Meningitis

Meningitis is an inflammation of the linings around the brain and spinal cord. Meningitis can be caused by viruses or bacteria. Often, the symptoms of viral meningitis and bacterial meningitis are the same. Diagnosis of both viral and bacterial meningitis is confirmed by a lumbar puncture (spinal tap).

Viral meningitis is serious but rarely fatal in persons with normal immune systems. Usually, symptoms last 7-10 days and the person recovers completely. Many different viruses can cause meningitis. About 90% of cases of viral meningitis are caused by members of a group of viruses known as enteroviruses, such as coxsackieviruses and echoviruses. Herpes viruses and the mumps virus can also cause viral meningitis. There is no vaccination available for viral meningitis and treatment is only available for meningitis caused by the herpes virus.

Bacterial meningitis is of greater concern than viral meningitis because it is associated with a significant risk of brain damage and death. Meningococcal meningitis, one type of bacterial meningitis, is of particular concern because while uncommon, it does affect college-age students and the disease may progress rapidly if untreated.

The most common symptoms include:

• Fever
• Headache
• Stiff neck

There are often additional symptoms, such as:

• Nausea
• Vomiting
• Photophobia (eyes being more sensitive to light)
• Altered mental status (confusion)

See the CDC for more information.

If you or someone you know has symptoms of meningitis, call UHS immediately at 734-764-8320 and request Nurse Advice, call 911, or go to the nearest emergency room.

Meningococcal disease can be difficult to diagnose because the signs and symptoms are often similar to those of other illnesses. If a doctor suspects meningococcal disease, they will advise that you go to the nearest emergency room to collect samples of blood or cerebrospinal fluid (fluid near the spinal cord).

Doctors then send the samples to a laboratory for testing. If Neisseria meningitidis bacteria are in the samples, laboratorians can grow (culture) the bacteria. If meningitis infection is suspected, antibiotics are started immediately while monitoring for improvement.

If you think you may be a close contact of a person with meningococcal disease, call UHS at 734-764-8320 and request Nurse Advice.

People spread meningococcal bacteria to other people by sharing respiratory and throat secretions. Generally, it takes close or lengthy contact to spread these bacteria. Fortunately, they are not as contagious as germs that cause the common cold or the flu. People do not catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been. Examples of close contacts include:

• People in the same household
• Roommates
• Anyone with direct contact with a patient's oral secretions (saliva or spit) through sharing drinks, utensils, or intimate contact, such as kissing

Doctors or local health departments recommend who should get prophylaxis. If you think you may be a close contact of a person with meningococcal disease, call UHS at 734-764-8320 and request Nurse Advice.

Close contacts of a person with meningococcal disease should receive antibiotics to prevent them from getting sick. Experts call this post-exposure prophylaxis (PEP).

Ideally, PEP should be started within 24 hours after contact or identification of the bacteria. However, PEP can still be helpful if started within 14 days from a potential close contact exposure. Make sure to complete the entire course of antibiotics if they are prescribed.

Understanding the characteristic signs and symptoms of meningococcal disease is critical and possibly lifesaving, because meningococcal disease can cause serious illness and rapidly progress to death if untreated.

Meningococcal disease is difficult to detect because it can be mistaken for other conditions. A person may have flu-like symptoms for a few days before experiencing a rapid progression to severe meningococcal disease.

Meningococcal disease is contagious. If you (or someone you know) experience symptoms, or think you may have been exposed, call UHS 24/7 at 734-764-8320 and request Nurse Advice, call 911, or go to the nearest emergency room. Also see Emergency/After Hours.

Keeping up-to-date with recommended vaccines is the best defense against meningococcal disease. UHS recommends a meningococcal vaccine to all students (note: MenACWY is required for students living in Michigan Housing), especially during a potential outbreak. You can schedule an appointment to get vaccinated by contacting UHS at 734-764-8320 during normal business hours. Maintaining healthy habits, like getting plenty of rest and not having close contact with people who are sick, also helps.

Vaccines help protect against all three serogroups (B, C, and Y) of Neisseria meningitidis bacteria most commonly seen in the United States. Like with any vaccine, meningococcal vaccines are not 100% effective. This means there is still a chance you can develop meningococcal disease after vaccination. People should know the symptoms of meningococcal disease since early recognition and quick medical attention are extremely important.

Infectious diseases tend to spread wherever large groups of people gather. Recent data show that the risk for meningococcal disease in college students is slightly higher than the risk in other teens and young adults who are not attending college. 

CDC recommends a meningococcal conjugate (MenACWY) vaccine for first-year college students living in residence halls. If they received it before their 16th birthday, they need a booster shot for maximum protection before going to college. However, the vaccine is safe and effective and therefore doctors can also give it to non-first-year college students.

