When most of us were children, we all wondered why out mothers constantly nagged us to wash out hands. What an unnecessary evil, right? Well, perhaps not. As we grow a little bit older and wiser – and especially for those of us that pursue careers in the medical field – we notice that anywhere and everywhere are tiny little threats that are typically invisible to the human eye such as viral meningitis.
Viral meningitis is one of those conditions that most of you have probably heard of, but if you’re like me, it may not have seemed too interesting because you could never get it, right? Never say never.. It wasn’t until I saw a small child in agonizing pain from viral meningitis that made me appreciate the horror of this condition. The child’s neck was stiff as a board, as well as the rest of its body from the pain. Viral meningitis usually stems from a common virus and while it isn’t as life threatening as other types of meningitis, it is something that you do not want to experience in your lifetime. I also have a friend that was lucky enough to catch viral meningitis from an enterovirus. She described viral meningitis as the post painful and agonizing week of her life.
Viral Meningitis Basics
Meningitis is the term describing a condition that involves acute inflammation of the meninges around the brain. There are several protective membrane layers that surround our brains and spinal cords called Meninges. The Meninges term refers to a group of three layers that help cushion and envelope the brain. These three specific layers are referred to as Pia Mater, Arachnoid Mater, and the Dura Mater. The Dura Mater can also be described as the outer layer of the skull. This layer is a fairly tough layer of fibroelastic cells and contains a bit of extracellular space. The Arachnoid mater consists of many blood vessels, the subarachnid space, and cerebrospinal fluid (CSF). The Pia Mater is the layer that is closest to the brain. It actually touches the brain and envelopes the brain and spinal cord’s contours.
Meningitis infections are generally classified into several types. These types include: Bacterial Meningitis, Viral Menengitis, Fungal Meningitis, Parasitic Meningitis, and Non-infectious Meningitis. Most of these are pretty self-explanatory. Many times, you’ll also hear the specific name of a type of meningitis, which is simply the specific type of infection responsible for the infectious meningitis.
Bacterial Meningitis is one of the most prevalent, damaging, and life threatening types of meningitis. It typically occurs when certain bacterium enter the blood stream and travel the brain and spinal cord, which often results in brain damage, hearing loss, and learning disabilities. Fungal Meningitis is the same scenario, but is caused by fungal matter that is usually introduced into the body by inhalation of spores in contaminated soil, bird droppings, or other things that you shouldn’t be sniffing around in. Parasitic Meningitis is very rare, with only 31 cases between 2002 and 2012, but is extremely fatal. Out of the 31 cases, there were no survivors. All other types of meningitis fall into the Non-infectious category. These cases of meningitis are usually caused by head injuries/trauma, cancer, Lupus, brain surgeries, or certain medications.
Viral Meningitis Prevalence
Now, how likely am I to get viral meningitis? Well, that’s not entirely easy to say because viral meningitis statistics may not be entirely accurate due to misdiagnoses, the illness being overlooked or unreported, and because many cases go untreated. Of all of the known cases (totally all types of meningitis) throughout the world, there were over 8.8 million cases throughout 2005-2015. Of these 8.8 million victims, 379,000 resulted in death. For this century, that’s a lousy survival rate and definitely something to fear. My first thought, since I’m terrified of obtaining any type of virus, was that viral meningitis was definitely the type killing everybody off. However, my assumption was entirely inaccurate. Viral meningitis is one of the more common forms of meningitis, but only claims the lives of less than 1% of its victims which is much better than the 20-40% mortality that bacterial meningitis has. Viral meningitis is most likely to occur in young children. However, symptoms of viral meningitis in children cannot always be communicated to doctors easily which makes it another condition that is hard to determine statistic for.
Viral Meningitis Causes
What causes viral meningitis? A virus, of course! It so happens that the meninges prove to be a nice place for a virus to hide out from the immune system to conduct some massive replications and to infect the host. Some people with very strong immune systems may be able to fend the virus off somewhat, but those that are experiencing a weakened immune system from things like HIV, cancer, chemotherapy, etc may be more likely to contract viral meningitis and may take long periods of time to recover from the meningitis infection.
