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FAQs, Links & Books
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Frequently Asked Questions
What is meningitis?
What are the signs and symptoms of meningitis?
How is meningitis diagnosed?
Can meningitis be treated?
Is meningitis contagious?
Are there vaccines against meningitis?
Who should receive the meningitis vaccine?
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,
learning disability, or death. 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.
NOVA's program "Killer Disease on Campus" depicts young adults and
children with N. meningitidis, also known as meningococcal
meningitis, a bacterial form of the disease.
What are the signs and symptoms of meningitis?
High fever, headache, and a stiff neck are common symptoms of
meningitis in anyone over the age of two years. These symptoms can
develop over several hours, or they may take one to two 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, experience 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 percent, although the risk is
higher among the elderly.
Is meningitis contagious?
Yes, some forms are 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 Hib or N. meningitidis. 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 four 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 S. 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 and is not effective in children under 18 months of age. The
vaccine against N. meningitidis is sometimes used to control
outbreaks of some types of meningococcal meningitis in the U.S.
Meningitis cases should be reported to state or local health
departments to assure follow-up of close contacts and recognize
outbreaks. Although large epidemics of meningococcal meningitis do
not occur in the U.S., 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 one 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.
A vaccine to prevent meningitis due to S. pneumoniae (also
called pneumococcal meningitis) can also prevent other forms of
infection due to S. pneumoniae. The pneumococcal vaccine is
not effective in children under two years of age but is recommended
for all persons over 65 years of age and younger persons with
certain chronic medical problems.
Who should receive the meningitis vaccine?
In 1999, the CDC, in cooperation with the American College Health
Association and others, conducted a number of studies and literature
reviews to better define the risk of meningococcal disease
associated with college students. As a result, it was determined
that freshman college students, particularly those who live in
dormitories, constitute a group at a modestly increased risk for
meningococcal disease.
The currently available meningococcal meningitis vaccine protects
against four types of the bacterium Neisseria meningitidis, a
very important cause of bacterial meningitis and sepsis in
adolescents and young adults in the United States. The vaccine will
not totally eliminate the risk of meningococcal disease, though it
is highly effective against the four types of bacterial meningitis
that account for about 70 to 80 percent of the cases of meningitis
in college students. It is recommended that parents and students
learn more about meningococcal disease (meningitis and sepsis) and
the vaccine that can prevent it. More information is available by
visiting the American College Health Association's Web site at
http://www.acha.org.
People travelling abroad should also check to see if meningococcal
vaccine is recommended for their destination. 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. Travelers should receive the vaccine at least one
week before departure, if possible.
Others who have certain disorders of the immune system or workers in
clinical laboratories responsible for processing specimens may be
candidates for meningococcal vaccination. Specific information and
recommendations are available at the CDC's Web site,
http://www.cdc.gov.
Links
MedLine Plus Meningitis Tutorial
www.nlm.nih.gov/medlineplus/tutorials/meningitis.html
The National Library of Medicine's Patient Education Institute
offers an interactive tutorial on the etiology of meningitis and
includes information on treatment and vaccination.
National Foundation for Infectious Diseases (NFID)
www.nfid.org/library/meningococcal/
Confused about the difference between bacterial and viral
meningitis? Looking for information about current research on
meningitis vaccines and treatments? The NFID's new meningitis site
is full of related information on the science behind the disease
and the efforts to fight it.
The Meningitis Foundation of America
www.musa.org
Read the first-person accounts of meningitis survivors and
participate in an online forum about the disease.
World Health Organization (WHO)
www.who.int/health-topics/meningitis.htm
The WHO provides detailed information on meningitis vaccines
currently in use. In addition, you'll find regular reports and
statistical analyses focusing on the global incidence of the
disease.
Books
Meningococcal Disease
by Keith Cartwright, ed. New
York: John Wiley and Sons, 1995.
Experts on the disease from a wide range of fields review major
advances regarding the epidemiology, molecular biology,
pathogenesis, clinical management, and prevention of the most
lethal form of meningitis.
Meningococcal Disease: Methods and Protocols
by Andrew
J. Pollard et al. New York: Humana Press, 2001.
An interdisciplinary survey of recent advances in the study of
meningococcal disease worldwide.
How the Immune System Works
by Lauren M. Sompayrac. New
York: Blackwell Science Inc, 1999.
In her highly readable volume—a favorite among medical
students—Dr. Sompayrac describes the overall design of the
immune system in layman's terms.
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