Meningitis

An Overview

Viral meningitis is an infection of the membranes (linings) that cover the brain and spinal cord. A variety of viruses can cause meningitis, including those that cause gastroenteritis, measles, mumps, chicken pox and herpes. Viral meningitis is rarely serious, although symptoms may be severe. People usually recover completely. However, anyone with symptoms of meningitis should see a doctor right away because some types of meningitis can be very serious. Only a doctor can determine if someone has meningitis, what is causing it and the best treatment.

Babies younger than 1 month old and people with weakened immune systems are more likely to have severe illness from viral meningitis. Viral meningitis is a virus-borne inflammation of the meninges, which are the protective membranes surrounding the brain and spinal cord. It’s far less severe than bacterial meningitis and generally only produces mild symptoms, such as headache, nausea, bright-light sensitivity and lethargy. Most cases go away on their own within 7 to 10 days. Sometimes recovery can take a few months; this is most likely if the meningitis is caused by West Nile virus or lymphocytic choriomeningitis virus.

Types of Viral meningitis

The list of types of Viral meningitis mentioned in various sources includes:

• Enterovirus-caused meningitis
• Arbovirus-caused meningitis
• Measles-caused meningitis
• Mumps-caused meningitis
• Chickenpox-caused meningitis

Causes of Viral meningitis

Non-polio enteroviruses are the most common cause of viral meningitis in the United States, especially from late spring to fall. That is when these viruses spread most often. However, only a small number of people infected with enteroviruses will actually develop meningitis. Viral meningitis is caused by viruses found in sputum (spit), blood, nose drainage and bowel movements. The virus is spread from an infected person to another by coughing, kissing, or sharing food or drinks.
Children younger than age 5 and people with weakened immune systems from diseases, medication, or recent surgeries or transplants are most likely to get meningitis from enteroviruses.

Other viruses that can cause meningitis are

  • Mumps virus
  • Enteroviruses
  • Herpesviruses, including Epstein barr virus herpes simplex viruses and varicella-zoster virus (which causes chicken pox and shingles)
  • Measles virus
  • Cytomegalovirus meningitis (CMV meningitis)
  • Influenza virus
  • Arboviruses, such as west Nile virus
  • West Nile virus from mosquitos in certain parts of the Americas, Africa, West Asia, Australia, and mainland Europe
  • St. Louis encephalitis virus from mosquitos in North America

Symptoms for Viral meningitis

It may take a few hours to a few days after being infected with viral meningitis to have any of the following :

  • Fever
  • Eyes being more sensitive to light
  • Sleepiness or trouble waking up from sleep
  • A stiff neck or neck pain
  • Severe headache
  • Nausea or vomiting
  • Red or purple rash
  • Eye pain when you look into bright lights
  • Sleepiness or confusion
  • Sleepiness or trouble waking up from sleep
  • Lethargy (a lack of energy)

Initial symptoms of viral meningitis are similar to those for bacterial meningitis. However, bacterial meningitis is usually severe and can cause serious complications, such as brain damage, hearing loss, or learning disabilities.

Diagnosis

Doctors diagnose meningitis by ordering specific lab tests on specimens from a person suspected of having meningitis.

  • Lumbar puncture is a procedure in which a needle is inserted in your back and into your spinal canal. This is usually done to collect cerebrospinal fluid (CSF). CSF is a clear, protective fluid that flows around the brain and inside the spinal canal. The fluid will be sent to a lab to check for infection.
  • Blood tests may be done to check for signs of infection.
  • Swabbing your nose or throat
  • Obtaining a stool sample
  • Drawing fluid from around your spinal cord

Treatment

If a person is acutely ill, antibiotics will be administered while waiting for test results to confirm whether the illness is bacterial meningitis, which requires immediate treatment.
Patients may also be given the antiviral drug acyclovir if there is high suspicion that the meningitis is caused by a herpes virus. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. However, antibiotics do fight bacteria, so they are very important when treating bacterial meningitis.
People who develop severe illness, or are at risk for developing severe illness may need care in a hospital.

• Acetaminophen decreases pain and fever. It is available without a doctor’s order. Ask how much to take and how often to take it. Follow directions. Read the labels of all other medicines you are using to see if they also contain acetaminophen, or ask your doctor or pharmacist
• Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
• Nausea medicine helps calm your stomach and control vomiting.
• Antiviral medicine helps treat an infection caused by a virus.

Prevention

Vaccines can prevent some types of viral meningitis, though this doesn’t include meningitis caused by enteroviruses.
In this case, avoiding close contact with those with enteroviruses and touching your face with unwashed hands can help minimize your chances.
• Rest as much as possible. A dark, quiet room is best if you have headaches or your eyes are sensitive to light.
• Drink liquids as directed. You may need extra liquids to help prevent dehydration. Ask how much liquid to drink each day and which liquids are best for you.
• Avoid close contact, such as touching and shaking hands, with people who are sick
• Clean and disinfect frequently touched surfaces
• Stay home when you are sick and keep sick children out of school
• Throat and stool cultures may be done. A swab of your throat or a bowel movement sample may be collected to learn what virus is causing your symptoms.

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