As mandated by state law, Belfonte School is providing the following information on BACTERIAL MENINGITIS for your review. No cases of this infection have been detected at school. THIS IS FOR YOUR INFORMATION ONLY, AS MANDATED BY STATE LAW.

Meningitis is an inflammation of the meninges, the membranes that cover the brain and spinal cord. The inflammation is usually caused by bacteria or viruses (viral meningitis is also called aseptic meningitis). Less common causes include fungi, protozoa, and other parasites. Sometimes certain medications, cancers, or other diseases can inflame the meninges, although such noninfectious cases of meningitis are much rarer.

Many of the bacteria or viruses that can cause meningitis are fairly common and are more often associated with other everyday illnesses. Sometimes, however, they spread to the meninges from an infection in another part of the body. The infection can start anywhere, including in the skin, gastrointestinal tract, or urinary system, but the most common source is the respiratory tract. From there the microorganisms can enter the bloodstream, travel through the body, and enter the central nervous system. In some cases of bacterial meningitis, the bacteria spread directly to the meninges from a severe nearby infection, such as a serious ear infection (otitis media) or nasal sinus infection (sinusitis). Bacteria may also enter the central nervous system after severe head trauma or head surgery.

Bacterial meningitis is less common than viral meningitis but is usually much more serious and can be life-threatening if not treated promptly. Many different types of bacteria can cause meningitis: Group B Streptococcus, Escherichia coli, and Listeria monocytogenes are the most common causes of meningitis in newborns. Streptococcus pneumoniae (pneumococcus) and Neisseria meningitidis (meningococcus) are more frequent in children older than 2 months of age. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of meningitis in children in the United States. But the widespread use of the Hib vaccine as a routine childhood immunization has dramatically decreased the frequency of meningitis caused by Hib.

Viral meningitis is relatively common and far less serious than bacterial meningitis. It often remains undiagnosed because its symptoms are similar to those of the common flu. The frequency of viral meningitis increases slightly in the summer and fall months because people are more often exposed to common viral agents during those seasons. Most cases of viral meningitis are associated with enteroviruses - viruses that typically cause stomach "flu." However, many other types of viruses, such as the herpes virus, can also cause meningitis. The mumps virus was once a common cause of viral meningitis, but it is now rare due to the routine use of the measles, mumps, and rubella (MMR) vaccine.

Bacterial meningitis occurs in people of all ages but is more common in the very young (infants and young children) and the elderly (people above age 60). Teenagers and college students are also slightly more at risk for the disease because of time spent in close contact with many of their peers. Viral meningitis occurs in people of all ages, although it is more common in children.

People with less competent immune systems, such as the very young or those whose immune systems have been compromised by disease, are more at risk for all types of meningitis. Some types are more common in child-care centers, boarding schools, dormitories, and military bases, mainly because infectious diseases tend to spread quickly among large groups of people. Not receiving routine vaccines for certain infectious agents that can cause meningitis - including those for mumps, Hib, and pneumococcus - also increases a person's risk for the disease.

The long-term outlook for children who develop meningitis varies greatly and depends on a child's age, the microorganism causing the infection, any other complications, and the treatment the child receives. The complications of bacterial meningitis can be severe and include neurological problems such as hearing loss, visual impairment, seizures, and learning disabilities. The heart, kidneys, and adrenal glands may also be affected. Although some children develop long-lasting neurological problems from bacterial meningitis, most who receive prompt diagnosis and treatment recover fully.

Signs and Symptoms

The symptoms of meningitis vary and depend both on the age of the child and on which bacterium or virus is causing the infection. The symptoms of viral meningitis are usually milder than those of bacterial meningitis. However, symptoms of bacterial and viral cases can be similar, particularly in the early stages of the disease. This makes prompt, accurate identification of the infectious organism crucial to effective treatment and the patient's recovery.

The first symptoms of meningitis may surface several days after a child has had a cold and runny nose, diarrhea and vomiting, or other signs of a bacterial or viral infection. Some of the more common symptoms of meningitis include fever, lethargy (decreased consciousness), or irritability. Older children may complain of a headache, photophobia (eye sensitivity to light), and a stiff neck, which is often noted by the doctor during a physical exam.

