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Our roving medical expert Dr. Erik McLaughlin MD explains why meningitis is an illness that all travelers need to be aware of.
Photo © Getty Images/Neal Wilson
Meningitis is a disease typically associated with groups of people in close quarters, such as prisons, military barracks and hostels.
Meningitis takes its name from the delicate tissue layer surrounding the brain and spinal cord (meninges) and the inflammation that results from the infection(-itis). Meningitis is a contagious disease, meaning it can be spread from person to person and is divided into two basic forms based on cause: viral and bacterial.
Symptoms of meningitis are similar in both forms of the illness and include headaches, stiff neck, fever and sensitivity to bright light (photophobia).
- Types of meningitis
- Meningitis diagnosis and treatment
- Vaccinations for meningitis
- Avoiding meningitis while traveling
Types of meningitis
Viral meningitis
Viral Meningitis can be caused by a large number of viruses with exotic-sounding names like Echovirus and Coxsackievirus. Fortunately, this a serious health concern but rarely fatal in people with a competent immune system.
Viral meningitis can also manifest from tick-borne encephalitis.
Typical symptoms last for 1-2 weeks and resolve without further problems. This infection is commonly spread through inhalation or contact with respiratory droplets or secretions like saliva or mucus. The best way for travelers to avoid viral meningitis is a regular routine of proper handwashing.
Perhaps the biggest concern with viral meningitis is not being able to differentiate it from bacterial meningitis, which is a much more serious and life-threatening disease. For this reason, all cases of suspected meningitis need prompt medical evaluation. If you are a World Nomads travel insurance policyholder and you suspect something sinister, contact our 24/7 Emergency Assistance team.
Bacterial meningitis
Bacterial Meningitis is a serious and life-threatening emergency and needs immediate medical treatment.
The two most common forms of bacteria involved are Neisseria meningitidis and Streptococcus Pneumoniae. Symptoms of bacterial and viral meningitis are similar and those with fevers, headaches and neck stiffness should consider meningitis as a cause.
Neisseria is famous for causing a rash with a special feature: the rash does not blanch when pressed with a glass. Typical rashes lose their redness when pressed and return to a rash appearance when the pressure is removed. A drinking glass works well for this as you can apply pressure and still see through at how the rash is behaving. A rash that does not turn back to normal skin color when pressure is applied can be a warning sign of a Neisseria bacterial infection, especially when found with headaches, fevers and neck stiffness. This infection requires immediate antibiotics as death can occur rapidly, within 24-48 hours. Long term complications can include deafness and other neurological disability.
Meningitis diagnosis and treatment
Doctors differentiate bacterial and viral meningitis by testing a sample of spinal fluid, obtained during a lumbar puncture (yes, the long needle in the spine) or "spinal tap". This is a safe procedure, carries few risks and is vital in proper diagnosis.
Treatment of bacterial meningitis requires intravenous antibiotics immediately, while the more benign viral type is largely supportive care consisting of fluids with pain and fever control. Special concerns exist for those who have come in close contact with a confirmed case of bacterial meningitis and those people may require oral antibiotics as prophylaxis (disease prevention).
Vaccinations for meningitis
Both Neisseria and "Strep. Pneumo" are bacteria for which there are vaccines to prevent illness. Vaccines for S. Pneumo are typically given during childhood, in developed nations. The vaccine for Neisseria Meningitidis covers 4 of the 5 strains of the bacteria including types A, C, Y, and W-135. Each serotype has certain geographical preferences with Group A being most common in the "African Meningitis Belt" and Asia.
There is a group B type of Neisseria Meningitidis that is not covered by the vaccine. Unfortunately, this is one of the most common forms, especially in the Americas and Europe, and full protection is not guaranteed by the vaccines at present.
Avoiding meningitis while traveling
Clearly, those traveling to areas know for meningitis risk should do a review of the immunizations and discuss the need for a meningitis vaccine with their health care provider. Even with vaccines for bacterial meningitis already taken, taking precautions such as:
- Practicing good personal hygiene by washing your hands
- Not sharing food, drinks or cutlery
- Washing fruit and vegetables before eating
- Making sure food is thoroughly heated through before eating
- Not sharing toothbrushes, lip balms or lipstick
- Keep your immune system healthy
- Know who you are kissing. Meningitis can be passed on via saliva.
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