By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

VIRAL MENINGITIS, UNLIKE THE BACTERIAL VARIETY, IS RARELY FATAL

Question: My 13-year-old daughter just told me her friend had been diagnosed with viral meningitis. They had been on a church camping trip, with several other kids, and this girl was diagnosed when they all got home. Do I need to get shots or medicine for my daughter? Is there anything I can do to keep her from getting sick?

Answer: I am sorry your child’s friend is ill, but the good news is that viral meningitis is usually mild and the patient makes a full recovery. In fact, even if your child gets the virus in her system, she probably won’t come down with meningitis.

Viral meningitis is the most common type of meningitis, with about 50,000 people hospitalized with it every year in the U.S. This is a viral infection in the tissues that cover the brain. The symptoms are usually fairly classic, including a bad headache, sensitivity to bright light, fatigue, fever, and sometimes nausea and vomiting. Viral meningitis is rarely fatal, and the patient usually makes a full recovery in about a week. About 90 percent of cases of viral meningitis are caused by members of a group of viruses known as enteroviruses, such as coxsackieviruses and echoviruses. Outbreaks due to these viruses are more common during summer and fall months. Other viruses -- including herpes viruses and the mumps virus -- can also cause viral meningitis.

The diagnosis of viral meningitis is based on physical examination and a spinal tap. By looking at the spinal fluid, your physician is able to tell if the meningitis is viral or the more serious bacterial meningitis. Once the diagnosis of viral meningitis is made, the treatment is aimed at relief of the symptoms -- medication for the headache, nausea, and fever. Neither antiviral medications nor antibiotics are appropriate.

Will your daughter get sick? I don’t know. She was exposed to the virus that made her friend sick, but most people who are exposed do not become ill. The incubation period for enteroviruses is usually between three and seven days from the time you are infected until you develop symptoms. So, once that period of time has elapsed, if your daughter doesn’t become ill, you are probably home free. If your daughter had a lot of close personal contact with this other child, you want to be sure to wash common objects well in hot soapy water. This will help to prevent others in your household from becoming infected.

Finally, for the benefit of my other readers, let me say a little more about that other more dangerous form of meningitis I mentioned earlier -- bacterial meningitis. This is a very serious medical condition that can be fatal if it's not treated right away. It can strike adults, but it is most common among babies and very young children. Symptoms include a high fever, chills, headache, and vomiting. Muscles may stiffen, especially in the neck. Within a few hours, the victim may become delirious, slip into a coma, or have convulsions. Infants may become irritable and develop a high pitched cry.

As you can see, the initial symptoms can be very similar to those for viral meningitis. A spinal tap is needed to distinguish one type of meningitis from the other. That’s why anyone who is suffering from these symptoms should be taken to a hospital emergency department right away. There's no time to waste.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.