It was very surprising to me to hear which culprits are responsible for this horrific condition. Over 80% of all viral meningitis cases these days are caused by the enteroviruses, which belong to the viral family Picornaviridae and are one of the most common types of viruses today. A couple of other fairly common viruses that are responsible are Herpes simplex virus 2 (HSV-2) which is another very common virus present in humans, and the Mumps virus. Varcella zoster and Herpes simplex virus `1 (HSV-`1) are two others that cause a significant amount of the viral meningitis cases, but are not near as prevalent as the enteroviruses. Other notable viruses that are known to cause viral meningitis include the West Nile virus, HIV, Epstein-Barr (EBV), Mumps virus, Saint Louis encephalitis virus, tick-borne encephalitis viruses, and Cytomegalovirus (CMV).
Symptoms of Viral Meningitis
The most common symptom of viral meningitis is a headache (and from reading experiences of viral meningitis patients, these headaches sound pretty intense and severe). Headaches are experienced by over 90% of people diagnosed with viral meningitis. The most common symptoms of viral meningitis in adults are photophobia (sensitivity to light), fever, and muscle stiffness in the neck, muscle aches and pains, nausea and vomiting. A notable side effect often seen in children is a meningitis rash.
Viral Meningitis Diagnosis
Upon arriving to the hospital, a patient’s medical history will be reviewed. If spinal meningitis or viral meningitis are suspected, the physician will most likely conduct tests to determine C-reactive Protein white blood cell counts, and glucose concentrations. Bacterial meningitis and viral meningitis have the same symptoms and cannot be clinically diagnosed because most medical clinics do not have the necessary equipment for collecting and testing blood or cerebrospinal fluid at their facilities. For this reason, patients should be referred to the hospital for further testing. A lumbar puncture for cerebrospinal fluid (C SF) is the only test that can distinguish the two types of meningitis.
It is extremely important that all known symptoms of viral meningitis are reported since this condition can often be misdiagnosed as a typical viral infection or other common occurrence. If viral meningitis goes undiagnosed, the patient may experience mental deterioration, death, or the viral meningitis may convert to an even more serious state/condition, referred to as meningoencephalitis. Meningoencephalitis occurs when the condition spreads from the meninges to other parts of the brain which causes those areas to inflame as well. Meningoencephalitis also carries a larger amount of symptoms and potential threats, such as seizures, additional brain damage, and a higher mortality rate. If you’ve ever seen the movie Contagion, you’ll understand how big of a threat meningoencephalitis can be – the virus in the movie causes meningoencephalitis in its hosts.
Viral Meningitis Treatment
Viral meningitis will typically last approximately 7-10 days for most of those that experience meningitis caused by one of its usual culprits. However, if viral meningitis spreads into parts of the brain or spinal column, the disease may progress and last longer/cause more damage to the body and nervous system. At this time, there are no specific treatments for viral meningitis. A large number of patients with viral meningitis overcome the infection without treatment. A patient will most likely receive a general antiviral medication after being diagnosed with viral meningitis. After the condition has been identified and declared to be the cause, the physicians should diagnose and determine the specific virus causing the infection because the most logical form of treatment would be to treat the condition that is known to be most effective for the specific virus responsible for meningitis.
Viral Meningitis Prevention
Like the introduction lead on, washing your hands is a good start to preventing viral meningitis (or any form of infectious meningitis for that matter) In theory, general virus prevention would applicable to viral meningitis prevention. Steps to avoid unwanted viruses and illnesses include washing hands thoroughly after using the restroom, handling food, or animals. Before traveling to other countries, it would be extremely wise to check the CDC’s map for disease prevalence in your destination country and obtain any shots/vaccines that are recommended by the CDC from your physician a reasonable amount of time before departing. Some cases of viral meningitis are thought to be caused by coming into contact with rodent droppings or urine, so it is recommended to get control of any rodents or other scavengers investing your home or office.