Five students of a private school at Kalamassery in Ernakulam district of Kerala have sought medical treatment after showing symptoms of viral meningitis. The condition of the children remains stable, according to the district health authorities. The samples have been sent to the National Institute of Virology, Alappuzha, for testing, they said.
Here’s an explainer on the infection:
What is meningitis?
The meninges are protective membranes that cover the brain and spinal cord. When these membranes become inflamed, the condition is called meningitis. Meningitis can be caused by infections of bacterial, viral, or fungal origin.
Is viral meningitis serious?
Viral meningitis is generally less severe than bacterial meningitis and commonly resolves without complications.
However, bacterial meningitis is a medical emergency requiring immediate diagnosis and antibiotic treatment. If treated early, bacterial meningitis has good outcomes. However, delays in diagnosis can lead to severe complications such as hearing loss, cognitive impairment, neurological issues, or even death.
A related but distinct condition is encephalitis, which occurs when the brain tissue itself becomes inflamed due to an infection. Patients with encephalitis may experience seizures, confusion, disorientation, and even loss of consciousness. Examples of viral causes include Japanese encephalitis, Nipah virus infection, and rabies. Unlike viral meningitis, encephalitis carries a higher risk of severe complications, including long-term neurological damage or death, and full recovery is less common.
What are the symptoms of viral meningitis?
The symptoms of viral meningitis include fever, headache, nausea or vomiting, discomfort while looking at light (photophobia)
In young children, symptoms may be less specific and include irritability, poor feeding, or lethargy.
How is viral meningitis diagnosed?
Early suspicion and testing are crucial for diagnosis. A lumbar puncture (spinal tap) is performed to collect cerebrospinal fluid (CSF), which surrounds the brain and spinal cord. CSF analysis helps distinguish between viral, bacterial, or other causes of meningitis. If viral meningitis is suspected, specific viruses can be identified using RT-PCR (reverse transcription polymerase chain reaction), which detects viral genetic material.
What is the treatment for viral meningitis?
The treatment of viral meningitis is supportive. Because it is caused by viruses and not by bacteria, antibiotics are not necessary. Close observation, pain relief, fluid management and attention to nutrition are essential. Most cases of viral meningitis resolve on their own within a week or two.
What are the chances of recovery?
Nearly all cases of viral meningitis recover fully without long-term effects. In contrast, bacterial meningitis can occasionally lead to complications such as hearing loss, cognitive impairment, and neurological problems. Some cases can be fatal if untreated.
What causes viral meningitis?
Many viruses can cause meningitis. The most common are enteroviruses, responsible for over 85% of cases. Other causes include
1. Herpes simplex virus (HSV-1 and HSV-2)
2. Varicella-zoster virus (VZV, chickenpox virus)
3. Mumps virus
4. Cytomegalovirus (CMV)
Can enteroviruses cause encephalitis?
Although viral meningitis is more common, rarely some enteroviruses such as EV-71 can result in encephalitis.
How do enteroviruses spread?
Enteroviruses enter the body through the mouth or respiratory tract, reach the intestines, then enter the bloodstream and spread to the meninges.
Transmission occurs through:
1. Direct contact (person-to-person, especially in crowded places)
2. Fecal-oral contamination (via contaminated food, water, or surfaces)
Are enteroviruses difficult to get rid of?
Yes, being a non-enveloped virus, the enterovirus is relatively hard to destroy, and in particular alcohol-based sanitisers are not effective. It can survive outside the human body in water or on surfaces for weeks. Bleach is an effective cleaning agent. By boiling water, the virus is destroyed.
How can the spread of viral meningitis be prevented?
1. Sick children should stay home to prevent spreading infections like enteroviruses, chickenpox, mumps, influenza, and COVID-19.
2. Frequent handwashing with soap helps remove viruses from the skin.
3. Avoid sharing personal items such as water bottles and utensils.
4. Cough etiquette: Sneezing or coughing into a bent elbow or tissue prevents virus-laden droplets from spreading in the air.
5. Cleaning high-touch surfaces (e.g., doorknobs, railings, tables) with disinfectants like bleach can reduce viral transmission.
6. Safe food and clean water minimize the risk of initial infection.
Are vaccines effective in preventing meningitis?
Effective vaccines are available against the two most common bacteria that cause meningitis, the pneumococcus and meningococcus. Vaccination against mumps and chickenpox prevents infection by these two viruses, which are known to occasionally cause meningitis.
Summary
While viral meningitis is usually mild and self-limiting, early diagnosis remains essential to rule out bacterial causes and ensure proper management. Preventive measures, particularly hygiene and sanitation, play a key role in reducing its spread.
(Rajeev Jayadevan is Convener, Research Cell, Kerala State IMA)
Published – March 12, 2025 08:38 pm IST