What is meningitis? 7 questions with Andy Dunn, M.D.

By Kristy Bleizeffer Aug 17, 2016

‘Meningitis is an infection or inflammation of the meninges – the membranes around your spinal cord and brain. It could be bacterial, viral or even fungal,’ said Dr. Andy Dunn.

Before shipping off your college student for another year, you have one item to check off their back-to-school list: The meningococcal vaccination.

College kids and other people who live in close quarters are especially susceptible to meningitis. While it is rare, it can be deadly or highly debilitating if contracted. Every few years, we read about another outbreak on another college campus.

Here, Andy Dunn, M.D., medical director of Mesa Primary Care and Sage Primary Care, answers seven questions about meningitis and its prevention.

1.    What is meningitis?

Meningitis is an infection or inflammation of the meninges – the membranes around your spinal cord and brain. It could be bacterial, viral or even fungal, but that is very rare. It can be a very devastating, very lethal process. People can go from 0 to 60 quick, in terms of how sick they can get.

2.    What is the difference between meningitis and meningococcal disease?

Most forms of meningitis are caused by either a virus or bacterium. “Coccal” is a form of the word “coccus” which means “spherical bacterium,” so meningococcal always implies that it’s meningitis caused by bacteria. Meningococcal is a bacterial form of meningitis that we really really want to target, because it's a really bad deal. Bacterial meningitis can be deadly and contagious among people in close contact. Viral meningitis isn’t great either, but tends to be less severe and most people recover completely without specific therapy. Fungal meningitis is a rare form of meningitis and generally occurs only in people with weakened immune systems

3.    Why are high school and college students at higher risk for bacterial meningococcal disease?

It’s about exposure. College and high school-aged people usually have lots of close contact with their peers. It’s mono-esque in that it spreads much the same way.  College students are more likely to share drinks or eating utensils, and those who live in the dorms or other close quarters really pre-disposes them to contracting this condition caused by a bacteria or virus. The same can be true with people in the armed forces who live in barracks.

4.    How common is meningococcal disease?

It’s not all that common, but very serious. People die; that’s worse-case scenario. Sometimes, people can become very disabled as a result of the infection and associated complications. It can have very serious residual effects, much like a stroke or heart attack can. It depends how far the infection progresses. It’s debilitating, and those that do recover, it’s a lengthy recovery process.

5.    What are the symptoms?

The symptoms of bacterial meningitis can appear quickly or over several days. Typically they develop within 3 to 7 days after exposure. Specifically for meningitis, symptoms include:

  • general malaise
  • fatigue
  • fever
  • confusion
  • Your neck can be very tight. That’s why they say “from chin to chest,” if that bothers you, it could be meningitis.
  • Light can give you headaches or make a headache worse, like a really bad migraine.

Especially in young healthy people, it can present as a smoldering illness that they don’t pay attention to. And then it gets bad super quick. That’s what makes it difficult to catch: It seems to present like a lot of other illnesses at first.

A physical examination is very important for diagnosis. Clinicians rely on meningeal signs to evaluate patients with suspected meningitis and help determine who should undergo a lumbar puncture and further blood work-up.  These include:

  • nuchal rigidity — inability to flex the neck forward
  • Kernig’s sign — severe stiffness of the hamstrings
  • Brudzinski’s sign — neck stiffness that causes the hips and knees to flex along with neck flexing

6.    How is it treated?

Bacterial meningitis can be treated with a number of antibiotics. It is important that treatment be started as soon as possible. There is usually no specific treatment for viral meningitis other than supportive care . Most people who get viral meningitis completely recover on their own within 7 to 10 days.

7.    Can it be prevented?

Yes. The vaccines work very well.

The one we are using is called the MenB vaccine, and the preferred age group is 16 to 18 years. It is given in two doses, one month apart.

Education is also a good prevention tool. If someone is exposed, or has potential symptoms, that person needs to be seen by a healthcare professional so they don’t expose more people. People should also avoid sharing drinks, eating utensils or other objects that could pass from one mouth to another.

Andy Dunn, MD

Andy Dunn M.D.

Dr. Dunn is board certified in family medicine and is medical director of Mesa Primary Care and Sage Primary Care. He grew up in Denver and moved to Casper to complete his residency at University of Wyoming Family Practice. He was a Wyoming Medical Center hospitalist for several years. 

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