College campuses have reported outbreaks of serogroup B meningococcal disease in recent years. CDC recommends the use of a serogroup B meningococcal (MenB) vaccine for people at increased risk during these outbreaks. MenACWY vaccines do not include protection against serogroup B meningococcal disease. In an outbreak setting, CDC recommends a MenB booster shot for college students who previously received the vaccine series. Talk with your clinician about what is best for your specific situation.

Learn more about what everyone should know about meningococcal vaccination.

Immunization is an effective means to prevent meningitis, and UHS offers immunization. See Immunizations for details.

Two categories of meningitis vaccine are available at UHS, quadrivalent vaccine (MenACWY) and meningitis B vaccine.

Quadrivalent vaccine, or MenACWY, is recommended for all first-year students:

• Protects against four strains (A, C, W, and Y), which cause 2/3 of meningitis cases
• Brand names are Menactra, Menomune and Menveo
• Recommended for adolescents 11-18 years old and certain others; first-year college students living in residence halls are at increased risk of disease
• For more information including side effects and contraindications, see CDC Vaccine Information Statement

Meningitis B vaccine expands protection against this serious but rare infection. 

The CDC currently recommends:

• People ages 16 -23 years old are eligible to receive this vaccine, and ages 16 -18 years are the preferred ages for vaccination.
• People 10 years or older who are at increased risk are recommended to receive the vaccine, including:
  • People at risk because of a serogroup B meningococcal disease outbreak
  • Anyone whose spleen is damaged or has been removed
  • Anyone with a rare immune system condition called “persistent complement component deficiency”
  • Anyone taking a drug called eculizumab (also called Soliris®)
  • Microbiologists who routinely work with isolates of N. meningitidis

The vaccine:

• Protects against strain B, which causes 1/3 of meningitis cases
• Brand names are Bexsero and Trumenba, which are both offered at UHS.
• Is relatively expensive, so be sure to check whether it is covered by your health insurance.

For more information including side effects and contraindications, see CDC Vaccine Information Statement

Meningococcal disease is rare, striking annually about 1 in every 100,000 people in the general population. Rates in adolescents and young adults have increased over the last 10 years. The rate of meningococcal infection for students living in residence halls in the U.S. is about 2 in every 100,000 students. The rate of infection is highest among first year students living in residence halls, with about 5 in every 100,000 freshmen infected.

U-M reported a case of meningococcal meningitis in January 2022, December 2014, November 2005 and in October 1995.

Approximately 10% of the general population carry meningococcal bacteria in the nose and throat in a harmless state. This carrier state may last for days or months before spontaneously disappearing, and it seems to give people who harbor the bacteria in their upper respiratory tracts some protection from developing meningococcal disease.

During meningococcal disease outbreaks, close to 95% of people may carry the bacteria, yet less than 1% of people develop meningococcal disease. This low occurrence of disease following exposure suggests that a person's own immune system, in addition to bacterial factors, plays a key role in allowing the disease to develop.

Meningococcal bacteria cannot usually live for more than a few minutes outside the body. As a result, they are not easily transmitted in water supplies, swimming pools, or by routine contact with an infected person in a classroom, dining room, bar, rest room, etc.

The vaccine for meningococcal meningitis is available at UHS.

UHS, in collaboration with the U-M Health System Department of Infectious Diseases and other community resources, monitors the campus community for cases of meningococcal disease.

If a case of meningococcal disease were to be identified at U-M, UHS would attempt to identify anyone who had clse exposure and provide advice and prophylactic antibiotics to prevent infection.

Description: Includes meningococcal meningitis and meningococcemia, an infection of the blood. More rare and more serious than other kinds of meningitis.

Symptoms: Sudden fever and severe headache can be initial manifestations. Also, stiff neck, mental changes (e.g., malaise, lethargy), and rash that may begin as flat, red eruptions, mainly on the arms and legs and evolve quickly into a rash of small dots that do not change with pressure.

Cause: Meningococcal bacteria, specifically Neisseria meningitidis

Transmission: Through fluids from the mouth or nose via kissing, sharing eating utensils or beverage containers, sharing cigarettes or cannabis and via droplets from coughing and sneezing.

Occurrence: Rarely and sporadically throughout the year. Outbreaks, which are unusual, tend to occur in late winter and early spring.

Diagnosis: Confirmed by lumbar puncture (spinal tap) and by culture of blood samples.

Treatment if diagnosed: Antibiotics

Treatment if exposed: Anyone who suspects possible exposure should consult a physician immediately. Prophylactic antibiotic therapy is frequently recommended after exposure.

Centers for Disease Control and Prevention offers information on meningitis.

Immunization Action Coalition Vaccine Information Statements are available in multiple languages.