Odds of getting meningitis

What’s Your Meningitis Risk Factor?

Anyone can get meningitis, an inflammation of the lining surrounding the spinal cord and brain. Viral meningitis and bacterial meningitis are the most common types; fungal and noninfectious meningitis are much rarer and usually associated with an autoimmune disorder or a medical condition such as cancer.

Bacterial meningitis, which according to the National Meningitis Association strikes an average of 1,500 Americans annually, can be fatal and may result in serious after-effects, such as deafness, brain damage, or amputation of an extremity. Viral meningitis is usually not fatal, but is nonetheless a serious disease, causing between 25,000 and 50,000 hospital visits each year in the United States.

Viruses that can cause meningitis include:

  • Mumps virus
  • Herpes simplex type 2 virus (genital herpes)
  • Varicella zoster virus, which causes chickenpox and, later in life, shingles

Bacteria that can cause meningitis include:

  • Neisseria meningitidis (meningococcus)
  • Streptococcus pneumoniae
  • Haemophilus influenzae type b

Some people are more susceptible to meningitis than others. Those at higher risk for meningitis include:

  • People with weakened immune systems
  • Child care providers
  • Pregnant women
  • College students and other people who live in close proximity to one another

Suppressed Immune Systems and Meningitis Risks

People at highest risk for getting meningitis are those whose immune systems are weak, such as people who:

  • Have certain diseases or are getting certain treatments. Some types of cancer and infection with HIV increase your risk, as does taking immunosuppressant medications such as chemotherapy and corticosteroids. Immunosuppressant medicines are drugs that lessen the infection-fighting power of the immune system, which normally guards the body against foreign invaders that can make you sick.
  • Engage in certain behaviors. Anyone who smokes or is exposed to secondhand smoke, drinks excessive amounts of alcohol, or takes part in binge drinking is at risk. All of these activities weaken the immune system.
  • Have had certain surgeries. Removal of your spleen puts you at risk for meningitis, because the spleen is an important part of the immune system.

Child Care and Meningitis Risk

People who change diapers have a higher than normal risk of meningitis. It doesn’t matter whether you are a parent, grandparent, babysitter, or day care employee — you are at risk. Why? Because stool can harbor a virus that can cause meningitis. So be sure to scrub your hands thoroughly with hot soapy water after changing a diaper.

Pregnancy and Meningitis Risk

Though it’s rare, pregnant women can be prone to developing meningitis associated with an infection called listeriosis in the last trimester. This puts the mother and child at risk of miscarriage, premature delivery, and stillbirth. Listeria is a kind of bacteria found in soil and water and, therefore, in food and animals. Pregnant women can be exposed to the bacteria from eating soft cheeses and certain meats, such as deli cold cuts.

Contact With Someone Who Has Meningitis

If you are in close contact with someone who contracts meningitis, you are at risk of getting it as well. If you share spoons, forks, lipstick, cigarettes, or anything on which someone else’s oral or respiratory secretions might lurk, you are at risk. College students, especially those who live in dorms, are particularly prone to getting meningitis.

Other circumstances where people are in close contact with one another and may more easily transmit the infection include:

  • Overnight camps
  • Crowded bars and parties
  • Day care centers
  • Military barracks

International travelers must also be wary. Before you leave on a trip abroad, check to see if meningitis is endemic in the country where you are going. If so, it’s recommended that you get a meningitis vaccination at least one week before you leave.

Other People at Increased Meningitis Risk

Others who are at increased risk of contracting meningitis are people who:

  • Have had a head injury or brain surgery
  • Have a chronic illness, like diabetes, heart disease, or liver disease
  • Have AIDS, which makes you more susceptible to a type of meningitis caused by a fungus rather than a virus or bacteria. This kind of meningitis can be treated, but often recurs.
  • Are in certain age age groups, including children under 5, teens and young adults ages 16 to 25 (especially college freshman living in dorms), and adults over 55.

If any of these categories apply to you, talk with your doctor to determine the best ways to manage your risk.

Bacterial Meningitis

Bacterial meningitis is very serious and can be deadly. Death can occur in as little as a few hours. Most people recover from meningitis. However, permanent disabilities (such as brain damage, hearing loss, and learning disabilities) can result from the infection.

Several types of bacteria can cause meningitis. Leading causes in the United States include

  • Streptococcus pneumoniae
  • Group B Streptococcus
  • Neisseria meningitidis
  • Haemophilus influenzae
  • Listeria monocytogenes

These bacteria can also be associated with another serious illness, sepsis. Sepsis is the body’s extreme response to infection. Without timely treatment, sepsis can quickly lead to tissue damage, organ failure, and death.

