Campus Health Information

 

 

Please be aware that winter and spring are peak meningitis seasons. Listed below is information on viral, bacterial, fungal, and other types of meningitis, along with recommendations for vaccination.

Meningitis Frequently Asked Questions:

Where can I get the vaccine?

  • The University Health Services in Ann Arbor offers the vaccine to UM-Flint students for a fee.  Their telephone number is (734) 762-8304.
  • Visiting Nurse Association in Flint offers the vaccination for a fee.  Their telephone number is (810) 496-8759 or toll free 1-800-343-6400.

For those persons needing assistance in locating a provider for the vaccine, please consult with your medical practitioner, local or state health department, or contact two additional resources: 1-800-VACCINE and www.meningitisvaccine.com

  • Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities.
  • Viral meningitis is generally less severe and resolves without specific treatment. 
  • Fungal meningitis is not contagious. It is not transmitted from person to person.

 

VIRAL MENINGITIS

http://www.cdc.gov/meningitis/viral.html

Viral meningitis is generally less severe and resolves without specific treatment.

Causes

Most viral meningitis cases in the United States, especially during the summer months, are caused by enteroviruses; however, only a small number of people with enterovirus infections actually develop meningitis.

Other viral infections that can lead to meningitis include

· Mumps

· Herpes virus, including Epstein-Barr virus, herpes simplex viruses, varicella-zoster virus (which also causes chicken pox and shingles), measles, and influenza

· Viruses spread through mosquitoes and other insects (arboviruses)

· In rare cases LCMV (lymphocytic choriomeningitis virus), which is spread by rodents, can cause viral meningitis

Risk Factors

Viral meningitis can affect anyone. But infants younger than 1 month old and people whose immune systems are weak are at higher risk for severe infection. People who are around someone with viral meningitis have a chance of becoming infected with the virus that made that person sick, but they are not likely to develop meningitis as a complication of the illness.

Factors that can increase your risk of viral meningitis include:

· Age

Viral meningitis occurs mostly in children younger than age 5. 

· Weakened immune system

There are certain diseases, medications and surgical procedures that may weaken the immune system and increase risk of meningitis.

Transmission

Enteroviruses, the most common cause of viral meningitis, are most often spread from person to person through fecal contamination (which can occur when changing a diaper or using the toilet and not properly washing hands afterwards). Enteroviruses can also be spread through respiratory secretions (saliva, sputum, or nasal mucus) of an infected person. Other viruses, such as mumps and varicella-zoster virus, may also be spread through direct or indirect contact with saliva, sputum, or mucus of an infected person. Contact with an infected person may increase your chance of becoming infected with the virus that made them sick; however you will have a small chance of developing meningitis as a complication of the illness.

Signs & Symptoms

Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as

· Nausea

· Vomiting

· Photophobia (sensitivity to light)

· Altered mental status

Viral meningitis is an infection of the meninges (the covering of the brain and spinal cord) that is caused by a virus. Enteroviruses, the most common cause of viral meningitis, appear most often during the summer and fall in temperate climates.

Viral meningitis can affect babies, children, and adults. It is usually less severe than bacterial meningitis and normally clears up without specific treatment. The symptoms of viral meningitis are similar to those for bacterial meningitis, which can be fatal. Because of this, it is important to see a healthcare provider right away if you think you or your child might have meningitis.

Symptoms of viral meningitis in adults may differ from those in children:

Common symptoms in infants

· Fever

· Irritability

· Poor eating

· Hard to awaken

Common symptoms in adults

· High fever

· Severe headache

· Stiff neck

· Sensitivity to bright light

· Sleepiness or trouble waking up

· Nausea, vomiting

· Lack of appetite

The symptoms of viral meningitis usually last from 7 to 10 days, and people with normal immune systems usually recover completely.

Diagnosis

If meningitis is suspected, samples of blood or cerebrospinal fluid (near the spinal cord) are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because the severity of illness and the treatment will differ depending on the cause.

The specific causes of meningitis may be determined by tests used to identify the virus in samples collected from the patient.

Treatment

There is no specific treatment for viral meningitis. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Most patients completely recover on their own within 7 to 10 days. A hospital stay may be necessary in more severe cases or for people with weak immune systems.

