Viral Meningitis
A Guide for Travelers

Excerpted from CDCP, where you can find much more information.
Emory University's database on meningitis | A Page on Bacterial Meningitis

Causes

Meningitis is an illness in which there is inflammation of the tissues that cover the brain and spinal cord. Viral or aseptic meningitis, which is the most common type, is caused by an infection with one of several types of viruses. Meningitis can also be caused by infections with several types of bacteria or fungi.


Bacterial meningitis is found worldwide and is most common in infants and children. Bacterial meningitis is a serious infection of the fluid in the spinal cord and the fluid that surrounds the brain. The bacteria are spread by direct close contact with the discharges from the nose or throat of an infected person. The bacteria often live harmlessly in a person's mouth and throat. In rare instances, however, they can break through the body's immune defenses and travel to the fluid surrounding the brain and spinal cord, where they begin to multiply quickly. Soon, the thin membrane that covers the brain and spinal cord (meninges) becomes swollen and inflamed, leading to the classic symptoms of meningitis.

Cases of bacterial meningitis have decreased since 1986, but in parts of Africa widespread epidemics of meningococcal meningitis occur regularly.

Symptoms

The symptoms of meningitis may not be the same for every person. The more common symptoms are fever, severe headache, stiff neck, bright lights hurt the eyes, drowsiness or confusion, and nausea and vomiting. The incubation period is usually between 3 and 7 days from the time you are infected until you develop symptoms. Viral meningitis is usually diagnosed by laboratory tests of spinal fluid obtained with a spinal tap.
Common symptoms of bacterial meningitis are high fever, headache, and stiff neck. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms can include nausea, vomiting, sensitivity to light, confusion, and sleepiness. In advanced disease, bruises develop under the skin and spread quickly.

Duration

Viral (aseptic) meningitis is serious but rarely fatal in persons with normal immune systems. Usually, the symptoms last from 7 to 10 days and the person recovers completely. Bacterial meningitis, on the other hand, can be very serious and result in disability or death if not treated promptly.
Advanced bacterial meningitis can lead to brain damage, coma, and death. Survivors can suffer long-term complications, including hearing loss, mental retardation, paralysis, and seizures.

Treatment

No specific treatment for viral meningitis exists at this time. Most patients recover completely on their own, and doctors often will recommend bed rest, plenty of fluids, and medicine to relieve fever and headache.
Bacterial meningitis can be treated with antibiotics.

Contagiousness

The viruses that cause viral meningitis are contagious. Enteroviruses, for example, are very common during the summer and early fall, and many people are exposed to them. However, most infected persons either have no symptoms or develop only a cold or rash with low-grade fever. Typically, fewer than 1 of every 1000 persons infected actually develop meningitis. Therefore, if you are around someone who has viral meningitis, you have a moderate chance of becoming infected, but a very small chance of developing meningitis. Enteroviruses, the most common cause of viral meningitis, are most often spread through direct contact with respiratory secretions (e.g., saliva, sputum, or nasal mucus). This usually happens by shaking hands with an infected person or touching something they have handled, and then rubbing your own nose, mouth or eyes. The virus can also be found in the stool of persons who are infected. You can usually spread the virus to someone else beginning about 3 days after you are infected until about 10 days after you develop symptoms.
None of the bacteria that cause bacterial meningitis are very contagious, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

Precautions

Because most persons who are infected with enteroviruses do not become sick, it can be difficult to prevent the spread of the virus. If you are in contact with someone who has viral meningitis, however, the most effective method of prevention is to wash your hands thoroughly and often.
Bacterial meningitis can be prevented with a vaccine. The vaccine against Streptococcal pneumoniae (pneumococcal vaccine) is recommended for all persons over age 65. Travelers should receive the vaccine at least 1 week before departure.