Causes

Common causes of bacterial meningitis vary by age group:

Risk Factors

Certain people are at increased risk for bacterial meningitis. Some risk factors include:

  • Age: Babies are at increased risk for bacterial meningitis compared to people in other age groups. However, people of any age can develop bacterial meningitis. See section above for which bacteria more commonly affect which age groups.
  • Group setting: Infectious diseases tend to spread where large groups of people gather. College campuses have reported outbreaks of meningococcal disease, caused by N. meningitidis.
  • Certain medical conditions: There are certain medical conditions, medications, and surgical procedures that put people at increased risk for meningitis.
  • Working with meningitis-causing pathogens: Microbiologists routinely exposed to meningitis-causing bacteria are at increased risk for meningitis.
  • Travel: Travelers may be at increased risk for meningococcal disease, caused by N. meningitidis, if they travel to certain places, such as:
    • The meningitis belt in sub-Saharan Africa, particularly during the dry season
    • Mecca during the annual Hajj and Umrah pilgrimage

How It Spreads

Generally, the germs that cause bacterial meningitis spread from one person to another. Certain germs, such as L. monocytogenes, can spread through food.

How people spread the germs often depends on the type of bacteria. It is also important to know that people can have these bacteria in or on their bodies without being sick. These people are “carriers.” Most carriers never become sick, but can still spread the bacteria to others.

Here are some of the most common examples of how people spread each type of bacteria to each other:

  • Group B Streptococcus and E. coli: Mothers can pass these bacteria to their babies during birth.
  • Hib and S. pneumoniae: People spread these bacteria by coughing or sneezing while in close contact with others, who breathe in the bacteria.
  • N. meningitidis: People spread these bacteria by sharing respiratory or throat secretions (saliva or spit). This typically occurs during close (coughing or kissing) or lengthy (living together) contact.
  • E. coli: People can get these bacteria by eating food prepared by people who did not wash their hands well after using the toilet.

People usually get sick from E. coli and L. monocytogenes by eating contaminated food.

Signs and Symptoms

Pregnancy

Pregnant women are at increased risk of developing listeriosis, an infection caused by the bacteria L. monocytogenes. Listeriosis is typically a mild illness for pregnant women, but it causes severe disease in the fetus or newborn baby. Pregnant women can reduce the risk of meningitis caused by L. monocytogenes by avoiding certain foods and safely preparing others.

Pregnant women can pass group B Streptococcus (group B strep) to their baby during delivery. A newborn infected with group B strep can develop meningitis or other serious infections soon after birth. Talk with your doctor or midwife about getting a group B test when you are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent infection in newborns.

Meningitis symptoms include sudden onset of

  • Fever
  • Headache
  • Stiff neck

There are often other symptoms, such as

  • Nausea
  • Vomiting
  • Photophobia (eyes being more sensitive to light)
  • Altered mental status (confusion)

Newborns and babies may not have or it may be difficult to notice the classic symptoms listed above. Instead, babies may

  • Be slow or inactive
  • Be irritable
  • Vomit
  • Feed poorly

In young babies, doctors may also look for a bulging fontanelle (soft spot on infant’s head) or abnormal reflexes. If you think your baby or child has any of these symptoms, call the doctor right away.

Symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3 to 7 days after exposure.

Later symptoms of bacterial meningitis can be very serious (e.g., seizures, coma). For this reason, anyone who thinks they may have meningitis should see a doctor as soon as possible.

Diagnosis

If a doctor suspects meningitis, they will collect samples of blood or cerebrospinal fluid (fluid near the spinal cord). A laboratory will test the samples to see what is causing the infection. It is important to know the specific cause of meningitis so the doctors know how to treat it.

Treatment

Doctors treat bacterial meningitis with a number of antibiotics. It is important to start treatment as soon as possible.

Prevention

Vaccines are the most effective way to protect against certain types of bacterial meningitis. There are vaccines for 3 types of bacteria that can cause meningitis:

  • Meningococcal vaccines help protect against N. meningitidis
  • Pneumococcal vaccines help protect against S. pneumoniae
  • Hib vaccines help protect against Hib

Make sure you and your child are vaccinated on schedule.

Like with any vaccine, the vaccines that protect against these bacteria are not 100% effective. The vaccines also do not protect against all the types (strains) of each bacteria. For these reasons, there is still a chance vaccinated people can develop bacterial meningitis.

