Meningitis is the inflammation of the meninges, the protective membranes surrounding the brain and spinal cord. Viral meningitis is the most common form of this condition and is generally less severe than its bacterial counterpart. Since symptoms of different forms of meningitis can overlap, patients are often placed under initial isolation precautions in clinical settings until diagnostic tests confirm the specific cause.
Understanding Viral Meningitis and Its Causes
Viral meningitis is caused by common viruses that circulate widely in the general population. The vast majority of cases, particularly in the United States, are caused by non-polio enteroviruses, especially during the summer and fall months. Other viruses, including mumps, measles, influenza, and herpes simplex virus (HSV), can also lead to this infection.
The prognosis for viral meningitis is significantly different from that of bacterial meningitis, which is a life-threatening medical emergency requiring immediate antibiotic treatment. Viral forms are usually self-limiting and resolve on their own, often without specific antiviral therapy. This distinction in severity is the primary reason that isolation protocols differ between the two types once a diagnosis is confirmed.
Formal Isolation Requirements
Patients hospitalized with suspected meningitis are often placed on temporary isolation precautions until the cause is determined, as bacterial meningitis is dangerous and requires immediate treatment. Once laboratory results confirm a viral etiology, standard infection control practices are sufficient for care, and strict isolation is discontinued.
Confirmed viral meningitis does not require the airborne or droplet isolation precautions necessary for highly contagious diseases like meningococcal meningitis. The primary infection control measure used in a hospital is Standard Precautions, involving meticulous hand hygiene and the use of personal protective equipment as needed. For specific viral causes, such as enterovirus, Contact Precautions may be implemented for children who are not toilet trained or incontinent adults, because the virus can be shed in stool.
Transmission and Practical Precautions
The viruses responsible for viral meningitis are transmitted through various routes, depending on the specific pathogen. Enteroviruses, the most frequent cause, are spread through the fecal-oral route (contact with the stool of an infected person). Transmission also occurs through respiratory droplets from coughing or sneezing, or by touching contaminated surfaces and then touching the mouth or nose.
Infected individuals can spread the virus before symptoms appear and for a period afterward; enteroviruses, for instance, can be shed in the stool for several weeks after recovery. Since strict isolation is often unnecessary outside of a hospital, practical measures focus on rigorous personal hygiene to prevent transmission in the home.
Practical Hygiene Measures
Practical measures focus on rigorous personal hygiene to prevent transmission in the home.
- Frequent and thorough hand washing with soap and water, especially after changing diapers or using the toilet.
- Cleaning and disinfecting frequently touched surfaces, such as doorknobs and toys.
- Avoiding the sharing of eating utensils and drinks.
- Avoiding the sharing of personal items like toothbrushes.
Recovery and Follow-Up Care
Most individuals with viral meningitis recover within 7 to 10 days without complications. Treatment is primarily supportive, focusing on rest, maintaining hydration, and using over-the-counter medications to manage symptoms like fever and headache. Specific antiviral medication is rarely needed unless the cause is a virus like herpes simplex.
Even after acute symptoms subside, some patients may experience residual symptoms for a short time. Lingering issues include fatigue, persistent headaches, and occasionally difficulty with concentration. Patients should seek follow-up medical attention if they experience worsening symptoms, such as an increasing headache, recurring fever, or signs of confusion or altered mental status.