Viral Meningitis

What is meningitis?

Meningitis is an inflammation of the membranes ("meninges") that cover the brain and spinal cord. Viral infections are the most common cause of meningitis; bacterial infections are the second most common cause. Other, rarer causes of meningitis include fungi, parasites, and non-infectious causes, including those that are related to drugs. (For more information, see What causes viral meningitis?.) Meningitis caused by viral infections is sometimes called "aseptic meningitis."

Is viral meningitis a serious disease?

Viral ("aseptic") meningitis is serious but rarely fatal in people with normal immune systems. Usually, the symptoms last from 7 to 10 days and the patient recovers completely. Bacterial meningitis, on the other hand, can be very serious and result in disability or death if not treated promptly. Often, the symptoms of viral meningitis and bacterial meningitis are the same. For this reason, if you think you or your child has meningitis, see your doctor as soon as possible.

What causes viral meningitis?

Different viral infections can lead to viral meningitis. But most cases in the United States, particularly during the summer and fall months, are caused by enteroviruses (which include enteroviruses, coxsackieviruses, and echoviruses). Most people who are infected with enteroviruses either have no symptoms or only get a cold, rash, or mouth sores with low-grade fever. And, only a small number of people with enterovirus infections develop meningitis.

Other viral infections that can lead to meningitis include mumps, herpesvirus (such as Epstein-Barr virus, herpes simplex viruses, and varicella-zoster virus—the cause of chickenpox and shingles), measles, and influenza.

Arboviruses, which mosquitoes and other insects spread, can also cause infections that can lead to viral meningitis. And lymphocytic choriomeningitis virus, which is spread by rodents, is a rare cause of viral meningitis.

What are the signs and symptoms of viral meningitis?

Symptoms can appear quickly or they can also take several days to appear, usually after a cold or runny nose, diarrhea, vomiting, or other signs of infection show up. Symptoms in adults may differ from those in children:

• Common in infants
  • Fever
  • Irritability
  • Poor eating
  • Hard to awaken
• Common in older children and adults
  • High fever
  • Severe headache
  • Stiff neck
  • Sensitivity to bright light
  • Sleepiness or trouble waking up
  • Nausea, vomiting
  • Lack of appetite

How is viral meningitis diagnosed?

Viral meningitis is usually diagnosed by laboratory tests of a patient’s spinal fluid (from a "spinal tap"). The test can reveal whether the patient is infected with a virus or a bacterium. The exact cause of viral meningitis can sometimes be found through tests that show which virus has infected a patient; however, identifying the exact virus causing meningitis may be difficult.

Because the symptoms of viral meningitis are similar to those of bacterial meningitis, which is usually more severe and can be fatal, it is important for people suspected of having meningitis to seek medical careas soon as possible. A hospital stay may be necessary in more severe cases or for people with weak immune systems.

How is viral meningitis treated?

There is no specific treatment for viral meningitis. Most patients completely recover on their own within 2 weeks. Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. Doctors often will recommend bed rest, plenty of fluids, and medicine to relieve fever and headache. A hospital stay may be necessary in more severe cases or for people with weak immune systems.

How is the virus spread?

Different viruses that cause viral meningitis are spread in different ways. Enteroviruses, the most common cause of viral meningitis, are most often spread through direct contact with an infected person’s stool. The virus is spread through this route mainly among small children who are not yet toilet trained. It can also be spread this way to adults changing the diapers of an infected infant.

Enteroviruses and other viruses (such as mumps and varicella-zoster virus) can also be spread through direct or indirect contact with respiratory secretions (saliva, sputum, or nasal mucus) of an infected person. This usually happens through kissing or shaking hands with an infected person or by touching something they have handled and then rubbing your own nose or mouth. The viruses can also stay on surfaces for days and can be transferred from objects. Viruses also can spread directly when infected people cough or sneeze and send droplets containing the virus into the air we breathe.

The time from when a person is infected until they develop symtoms (incubation period) is usually between 3 and 7 days for enteroviruses. An infected person is usually contagious from the time they develop symptoms until the symptoms go away. Young children and people with low immune systems may spread the infection even after symptoms have resolved.

Can I get viral meningitis if I’m around someone who has it?

If you are around someone with viral meningitis, you may be at risk of becoming infected with the virus that made them sick. But you have only a small chance of developing meningitis as a complication of the illness.

How can I reduce my chances of becoming infected with viruses that can lead to viral meningitis?

Viral meningitis most commonly results from infection with enteroviruses. But there are other causes, such as measles, mumps, and chickenpox. Viral meningitis can also be caused by viruses that are spread by mosquitoes and other insects that bite people.

The specific measures for preventing or reducing your risk for viral meningitis depend on the cause.

• Following good hygiene practices can reduce the spread of viruses, such as enteroviruses, herpesviruses, and measles and mumps viruses. Preventing the spread of virus can be difficult, especially since sometimes people are infected with a virus (like an enterovirus) but do not appear sick. In such cases, infected people can still spread the virus to others. Thus, it is important to always practice good hygiene to help reduce your chances of becoming infected with a virus or of passing one on to someone else:
  • Wash your hands thoroughly and often (see CDC’s Clean Hands Save Lives! web site). This is especially important after changing diapers, using the toilet, or coughing or blowing your nose in a tissue. For more information on hand washing, see the video Put Your Hands Together, listen to the podcast Put Your Hands Together.
  • Cleaning contaminated surfaces, such as handles and doorknobs or the TV remote control, with soap and water and then disinfecting them with a dilute solution of chlorine-containing bleach may decrease the spread of viruses. This solution can be made by mixing ¼ cup of bleach with 1 gallon (16 cups) of water. (See more about cleaning and disinfecting in general in CDC's Prevention Resources).
  • Cover your cough. The viruses that cause viral meningitis can be spread by direct and indirect contact with respiratory secretions, so it is important to cover your cough with a tissue or, if you do not have a tissue, to cough into your upper arm. After using a tissue, place it in the trash and wash your hands.
  • Avoid kissing or sharing a drinking glass, eating utensil, lipstick, or other such items with sick people or with others when you are sick.
• Receiving vaccinations included in the childhood vaccination schedule can protect children against some diseases that can lead to viral meningitis. These include vaccines against measles and mumps (the MMR vaccine) and chickenpox (the varicella-zoster vaccine).
• Avoiding bites from mosquitoes and other insects that carry diseases that can infect humans may help reduce your risk for viral meningitis (see West Nile Virus, Fight the Bite!).
• If you have a rodent infestation in and around your home, follow the cleaning and control precautions listed on CDC’s Web site about lymphocytic choriomeningitis.

If you have any further questions, please contact your healthcare provider. 

For additional information on vaccine recommendations visit the DOH's Vaccine Preventable Disease website.

For information from the Centers for Disease Control and Prevention (CDC) visit: https://www.cdc.gov/meningitis/index.html.