Pregnant women should talk to their doctor or midwife about getting tested for group B Streptococcus. Women receive the test when they are 36 through 37 weeks pregnant. Doctors give antibiotics (during labor) to women who test positive in order to prevent passing group B strep to their newborns.

Pregnant women can also reduce their risk of meningitis caused by L. monocytogenes. Women should avoid certain foods during pregnancy and safely prepare others.

If someone has bacterial meningitis, a doctor may recommend antibiotics to help prevent other people from getting sick. Doctors call this prophylaxis. CDC recommends prophylaxis for:

  • Close contacts of someone with meningitis caused by N. meningitidis
  • Family members, especially if they are at increased risk, of someone with a serious Hib infection

Doctors or local health departments recommend who should get prophylaxis.

You can also help protect yourself and others from bacterial meningitis by maintaining healthy habits:

  • Don’t smoke and avoid cigarette smoke
  • Get plenty of rest
  • Avoid close contact with people who are sick

This is especially important for people at increased risk for disease, including:

  • Young babies
  • Older adults
  • People with weak immune systems
  • People without a spleen or a spleen that doesn’t work the way it should

Top of Page

Meningococcal Disease

Meningococcal (muh-nin-jo-cok-ul) disease is a serious bacterial illness that can lead to severe swelling of the tissues surrounding the brain and spinal cord (meningitis) or infection of the bloodstream (meningococcemia). Even with treatment, approximately one out of every 10 people who get meningococcal disease will die, and of those who survive, up to 20 percent will suffer serious and permanent complications including brain damage, kidney damage, hearing loss, and amputation of arms, legs, fingers, or toes.

Anyone can get meningococcal disease but certain people are at increased risk, including:

  • Infants younger than one year old
  • Adolescents and young adults age 16 through 23 years old
  • People with certain medical conditions that affect the immune system
  • Microbiologists who routinely work with isolates of N. meningitidis, the bacteria that cause meningococcal disease
  • People at risk because of an outbreak in their community

According to the Centers for Disease Control and Prevention (CDC), meningococcal bacteria spread through the exchange of respiratory and throat secretions like saliva or spit (e.g., by coughing, living in close quarters, kissing). Meningococcal disease can be treated with antibiotics, but quick medical attention is extremely important.

Prevention

Keeping up to date with recommended vaccines is the best way to protect against meningococcal disease. Two meningococcal vaccines (MenACWY and MenB) provide protection against the five serogroups that cause most meningococcal disease in the US (serogroups A, B, C, W, and Y). CDC recommends meningococcal vaccines for preteens, teens, and people with certain medical conditions, travel plans, or jobs. The recommendations for the use of these vaccines differ:

  • Meningococcal ACWY vaccine is recommended for all adolescents at age 11-12 years with a booster dose at age 16 years.
  • Meningococcal ACWY vaccine is recommended for children age 2 months through 10 years who have an increased risk of infection due to certain medical conditions, travel, or an outbreak.
  • Teens and young adults (16 through 23 year olds) may also get a MenB vaccine, preferably at 16 through 18 years old. CDC does not routinely recommend this vaccine and asks that parents and healthcare professionals discuss the risk of disease and weigh the risks and benefits of vaccination before deciding. People need multiple doses of a MenB vaccine for best protection and must get the same brand for all doses.
  • Meningococcal B vaccines are recommended for people age 10 years or older who are at increased risk for serogroup B meningococcal disease, including people at risk because of an outbreak.

Talk to your healthcare professional to make sure that your family is protected against this deadly disease.

Learn more about serogroup B disease and recent outbreaks on US college campuses. View the Meningococcal Disease College Toolkit for resources to help increase awareness among the college community about the importance of meningococcal disease prevention. Read NFID’s report on Addressing the Challenges of Serogroup B Meningococcal Disease Outbreaks on Campuses (May 2014).

Additional Resources

Sample social media posts focused on meningococcal disease prevention

30-second public service video on the two types of meningococcal vaccines to help protect adolescents and young adults

Many adults need to be vaccinated if they are at increased risk of meningococcal disease, including college students, military personnel, and some international travelers

Anyone can get meningococcal disease, but young adults and adolescents generally have a higher risk

Definitions of medical terms about meningococcal disease

Serogroup B is the most common cause of meningococcal disease in US adolescents and young adults

26-second public service video featuring Carol Baker, MD

15-second public service video featuring Susan Rehm, MD

A 16-second public service video featuring Susan Rehm, MD

10-second video from Susan Rehm, MD

16-second video from Vaughn Rickert, PsyD

15-second video with Ardis Hoven, MD

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