Prevention

People with certain viral infections can sometimes develop meningitis. There are no vaccines for the most common causes of viral meningitis. Thus, the best way to prevent it is to prevent viral infections. However, that can be difficult since sometimes people can be infected with a virus and spread the virus even though they do not appear sick. Following are some steps you can take to help lower your chances of becoming infected with viruses or of passing one on to someone else:

· Wash your hands thoroughly and often, especially after changing diapers, using the toilet, or coughing or blowing your nose.

· Clean contaminated surfaces, such as doorknobs or the TV remote control, with soap and water and then disinfect them with a dilute solution of chlorine-containing bleach.

· Avoid kissing or sharing a drinking glass, eating utensil, lipstick, or other such items with sick people or with others when you are sick.

· Make sure you and your child are vaccinated. Vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (MMR vaccine) and chickenpox (varicella-zoster vaccine).

· Avoid bites from mosquitoes and other insects that carry diseases that can infect humans.

· Control mice and rats. If you have a rodent infestation in and/or around your home, follow the cleaning and control precautions listed on CDC’s website about LCMV (Lymphocytic choriomeningitis virus).

 

BACTERIAL MENINGITIS

http://www.cdc.gov/meningitis/bacterial.html

Bacterial meningitis is usually severe. While most people with meningitis recover, it can cause serious complications, such as brain damage, hearing loss, or learning disabilities.

There are several pathogens (types of germs) that can cause bacterial meningitis. Some of the leading causes of bacterial meningitis in the United States include Haemophilus influenzae (most often caused by type b, Hib), Streptococcus pneumoniae, group B Streptococcus, Listeria monocytogenes, and Neisseria meningitidis.

In the United States, about 4,100 cases of bacterial meningitis, including 500 deaths, occurred each year between 2003–2007.

Causes

Common causes of bacterial meningitis vary by age group:

Age Group

Causes

Newborns

Group B Streptococcus, Escherichia coli, Listeria monocytogenes

Infants and Children

Streptococcus pneumoniae, Neisseria meningitidis, Haemophilus influenzae type b

Adolescents and Young Adults

Neisseria meningitidis, Streptococcus pneumoniae

Older Adults

Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes

Risk Factors

Factors that can increase your risk of bacterial meningitis include:

· Age

Infants are at higher risk for bacterial meningitis than people in other age groups. However, people of any age are at risk. See the table above for which pathogens more commonly affect which age groups.

· Community setting

Infectious diseases tend to spread more quickly where larger groups of people gather together. College students living in dormitories and military personnel are at increased risk for meningococcal meningitis.

· Certain medical conditions

There are certain diseases, medications, and surgical procedures that may weaken the immune system or increase risk of meningitis in other ways.

· Working with meningitis-causing pathogens

Microbiologists who are routinely exposed to meningitis-causing pathogens are at increased risk.

· Travel

Travelers to the meningitis belt in sub-Saharan Africa may be at risk for meningococcal meningitis, particularly during the dry season. Also at risk for meningococcal meningitis are travelers to Mecca during the annual Hajj and Umrah pilgrimage.

Transmission

The germs that cause bacterial meningitis can be contagious. Some bacteria can spread through the exchange of respiratory and throat secretions (e.g., kissing). Fortunately, most of the bacteria that cause meningitis are not as contagious as diseases like the common cold or the flu. Also, the bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been. Other meningitis-causing bacteria are not spread person-to-person, but can cause disease because the person has certain risk factors (such as a weak immune system or head trauma). Unlike other bacterial causes of meningitis, you can get Listeria monocytogenes by eating contaminated food.

Sometimes the bacteria that cause meningitis spread to other people. This usually happens when there is close or long contact with a sick person in the same household or daycare center, or if they had direct contact with a patient's oral secretions (such as a boyfriend or girlfriend). People who qualify as close contacts of a person with meningococcal or Haemophilus influenzae type b (Hib) meningitis are at higher risk of getting disease and may need antibiotics (see Prevention). Close contacts of a person with meningitis caused by other bacteria, such as Streptococcus pneumoniae, do not need antibiotics. Tell your doctor if you think you have been exposed to someone with meningitis.

Healthy people can carry the bacteria in their nose or throat without getting sick. Rarely, these bacteria can invade the body and cause disease. Most people who ‘carry’ the bacteria never become sick.

