Meningitis

Minimizing Meningitis Risk

By Christine Haran

As many college first-year students prepare for the first year of dorm life, their concerns often swirl around getting a good roommate, the size of their closet and the dorm's distance from the dining hall. They tend not to worry as much about their increased exposure to infections, from everyday colds to meningitis, which is an infection of the coverings around the brain and spinal cord usually caused by a virus or bacteria.

While many cases of meningitis are mild, some bacterial infections can lead to hearing loss, brain damage and even death. In the 1990s, rates of a type of bacterial meningitis called meningococcal meningitis increased among college students living in dorms, and today students who live in dorms are encouraged by their colleges and universities to be vaccinated with the meningococcal vaccine, which can prevent many of the cases seen on college campuses. Individual cases of meningococcal disease, and outbreaks, have also occurred in military housing, campsites and other places where people are living in close quarters.

Below, Thomas Belhorn, MD, PhD, a pediatric infectious disease specialist at the University of North Carolina at Chapel Hill School of Medicine, discusses the different types of meningitis, meningitis treatments, and how college students and others can reduce their risk.

What is meningitis?
Many people think of it as infection of the brain. In truth, it's an infection of the fluid and membranes or lining that are around the brain and the spinal cord. The usual types of meningitis that we see in children and adolescents are caused by either bacteria or viruses. In the summer and fall, we see a fair amount of viral meningitis, which, in general, is not as severe and doesn't have as severe complications as bacterial meningitis. The most common type of viral meningitis this time of year is caused by a broad class of viruses called enteroviruses. Different types of bacteria can cause bacterial meningitis, and the top two types are meningococcal meningitis and pneumococcal meningitis.

How do these infections progress to the brain?
The bacteria or viruses are often first on your mucosal membranes, such as those in your nose or throat. They can sometimes then gain entry into the bloodstream and eventually cross into the brain and associated structures, causing meningitis. Less commonly they can more directly extend from severe infections in areas near the brain, such as from sinus or ear infections.

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