Definition

The brain and spinal cord are surrounded by layers of tissue. These layers are called the meninges. When these layers becomes swollen and irritated, it is called meningitis. The swelling in these layers can put pressure on the brain and spinal cord. The most common forms of meningitis include:

• Viral meningitis
• Aseptic meningitis —caused by a variety of medical conditions except bacteria
• Bacterial meningitis —generally the most serious infection

Causes

Viral meningitis may be caused by several viruses. Examples include:

• Enteroviruses
• Herpes viruses
• Mumps
• Varicella virus— chickenpox
• Measles
• Rubella viruses
• West Nile virus

Viruses can be spread in numerous ways including:

• Contact with fluids from the cough or sneeze of an infected person
• Contact with feces from an infected person
• Close personal contact with someone who is sick
• Through insect bites

Risk Factors

Viral meningitis is more common in children under 5 years old. Other factors that may increase the chance of viral meningitis include:

• Conditions that weaken the immune system, such as HIV
• Immunosuppressive treatments
• Crowded, unsanitary conditions
• Season: summer and early fall

Symptoms

Symptoms of viral meningitis include:

• High fever
• Headache
• Stiff, sore neck
• Nausea
• Vomiting
• Sensitivity to bright lights
• Sleepiness

Symptoms in newborns and infants include:

• Inactivity
• High fever—especially unexplained high fever
• Irritability
• Vomiting
• Feeding poorly or refusing to eat
• Tautness or bulging of soft spots between skull bones
• Difficulty awakening

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done. The doctor will focus on the nervous system.

To help rule out other causes of the inflammation, such as a tumor, your doctor may need pictures of the brain, spine, and skull. These pictures can be created with:

• MRI scan
• CT scan

Viral meningitis has similar symptoms as bacterial meningitis. To make sure you do not have bacterial meningitis, the following tests of your bodily fluids may be done:

• Blood tests
• Urine tests
• Sputum tests
• Lumbar puncture —to evaluate cerebralspinal fluid that surrounds the spinal cord and brain
• Tests of pus from skin infections

Treatment

Treatment includes:

• Rest and fluids
• Nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Note: Aspirin is not recommended for children with a current or recent viral infection. Check with your doctor before giving your child aspirin.
• Antibiotics may be given for 2-3 days while the doctor waits for test results—antibiotics are not effective in treating viral infections
• IV antiviral drugs—for severe infections—few viruses can be treated this way

Prevention

To reduce your chance of a viral infection:

• Wash your hands often, especially:
  • If you are in close contact with an infected person
  • After you change the diaper of an infected infant
• Regularly wash objects and surfaces touched by children. Use a diluted bleach solution.
• Ask your doctor about appropriate vaccinations, especially if you’ve never had measles, mumps, rubella, and chickenpox.
• To prevent infections spread by mosquito bites:
  • Follow public health recommendations for reducing mosquitoes near your home.
  • Take steps to avoid being bitten by mosquitoes. Use insect repellent and appropriate clothing when outdoors.
  • Avoid areas or being outside when mosquitoes are prevalent.
• If you are contemplating a pregnancy:
  • Be sure you are protected from common diseases like chickenpox. Ask your doctor about recommended vaccinations.
  • Avoid all contact with rodents during pregnancy.

US Centers for Disease Control and Prevention http://www.cdc.gov

Public Health Agency of Canada http://www.phac-aspc.gc.ca

Viral meningitis. Centers for Disease Control and Prevention website. Available at:
http://www.cdc.gov/meningitis/viral.html
Updated April 1, 2014. Accessed August 27, 2014.