. The bacteria, viruses, and fungi that cause meningitis usually grow in a person’s respiratory tract. A child may have no symptoms at all, but may carry the organism in his or her nose and throat. They may be spread by:

  • Close contact with someone carrying the infection

  • Touching infected objects, such as doorknobs, hard surfaces, or toys, and then touching nose, mouth, or eyes

  • Droplets from a sneeze, close conversation, or kissing

An infection usually starts in the respiratory tract. In a child, it may first cause a cold, sinus infection, or ear infection. It can then go into the bloodstream and reach the brain and spinal cord.

Which children are at risk for meningitis?

A child is more at risk for meningitis if he or she has an infection caused by a number of viruses, bacteria, or fungi. Children with a weakened immune system are at great risk.

What are the symptoms of meningitis in a child?

The symptoms of meningitis vary depending on what causes the infection. The symptoms may start several days after your child has had a cold and runny nose, or diarrhea and vomiting. Symptoms can occur a bit differently in each child. Symptoms may appear suddenly. Or they may develop over several days.

In babies, symptoms may include:

  • Irritability

  • Fever

  • Sleeping more than usual

  • Poor feeding

  • Crying that can’t be soothed

  • High-pitched cry

  • Arching back

  • Bulging soft spots on the head (fontanelles)

  • Changed temperament

  • Purple-red splotchy rash

  • Seizures

  • Vomiting

In children age 1 or older, symptoms may include:

  • Neck pain

  • Back pain

  • Headache

  • Sleepiness

  • Confusion

  • Irritability

  • Fever

  • Refusing to eat

  • Reduced level of consciousness

  • Seizures

  • Eyes sensitive to light (photophobia)

  • Nausea and vomiting

  • Neck stiffness

  • A purple-red splotchy rash

The symptoms of meningitis can be like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

How is meningitis diagnosed in a child?

The healthcare provider will ask about your child’s symptoms and health history. He or she may also ask about your family’s health history. He or she will give your child a physical exam. Your child may also have tests, such as:

  • Lumbar puncture (spinal tap). This is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain is measured. A small amount of cerebral spinal fluid (CSF) is removed and sent for testing to see if there is an infection or other problems.

  • Blood tests. These can help diagnose infections that cause meningitis.

  • CT scan or MRI. These are tests that show images of the brain. A CT scan is sometimes done to look for other conditions that may cause similar symptoms as meningitis. An MRI may show inflammatory changes in the meninges. These tests give more information. But meningitis can’t be diagnosed using these tests alone.

  • Nasal, throat, or rectal swabs. These tests help diagnose viral infections that cause meningitis.

How is meningitis treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

Treatment varies by type of meningitis. The treatments by type include:

  • Bacterial meningitis. Treatment is started as quickly as possible. The healthcare provider will give your child IV (intravenous) antibiotics, which kill bacteria. Your child will also get a corticosteroid medicine. The steroid works by decreasing the swelling (inflammation) and reducing pressure that can build up in the brain. Steroids also reduce the risk for hearing loss and brain damage.

  • Viral meningitis. Most children get better on their own without treatment. In some cases, treatment may be done to help ease symptoms. There are no medicines to treat the viruses that cause viral meningitis. The only exception is herpes simplex virus, which is treated with IV antiviral medicine. Babies and children with a weakened immune system may need to stay in the hospital.

  • Fungal meningitis. Your child may get IV antifungal medicine.

  • Tuberculous (TB) meningitis. Your child will be treated with a course of medicines over 1 year. Treatment is done with several medicines for the first few months. This is followed by other medicines for the remaining time.

While your child is recovering from meningitis, he or she may also need:

  • Bed rest

  • Increased fluid intake by mouth or IV fluids in the hospital

  • Medicines to reduce fever and headache. Don’t give aspirin or medicine that contains aspirin to a child younger than age 19 unless directed by your child’s provider. Taking aspirin can put your child at risk for Reye syndrome. This is a rare but very serious disorder. It most often affects the brain and the liver.

  • Supplemental oxygen or breathing machine (respirator) if your child has trouble breathing

Talk with your child’s healthcare providers about the risks, benefits, and possible side effects of all treatments.

What are the possible complications of meningitis in a child?

Bacterial meningitis is usually more severe and may lead to long-term complications. Some children may have long-term problems with seizures, brain damage, hearing loss, and disability. Bacterial meningitis can also cause death.

How can I help prevent meningitis in my child?

Several vaccines are available to prevent some of the bacterial infections that can cause meningitis. These include:

  • H. influenzae type b vaccine (Hib). This is given as a 3- or 4-part series during your child’s routine vaccines starting at 2 months old.

  • PCV13 pneumococcal vaccine. The American Academy of Pediatrics recommends this vaccine for all healthy children younger than age 2. PCV13 can be given along with other childhood vaccines. It is recommended at ages 2 months, 4 months, 6 months, and 12 to 15 months. One dose is also advised for older children who did not get the 4-dose series, and for those at high risk for pneumococcal disease.

  • PPSV23 pneumococcal vaccine. This vaccine is also recommended for older children at high risk for pneumococcal disease.

  • Meningococcal vaccine. This vaccine is part of the routine vaccine schedule. It is given to children ages 11 to 12, with a booster given at age 16. It is given to teens entering high school if they were not vaccinated at age 11 or 12. A booster is also given at age 16 to 18, or up to 5 years later. Babies and young children at increased risk may also have this vaccine. Ask your child’s healthcare provider about the number of doses and when they should be given.

Vaccines that protect against viruses such as measles, mumps, chickenpox, and the flu can prevent viral meningitis.

Talk with your child’s healthcare provider if you have questions about the vaccines.

You and your child can do other things to prevent the spread of infections. Proper handwashing and staying away from people who are sick can help prevent meningitis.

When should I call my child’s healthcare provider?

Call the healthcare provider if your child has:

  • Not received vaccines

  • Contact with someone who has meningitis

  • Symptoms that don’t get better, or get worse

  • New symptoms

Key points about meningitis in children

  • Meningitis is an inflammation of the thin membranes that cover the brain and the spinal cord.

  • It is most often caused by a bacterial or viral infection that moves into the cerebral spinal fluid. A fungus or parasite may also cause meningitis.

  • Meningitis caused by a virus is more common and usually less severe. Bacterial meningitis is usually more severe and may lead to long-term complications or death.

  • An infection usually starts in the respiratory tract. In a child, it may first cause a cold, sinus infection, or ear infection. It can then go into the bloodstream and reach the brain and spinal cord.

  • A lumbar puncture (spinal tap) is the only test that diagnoses meningitis. A needle is placed into the lower back, into the spinal canal.

  • Several vaccines are available to prevent some of the bacterial and viral infections that can cause meningitis.

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.

  • Before your visit, write down questions you want answered.

  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

  • Ask if your child’s condition can be treated in other ways.

  • Know why a test or procedure is recommended and what the results could mean.

  • Know what to expect if your child does not take the medicine or have the test or procedure.

  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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