Meningitis is a dangerous infectious disease that crops up year after year, much like the flu, and spreads very quickly. What do you need to know so you can protect yourself and your loved ones from this aggressive, potentially life-threatening disease? We spoke with Igor Abolnik, MD, an infectious diseases physician at St. Joseph Health Medical Group, to find out.
Q. There have been regular reports in the news through last winter and spring about meningitis cases cropping up in both Northern and Southern California. For example, through July 7, 2017, ten cases of invasive meningococcal disease--including two fatalities--have been found in Los Angeles County this year, exceeding the previous five-year average. All but one of the cases occurred between January and March. Is this an outbreak that people need to be concerned about?
A. There has definitely been an increase as compared to previous years. Last winter was harsher than usual, resulting in people staying inside more than normal. This meant people were spending more time in close contact with others and, because of the contagious nature of meningococcal meningitis, the disease spread very quickly. When you combine winter weather with people in close proximity, like a school or office, the risk of any infectious disease rises. Again, I would not consider these recent cases an epidemic. However, meningitis outbreaks--even if seemingly limited in scope--are serious public health concerns. When meningitis is afoot, as it was earlier this year, it is important to understand the nature of the disease, the symptoms, how it spreads, and how to protect yourself against it.
Q. What are the different kinds of meningitis?
A. There are five different types of meningitis; however, three are very rare. The two most common and basic strains are:
1. Bacterial: The first and most dangerous is bacterial meningococcal meningitis. It can be deadly, even if it’s detected quickly. The bacteria get into the bloodstream and cause swift, widespread infection and inflammation of the brain and spinal cord. Bacterial meningitis proves fatal in 5-15 percent of people who contract it, even with prompt medical treatment.
2. Viral: Viral meningitis is more common and much less dangerous. Most cases stem from enteroviruses (which are transmitted through the intestines), measles, mumps, chicken pox or viruses from insects. In most cases, it resolves on its own within seven to 10 days without treatment.
Q. How is meningitis most commonly spread?
A. Bacterial meningococcal meningitis spreads very easily through direct contact, like coughing, sneezing or saliva transfer (such as kissing or even mouth-to-mouth resuscitation). Viral meningitis spreads most commonly through fecal contamination, or secretions of the eyes, nose or mouth. The best way to prevent viral meningitis is frequent and proper hand washing – and, of course, vaccination.
You can't get either type of meningitis from casual contact or from simply breathing the air that an infected person has breathed. To become infected yourself, you have to have close and sustained contact with an infected person, or you have to share something with that person that can spread germs, like tissues, towels, lip gloss, makeup, eating utensils or drinking cups.
Q. We're told that meningococcal meningitis symptoms resemble the flu – is this true? What are the primary symptoms of bacterial and viral meningitis?
A. It's not accurate to say that the symptoms are the same, but people who have the flu might mistakenly associate meningitis symptoms as simply part of their flu. Meningitis is a potential complication of the flu, especially for people with asthma, diabetes or heart disease, but meningitis has its own set of recognizable symptoms: a sudden high fever, a stiff neck (which usually doesn't occur in flu), and mental confusion or other unusual changes in cognitive ability. Taken together, these are significant warning signs of a potential case of meningococcal meningitis, even more so if accompanied by nausea, bad headaches, rashes or pain all over the body.
If you exhibit these symptoms, you should go to the emergency department immediately. Time is of the essence in treating meningitis. In fact, I recommend larger, urban hospitals rather than smaller, rural hospitals if you have the option. Facilities in large metropolitan areas tend to be better equipped and have a larger selection of medications on hand. This will give your doctors the quickest access to the widest range of antibiotics. You should also see your doctor right away if you've recently been in close contact with a person who has just had meningitis.
Q: What is the treatment for meningitis?
A. Antibiotics. I cannot stress enough how important it is to been seen by a physician and obtain the proper antibiotics without delay. Meningitis is a well-understood disease and full recovery is possible. However, the consequences of an untreated bacterial meningitis infection, even if not fatal, can include lifelong and disabling after-effects like hearing loss, sight problems and brain injury.
Q. How can meningitis be prevented?
A. There’s no question that prevention is a crucial first step in keeping isolated cases from becoming an outbreak. First and foremost, you should protect yourself from all types of meningococcal meningitis with the appropriate vaccinations. Adults who have an immune system disorder, or who live in or travel to an area where meningitis is common, or who have been exposed to someone with meningitis, should be especially sure to ask their doctor about a vaccination. There is a new recommendation from the Centers for Disease Control and Prevention (CDC) for all men who have sexual relations with other men to get the meningococcal meningitis vaccination. There is also a vaccination available specifically for people with diabetes or who are over the age of 65. These people are at a higher risk of pneumonia and sepsis, which weakens the immune system and makes them more vulnerable to meningococcal meningitis.
Second, you should not share items that can spread germs through saliva like food, drinks, cups, utensils or toothbrushes.
Lastly, maintaining a healthier overall lifestyle can enhance your immune system's ability to protect you not just from meningitis, but a wide range of disease. Don't smoke, drink alcohol only in moderation, eat a nutritious diet, and exercise regularly.
Q. How can I protect my children from meningitis?
A. I’m an adult infectious disease specialist; however, the CDC recommends meningococcal vaccinations for all children ages 11 to 12, along with a follow-up booster shot at age 16. Ask your pediatrician or family doctor about the right immunization schedule for your kids. Children who are about to go to summer camp, for example, may need a meningitis vaccination due to the shared sleeping and dining arrangements. In addition to vaccination, you can help protect your kids from meningitis by teaching them good personal hygiene, like frequent hand-washing, and instilling the same habits that can keep their immune system healthy like they can yours, such as eating a balanced diet, getting plenty of sleep, and staying physically active.
Q: How can I find out if I’ve been vaccinated? If not, can I get the vaccination?
A. Your primary care physician can check your health records and tell you if you’ve received the vaccination. If you haven’t been vaccinated, he or she can give you the vaccination right in the physician's office. Women who are pregnant or breastfeeding, and people with severe allergies, need to be medically cleared before receiving certain meningococcal vaccinations; but, in general, everyone can and should be vaccinated. Your doctor can advise you about which specific vaccines are right for you and when you should get them.
This information is not intended as a substitute for professional medical care. Always follow your health care professional's instructions.