Meningitis also can lead to skin rashes, although rashes caused by bacterial meningitis look different from those caused by viral meningitis. Seizures occasionally accompany meningitis as well.

Newborns and infants with meningitis may lack the classical signs described above and simply be extremely irritable or lethargic. Normally, infants who are not feeling well will be comforted when their mothers pick them up. However, a baby who has meningitis may display something called paradoxical irritability - when picking up and rocking a child makes the child more distressed. This can be a sign of irritated meninges.

Other symptoms of meningitis in infants can include: jaundice (a yellowish tint to the skin), a stiffness of the body and neck (neck rigidity), a mild fever, a lower-than-normal temperature, poor feeding, a weak suck, and a high-pitched cry. Parents may also notice bulging fontanelles on their baby's head. (Fontanelles are the soft spot at the top/front of the baby's skull, where the bones of the skull join and are still open at that age.)

Contagiousness

Most cases of meningitis result from infections that are contagious. The infectious agents usually spread from person to person in tiny drops of fluid from the throat and nose of someone who is infected. (This could be a person with either meningitis or, more likely, the common infection caused by that germ.) The drops may become airborne when the person coughs, laughs, talks, or sneezes. They then can infect others when people breathe them in or touch the drops and then touch their own noses or mouths.

Sharing food, drinking glasses, eating utensils, tissues, or towels may all transmit the infections as well. Some infectious organisms can spread through a person's stool, and someone who comes in contact with the stool - such as a child in day care - may contract the infection.

The infections most often spread between people who are in close contact, such as those who live together or people who are exposed by kissing or sharing eating utensils. Casual contact at school or work with someone who has one of these infections usually will not transmit the infectious agent. In some instances, people may carry one of the germs that can cause meningitis without becoming ill at all. Even though they have no symptoms of disease, they can still spread the germ, however.

Patients with meningitis typically remain contagious while they still have symptoms. People who have bacterial meningitis can be contagious for about 24 hours after they begin taking antibiotics.

Prevention

Routine immunization of young adolescents will help prevent this rare but serious infection. Experts now recommend that kids who are 11 years old get vaccinated for meningococcal disease, a serious bacterial infection that can lead to meningitis. The vaccine is called quadrivalent meningococcal vaccine, or MCV4. Children who have not had the vaccine and are 15 years old, or entering high school should also get the vaccine. People who are entering college, and will be living in a dormitory setting should also get the vaccine.

Many of the bacteria and viruses that are responsible for meningitis are fairly common. Good hygiene is an important means of preventing any infection. Encourage your family members to wash their hands thoroughly and often, particularly before eating and after using the bathroom. Avoiding close contact with someone who is obviously ill and not sharing food, drinks, or eating utensils can help halt the spread of germs as well.

In certain cases of meningitis, doctors may decide to give antibiotics to anyone who has been in close contact with the person who is ill to help prevent additional cases of illness.

The vaccines against Hib, measles, mumps, rubella, polio, and pneumococcus can protect against meningitis caused by these microorganisms. Some high-risk children should also be immunized against certain types of meningococcus.

Because bacterial meningitis is most likely to occur in confined settings such as college dorms, some colleges ask that incoming students be vaccinated against meningococcus. This vaccine may also be recommended for people who are traveling to countries where meningitis is more common.

Any child with possible meningitis needs aggressive diagnosis and treatment. First the doctor will take a history and perform a physical examination. If meningitis is suspected, the doctor will order laboratory tests to help make the diagnosis. The tests will likely include a lumbar puncture (spinal tap) to collect a sample of spinal fluid. This sample will be examined for signs of inflammation and cultured for the organism that may be causing the infection.

It is crucial to fight cases of bacterial meningitis quickly. If a child is diagnosed with (or strongly suspected to have) bacterial meningitis, doctors will start intravenous antibiotics as soon as possible, often before the exact microorganism causing the infection has been pinpointed. Once the infectious agent is identified through laboratory tests, the antibiotics can be changed, if necessary, or discontinued if the patient turns out to have viral meningitis..

When to Call Your Child's Doctor

Seek medical attention immediately if you suspect your child has meningitis or if your child exhibits symptoms such as vomiting, headache, lethargy or confusion, neck stiffness, rash, and fever. Infants who have fever, irritability, poor feeding, and lethargy should be assessed by a doctor right away.