Signs & Symptoms

Pregnancy

Pregnant women are at increased risk of developing listeriosis (caused by the bacterium Listeria monocytogenes). Pregnant women typically experience only a mild, flu-like illness with Listeria infection. However, infections during pregnancy can lead to miscarriage, stillbirth, premature delivery, or life-threatening infection of the newborn, including meningitis.

Pregnant women who test positive for group B Streptococcus (group B strep) can pass the bacteria to their baby, most often during labor and birth. A newborn infected with group B strep bacteria can develop meningitis or other life-threatening infections soon after birth.

You can reduce your risk of meningitis caused by Listeria monocytogenes by learning what foods to avoid and how to safely prepare and refrigerate food. If you are pregnant, you should get screened for group B strep at 35-37 weeks. Women who test positive for group B strep will be given antibiotics during labor to prevent infection in a newborn.

Talk to your doctor to learn more about how to prevent these infections.

Meningitis infection may show up in a person by a sudden onset of fever, headache, and stiff neck. It will often have other symptoms, such as

· Nausea

· Vomiting

· Increased sensitivity to light (photophobia)

· Altered mental status (confusion)

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3-7 days after exposure.

Babies younger than one month old are at a higher risk for severe infections, like meningitis, than older children. In newborns and infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to notice. The infant may appear to be slow or inactive (lack of alertness), irritable, vomiting or feeding poorly. In young infants, doctors may look for a bulging fontanelle (soft spot on infant’s head) or abnormal reflexes, which can also be signs of meningitis. If you think your infant has any of these symptoms, call the doctor or clinic right away.

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

Diagnosis

If meningitis is suspected, samples of blood or cerebrospinal fluid (near the spinal cord) are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because that helps doctors understand how to treat the disease, and possibly how bad it will get. In the case of bacterial meningitis, antibiotics can help prevent severe illness and reduce the spread of infection from person to person.

If bacteria are present, they can often be grown (cultured). Growing the bacteria in the laboratory is important for confirming the presence of bacteria, identifying the specific type of bacteria that is causing the infection, and deciding which antibiotic will work best. Other tests can sometimes find and identify the bacteria if the cultures do not.

Treatment

Bacterial meningitis can be treated effectively with antibiotics. It is important that treatment be started as soon as possible. Appropriate antibiotic treatment of the most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk remains higher among young infants and the elderly.

Prevention

The most effective way to protect you and your child against certain types of bacterial meningitis is to complete the recommended vaccine schedule. There are vaccines for three types of bacteria that can cause meningitis: Neisseria meningitidis (meningococcus), Streptococcus pneumoniae (pneumococcus), and Haemophilus influenzae type b (Hib).

Antibiotics may be recommended for close contacts of people with meningococcal meningitis. Antibiotics may also be recommended for the entire family if a family member develops severe Hib infection and there’s a high risk person in the house. This is to decrease the risk of spreading disease to a high risk person, since they are at increased risk for severe disease. Your doctor or local health department will tell you if there’s a high risk person in your house and antibiotics are needed.

Maintaining healthy habits, like not smoking and avoiding cigarette smoke, getting plenty of rest, and not coming into close contact with people who are sick, can also help. This is especially important for young infants, the elderly, or for those with a weakened immune system, since they are at increased risk for severe disease.

 

FUNGAL MENINGITIS

http://www.cdc.gov/meningitis/fungal.html

Fungal meningitis is not contagious. It is not transmitted from person to person.

Causes

Fungal meningitis is rare, but can be life threatening. Although anyone can get fungal meningitis, people at higher risk include those who have AIDS, leukemia, or other forms of immunodeficiency (an immune system that does not respond adequately to infections) and immunosuppression (immune system malfunction as a result of medical treatment).

The most common cause of fungal meningitis for people with immune system deficiencies, like HIV, is Cryptococcus. This disease is one of the most common causes of meningitis in Africa.

The fungus that causes thrush, Candida, can lead to meningitis in rare cases, especially in pre-mature babies with very low birth weight. 

Meningitis due to Histoplasma can happen in anybody, but people with immunodeficiencies are at a higher risk.  Histoplasma is found primarily in soil or bird/bat droppings in the Midwestern United States, although it can be seen in other places.

