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Frequently Asked Questions
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 (Hib) was the leading cause of bacterial meningitis, but
new vaccines being 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.
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 symptoms
occur, the patient should see a doctor immediately. The 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 responsible 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, kissing). Fortunately, none of the bacteria that
cause meningitis are 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
patient with meningitis caused by Neisseria meningitidis
(also called meningococcal meningitis) or Hib. People in the same
household 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 Hib meningitis disease are no longer recommended
if all contacts 4 years of age or younger are fully vaccinated
against Hib disease (see below).
Are
there vaccines against meningitis?
Yes, there are vaccines against Hib and against some strains of
N. meningitidis and many types of Streptococcus pneumoniae.
The vaccines against Hib are very safe and highly effective.
There is also a vaccine that protects against four
strains of N. meningitidis, but it is not routinely used
in the United States. The vaccine against N. meningitidis
is sometimes used to control outbreaks of some types of meningococcal
meningitis in the United States. Meningitis cases should be reported
to state or local health departments to assure follow-up of close
contacts and recognize outbreaks. College freshman, especially
those who live in dormitories are at higher risk for meningococcal
disease and should be educated about the availability of a safe
and effective vaccine which can decrease their 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 (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 greater than 2 years of age.
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