Viral Meningitis

The brain and spinal cord are encased by layers of tissue. These layers are called the meninges. Certain viruses can cause an infection in these layers. This is called viral meningitis.

Some types of viral meningitis can be less serious than bacterial meningitis .

A number of viruses can cause viral meningitis including:

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

Most of these are also able to cause encephalitis . This is an inflammation of the brain tissue. It is a much more serious condition.

Viruses that cause meningitis can be spread in numerous ways:

• Enteroviruses are spread:
  • Through feces
  • Via direct contact with respiratory secretions of an infected person
• Other viruses (mumps, herpes, chickenpox) spread though close personal contact or through the air
• Some viruses (West Nile) that cause encephalitis are spread by insects

Risk factors for viral meningitis include:

• Conditions that weaken the immune system, such as HIV infection (which itself can lead to meningitis/encephalitis)
• Crowded, unsanitary conditions
• Immunosuppressive treatments
• Season: summer and early fall

Classic symptoms of viral meningitis include:

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

In newborns and infants:

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

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 order an:

• CT scan —a type of x-ray that uses a computer to make pictures of structures inside of the body
• MRI scan —a test that uses magnetic waves to make pictures of structures inside of the body

To rule out bacterial meningitis, the following tests may be done:

• Lumbar puncture (spinal tap) —removal of fluid from the lower spinal column to be tested for bacteria (bacterial cultures)
• Other cultures—blood, urine, mucus, and/or pus from skin infections

Treatment includes: If encephalitis is present:

• Antibiotics may be given for 2-3 days while waiting for bacterial cultures to be reported as negative
• Aspirin —Note: Aspirin is not recommended for children with a current or recent viral infection
  • Check with your doctor before giving a child aspirin
• Nonsteroidal anti-inflammatory drugs
• Rest and fluids

• IV antiviral drugs and other medications may be given

If you are diagnosed with viral meningitis, follow your doctor's instructions .

Wash your hands often particularly:

• If you are in close contact with an infected person
• Immediately after changing the diaper of an infected infant

If you work in a childcare setting:

• Regularly wash objects and surfaces touched by children
• Use a diluted bleach solution

If you've never had measles, mumps, rubella, and chickenpox:

• Consider being vaccinated

Some forms of viral meningitis are spread by mosquito bites:

• Follow public health recommendations for reducing mosquitoes near your home
• Take steps to avoid being bitten by mosquitoes

If you are contemplating a pregnancy:

• Avoid all contact with rodents during pregnancy:
  • If you own a rodent, consider finding another home for it while you are pregnant
  • Lymphocytic choriomeningitis virus can be acquired from pet hamsters, mice, or other rodents
• Be sure you are protected from common diseases (eg, chickenpox vaccine )