Soil in Southwestern United States and northern Mexico contain the fungus Coccidioides which can cause fungal meningitis.  Although anyone can get infected with coccidioidal meningitis, people at higher risk include African Americans, Filipinos, pregnant women in the third trimester, and immunocompromised persons.

Risk Factors

There are certain diseases, medications and surgical procedures that may weaken the immune system and increase risk of fungal meningitis. Pre-mature babies with very low birth weights are also at increased risk.

Living in certain areas of the U.S.. may increase one’s risk. For example, bird/bat droppings in the Midwestern United States and soil in the Southwestern United States are more likely to contain a fungus that can cause meningitis.

Transmission

Fungal meningitis is not contagious. It is not transmitted from person to person. People at risk for fungal meningitis acquire the infection usually by inhaling fungal spores from the environment. People with certain medical conditions like diabetes, cancer, or HIV are at higher risk of fungal meningitis. You may also get fungal meningitis after taking medications that weaken your immune system. Examples of these medications include steroids (such as prednisone), medications given after organ transplantation, or anti-TNF medications, which are sometimes given for treatment of rheumatoid arthritis or other autoimmune conditions.

Cryptococcus is felt to be acquired through inhaling soil contaminated with bird droppings, and Histoplasma is found in environments with heavy contamination of bird or bat droppings, particularly in the Midwest near the Ohio and Mississippi Rivers. The Midwest United States, particularly the northern Midwest, is endemic to the fungus Blastomyces. This fungus is thought to exist in soil rich in decaying organic matter. Coccidioides is found in the soil of endemic areas (Southwestern US and parts of Central and South America). When these environments are disturbed, the fungal spores can be inhaled. Meningitis results from the fungal infection spreading to the spinal cord.

Candida is usually acquired in a hospital setting. Fungal meningitis is rare and usually is the result of spread by the fungus through the blood to the spinal cord.

Signs & Symptoms

Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as

· Nausea

· Vomiting

· Photophobia (sensitivity to light)

· Altered mental status

Symptoms of fungal meningitis are similar to symptoms of other forms of meningitis; however, they often appear more gradually. In addition to typical meningitis symptoms, like headache, fever, nausea, and stiffness of the neck, people with fungal meningitis may also experience:

· Dislike of bright lights

· Changes in mental status, confusion

· Hallucinations

· Personality changes

Diagnosis

If meningitis is suspected, samples of blood or cerebrospinal fluid (near the spinal cord) are collected and sent to the laboratory for testing. It is important to know the specific cause of meningitis because the severity of illness and the treatment will differ depending on the cause.

To confirm fungal meningitis, specific lab tests can be performed, depending on the type of fungus suspected.

Treatment

Fungal meningitis is treated with long courses of high dose antifungal medications. This is usually given using an IV line and is done in the hospital. The length of treatment depends on the status of the immune system and the type of fungus that caused the infection. For people with immune systems that do not function well because of other conditions, like AIDS, diabetes, or cancer, there is often a need for longer treatment.

Prevention

There is little evidence that specific activities can lead to developing fungal meningitis, although avoiding exposure to environments likely to contain fungal elements is prudent. People who are immunosuppressed (for example, those with HIV infection) should try to avoid bird droppings and avoid digging and dusty activities, particularly if they live in a geographic region where fungi like Histoplasma,Coccidioides, or Blastomyces species exist. HIV-infected people cannot completely avoid exposure. Some guidelines recommend that HIV-infected people receive antifungal prophylaxis if they live in a geographic area where the incidence of fungal infections is very high.

 

NON-INFECTIOUS MENINGITIS

Causes

Non–infectious meningitis causes include

· Cancers

· Systemic lupus erythematosus (lupus)

· Certain drugs

· Head injury

· Brain surgery

Transmission

This type of meningitis is not spread from person to person. Non-infectious meningitis can be caused by cancers, systemic lupus erythematosus (lupus), certain drugs, head injury, and brain surgery.

Signs & Symptoms

Meningitis infection is characterized by a sudden onset of fever, headache, and stiff neck. It is often accompanied by other symptoms, such as

· Nausea

· Vomiting

· Photophobia (sensitivity to light)

· Altered mental status