Meningitis is an inflammation of the meninges, which are membranous coverings of the brain and spinal cord. The cause of infection in this area is usually invasion by either bacteria or viruses. Infection can reach the meninges in several ways. It can be transported via the bloodstream from some other part of the body, such as the lungs or nasopharynx. It can also spread to the brain from an infected ear or sinus which is contiguous with the bones of the skull. An easy portal of entry would be a fractured skull with a meningeal tear. There are many types and degrees of severity of meningitis depending on the micro-organism involved and the immune status of the patient.
Symptoms of viral or bacterial meningitis include fever, headache, nausea, vomiting, a stiff neck and photophobia (intolerance of bright light). If you or someone you know develops a combination of severe headache, stiff neck and photophobia, consult a physician immediately. A suspected diagnosis of meningitis can be confirmed by exam of cerebral spinal fluid, the liquid that surrounds the brain and spinal cord.
Meningitis is not a common illness in this country, although it can occur in epidemics at times when certain organisms are most prevalent in the population. The most common form is a viral infection spread from person to person like a cold, through the air or from hand to mouth contact; this form occurs in late spring and summer. As most cases are short and uneventful, persons who have had contact with a case do not require treatment and in most cases of viral meningitis there is full recovery. We do not have antiviral medications for most viruses, so patients are given supportive, symptomatic care.
Bacterial meningitis tends to occur in outbreaks in late winter and early spring. The symptoms are similar to viral meningitis, with the addition of a skin rash in some cases. Treatment requires hospitalization and intravenous antibiotics. Because of the rapid progress and possibly grave consequences, a person who has had intimate contact with someone diagnosed with bacterial meningitis requires preventative therapy.
To reduce the risks of acquiring meningitis, maximize the body's immune system with a balanced diet, adequate sleep, proper exercise and by avoiding excessive stress. Avoid close contact with upper respiratory tract infections and cigarette smoke inhalation. Two clusters of meningococcal (bacterial) meningitis have occurred on college campuses in association with heavy drinking and random sharing of beverage containers. This probably represents transmission from a fellow student who is a carrier of this organism. Everyone should follow basic public health measures such as covering one's mouth when coughing or sneezing and washing one's hands after contact with oral and nasal secretions.
The American College Health Association recommends that all college students under the age of 30 consider getting vaccinated against meningococcal disease. The meningococcal vaccine offers three to five years' protection against one of the two strains most prevalent in the U.S. The vaccine is available through the Garrison-Foster Health Center for about $60 if special ordered. Call a nurse X3402 to have the vaccine ordered for you. (Because this vaccine is a "preventive" treatment, most health insurance plans will not pay for it, but if you have prescription coverage through your home insurance, you may wish to present your card when you order the vaccine to see if your company follows the norm.
Melanie Thompson, MD
