Myths and Facts: Meningitis

It’s been called the silent killer because there are no obvious symptoms that would lead one to believe they have meningococcal meningitis. In fact, when victims first experience symptoms, they typically believe they have the flu. This often ignored and misunderstood disease strikes about 3,000 Americans each year and is responsible for approximately 300 to 360 deaths annually. About 20 percent of those who survive meningococcal disease suffer long-term consequences, such as brain damage, kidney disease, hearing loss or limb amputations.¹

In the vast majority of cases, these are needless hospitalizations and deaths. Meningitis — the deadly form — can be prevented. All that is needed is to raise awareness of the seriousness of this disease, and dispel the myths surrounding it. Following are the most common myths about meningitis along with the facts to set the record straight.

Myth: Only one type of meningitis exists.

Fact: Two main types of meningitis exist: bacterial and viral. Bacterial meningitis, also known as meningococcal meningitis, is most commonly caused by one of three types of bacteria: Haemophilus influenzae type b (Hib), Neisseria meningitidis and Streptococcus pneumoniae. It is a serious infection of the fluid in the spinal cord and the fluid that surrounds the brain, and it can cause brain damage and even death.² Viral meningitis, the more common form, is also known as aseptic meningitis and is caused by any of a number of different viruses, many of which are associated with other diseases. This form of meningitis is a relatively common, but rarely serious infection of the fluid in the spinal cord and the fluid that surrounds the brain.³

Myth: Meningitis is a disease of the past now that there is a vaccine to prevent it.

Fact: While the number of cases of meningitis has declined since the introduction of a vaccine, it is still a serious disease that sickens, hospitalizes and kills. There are approximately 9,000 new cases of viral meningitis in America each year,⁴ which normally occur as single, isolated events.³ About 3,000 new cases of bacterial m

eningitis occur each year, responsible for between 300 and 360 deaths annually. 1 However, bacterial meningitis is relatively rare and usually occurs in isolated cases.²

Myth: Only children and teenagers can get meningitis. Healthy adolescents and young adults don’t need to worry.

Fact: Anyone is at risk of contracting meningitis. Viral meningitis most often occurs in children and young adults.³ The highest risk groups for bacterial meningitis are adolescents and preteens, college students and travelers.⁵ People who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis or Hib can also be at increased risk. This includes people in the same household or daycare center, or anyone with direct contact with discharges from a meningitis patient’s mouth or nose.² College students who live in dorms or group housing are at higher risk because of close contact and increased likelihood of sharing items, such as drinking glasses and utensils.⁶

Myth: Meningitis is caused by casual contact with another person.

Fact: None of the bacteria that cause 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. Instead, the bacteria are spread by direct close contact with the discharges from the nose or throat of an infected person.² The spread of viral meningitis depends on the virus involved. Some viruses are spread by person-to-person contact; others are spread by insects, such as mosquitoes.And, very few people who become infected with these viruses actually develop meningitis.³

Myth: The symptoms of meningitis take a while to develop. Fact: Viral meningitis symptoms include fever, chills, headache, abdominal pain, muscle pain, nausea and vomiting, drowsiness, confusion and abnormal sensitivity to light.⁷ These symptoms generally appear within one week of exposure, are mild and typically clear up in less than 10 days.³ Symptoms of bacterial meningitis develop quickly, usually between several hours and one to two days, and include high fever, nausea, severe headache, a stiff neck, vomiting, purple bruise-like areas, rash, sensitivity to light, mental status changes and a severe general ill feeling.⁸

Myth: It is easy to diagnose meningitis.

Fact: Bacterial meningitis is often misdiagnosed as something less serious because early symptoms are similar to influenza and other viral illnesses.⁹ A physical examination will show a fast heart rate, low blood pressure, a stiff neck and a possible rash.⁸ To diagnose both bacterial and viral meningitis, a lumbar puncture (spinal tap) needs to be performed to collect spinal fluid.Other tests could include a blood culture, CSF culture, CT scan of the brain, special strains of spinal fluid and white blood cell count.^7,8

Myth: Meningitis will go away on its own.

Fact: Viral meningitis will go away on its own, but bacterial meningitis will not.In fact, bacterial meningitis must be treated early, or the risk of long-term complications, brain damage or death is possible. Once it is determined which strain of bacteria has been contracted, bacterial meningitis can be treated with a number of effective antibiotics.^7,8 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.¹⁰

Myth: There is no way to prevent meningitis.

Fact: Individuals can reduce their risk of contracting both bacterial and viral meningitis. Bacterial meningitis can be prevented in most cases with vaccines. The Advisory Committee on Immunization Practices (ACIP) recommends all people ages 11 through 18 be vaccinated with one dose of MCV4, the meningococcal conjugate vaccine known as Menactra. ACIP also recommends college freshmen living in dormitories be vaccinated with MCV4 before entering college, as well as people who have increased risk for meningococcal disease, if they have not previously been vaccinated.¹⁰ MCV4 protects against Neisseria meningitides bacteria, as does a new vaccine called Menveo, which as of this writing, is expected to receive FDA approval by the end of 2009. Menveo is recommended for individuals ages 11 to 55.¹¹

Two additional vaccines are available to protect against meningitis caused by the Streptococcus pneumoniae bacteria.

The pneumococcal polysaccharide vaccine PPV23 (Menomune) is recommended for all people ages 65 and older, as well as individuals at least 2 years old with certain chronic medical problems. The pneumococcal conjugate vaccine PCV7 is effective in infants to prevent pneumococcal infections and is routinely recommended for all children younger than 2 years old.¹⁰ It is also recommended for children between 2 and 5 years old who have not already gotten the vaccine and are at high risk of serious pneumococcal disease.¹²

To protect against viral meningitis, individuals should pay particular attention to personal hygiene. Many of the viruses that cause viral meningitis can be prevented with handwashing. Hands should be washed with soap and warm water after using the toilet, after changing diapers, before preparing and eating food and after sneezing and coughing. In addition, individuals should avoid mosquito bites by staying inside between dusk and dark, when mosquitoes are most active. If outside, long pants and long-sleeved shirts should be worn, and insect repellent should be used.³

The CDC also notes that children can be protected against some diseases that can lead to viral meningitis by receiving their childhood vaccinations. These include vaccines against measles and mumps (the MMR vaccine) and chickenpox (the varicella-zoster vaccine).¹⁰

Myth: An individual can get sick from the meningitis vaccine.

Fact:The meningitis vaccine does not contain any live bacteria, so it is impossible to get meningococcal disease from the vaccination. Individuals may experience mild side effects that include redness or swelling at the site of injection that could last up to two days.

Myth: Getting a vaccine to prevent meningitis will protect individuals for life.

Fact: Menactra and Menveo provide at least eight years of protection, whereas Menomune lasts for around three to five years. Because the vaccines wear off, the CDC recommends individuals be vaccinated when they are exposed to a high-risk setting, such as moving into a college dormitory or traveling to Saudi Arabia or certain parts of Africa. Individuals who cannot afford the vaccine can call the CDC at (800) 232-4636 to find out where they can receive the vaccine for free or at a discounted price.⁶