Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord known as the meninges. This inflammation is usually caused by an infection of the fluid surrounding the brain and spinal cord. Meningitis is usually caused by bacteria or viruses, but can be a result of injury, cancer, or certain drugs. It is important to know the specific cause of meningitis because the treatment differs depending on the cause.
How it Spreads:
Meningitis (Meningococcal disease) is spread by direct contact with infected people. It is spread by exchanging respiratory and throat secretions (saliva or spit) during close or lengthy contact (For example: coughing, kissing, or sharing anything by mouth, like utensils or toothbrushes). It can cause pneumonia, blood stream infection, and meningitis (swelling of the covering of the brain and spinal cord). Severe disease can cause brain damage, hearing loss, or limb loss.
People exposed to the meningococcal bacteria may experience the following symptoms:
- Runny nose
- Intense headache
- Stiff neck
- Unusual skin lesions
- Fine, spotty pink rash that progresses to dark patches
- Infections of the blood or brain, which can be fatal
Even with treatment, about 10% of severe cases are fatal. Up to 25% of patients who recover have chronic damage to the nervous system.
Rates are highest for infants under 12 months. An increasing proportion of cases are in adolescents and young adults. Crowded living conditions, low socioeconomic status, travel, and tobacco smoke exposure may increase risk, as do certain medical conditions.
Universal immunization of all adolescents aged 11–18 years and persons aged 2–55 years who are considered at increased risk is recommended. Good respiratory hygiene can reduce the likelihood of transmission. Exposed persons should take prophylactic antibiotics.
The recommended course of prophylactic therapy:
- Rifampin 600mg bid x 2 day or
- Ceftriaxone 250mg IM given in a single dose or
- Ciprofloxacin 500mg po given as a single dose
- < 1-month Rifampin 5mg/Kg (body weight every 12 hrs.) x 2 day;
- > 1-month Rifampin 10mg/Kg (body weight every 12 hrs. [max 600 mg/dose]) x 2 day or
- Ceftriaxone 125mg IM given as a single dose for under 15yr
- Pregnant Women:
- Avoid Rifampin
Rifampin is the drug of choice for most children. Rifampin is not recommended for pregnant women. Those taking rifampin should be informed that the following side effects can occur: gastrointestinal upset, orange discoloration of urine and tears, discoloration of soft contact lenses, and decreased effectiveness of oral contraceptives.
Ciprofloxacin can be used for chemoprophylaxis of persons 18 years and older. Ciprofloxacin is not recommended for pregnant women.
Ceftriaxone can be used for children and adults (including pregnant women) to eradicate nasopharyngeal carriage if rifampin is contraindicated.
Treatment is best when given within 24 hours and unlikely to be effective if given more than 14 days following exposure.
Meningococcal Disease Reporting:
Meningoccocal Meningitis is immediately reportable to GCHD. If you suspect illness, please contact GCHD as soon as possible. Please “Reporting and Surveillance Guidelines” from the state Department of Health for more in depth information.
Meningitis | CDC