Last Updated: September 11, 2017

Viral Meningitis

Overview

Viral meningitis is the most common form of meningitis, which is inflammation of the tissue that lines the brain and spinal cord. Other causes of meningitis include bacteria, fungi and non-pathogenic triggers of inflammation. The initial phase of the disease is marked by flu-like symptoms, such as fever and body ache. As the disease progresses, characteristic symptoms of headache and stiff neck develop. Most healthy individuals show no symptoms or recover over a few weeks without medical intervention. However, infants and patients with compromised immunity are at greater risk of severe illness. The bacterial form of meningitis is a more serious disease and carries the risk for complications, including brain damage and death.

Causes and Risk Factors

Viral meningitis is caused by a variety of viruses, including enteroviruses, herpesviruses, arboviruses (West Nile virus), measles virus, mumps virus, influenza virus, lymphocytic choriomeningitis virus and human immunodeficiency virus (HIV). The two common causes of viral meningitis in the United States are the following.

The route of transmission varies depending on the virus.

Risk factors for viral meningitis include the following:

Symptoms

The early symptoms of viral meningitis mimic common flu symptoms. As the inflammation worsens, headache and neck stiffness develop. Some people do not experience any symptoms.

Symptoms in babies:

Symptoms in those over the age 2:

Diagnosis and Treatment

Meningitis is initially diagnosed based on the symptoms, specifically the headache and stiff neck symptoms. Follow-up laboratory testing of naso-oropharyngeal swabs, rectal swabs, stool, cerebrospinal fluid, blood and serum allow for an accurate diagnosis. Imaging techniques (e.g., computerized tomography or magnetic resonance) help detect inflammation in the head and neck region.

Timely diagnosis and treatment of meningitis, in particular bacterial meningitis, is critical; delayed treatment can result in severe complications, including brain damage, hearing loss, impaired memory/learning, seizures and even death. The bacterial form of meningitis requires immediate treatment with antibiotics. There are no known drugs for treating the common viral causes of meningitis; in most cases, patients improve with bed rest and proper intake of fluids. Over-the-counter medication is used to alleviate some of the associated symptoms.

Prevention

Routine vaccination according the guidelines established by the Centers for Disease Control and Prevention (CDC) is the best way to prevent meningitis caused by some viruses (e.g., measles and mumps virus). There is no vaccine against enteroviruses, the most common cause of viral meningitis. Routine handwashing and avoiding contact with sick individuals is the best way to prevent viral meningitis.

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Authored by: Tina Shahian, PhD