WHAT IS IT? Meningitis is an infection of the covering of the brain and spinal cord.  It can be caused by viruses, bacteria, parasites, or fungi.  It is relatively rare, but the symptoms can be severe.  Symptoms include headache, stiff neck, irritability, fever, vomiting, and listlessness.  Infants may have a high-pitched cry, bulging fontanelle (soft spot) on top of the head.  meningitis can also cause seizures, deafness, learning disabilities, and death.

HOW IS IT SPREAD? Meningitis can be spread by contact with mucus from the nose or saliva.  It can spread by coughing and sneezing, kissing on the lips and sharing food, eating utensils and mouthed toys.  It is also spread by touching your hands to your nose and mouth, reusing tissues, and forgetting to wash your hands after blowing noses.  It spreads most easily in crowded, poorly ventilated rooms.  Meningitis can also be spread when stool gets onto hands, objects, surfaces, food, water and then gets into another person's mouth.  It can spread in infant and toddler child care from not washing hands well after diapering and toileting, and before food preparation.

Children under 5 years of age who have not been immunized against haemophilus influenza B (HIB) are susceptible to HIB meningitis.

WHEN IS IT CONTAGIOUS? The contagious period can vary depending upon the cause of the meningitis.  Meningitis may be contagious from 1 to 2 weeks before the start of symptoms until months after the illness.  For bacterial meningitis, the person is not contagious after 24-48 hours of effective antibiotic treatment.  After exposure, another person may develop meningitis from a couple days to several weeks later, depending upon the specific infection.

Symptoms can appear about 3 to 4 days after contacting the germs.

HOW IS IT DIAGNOSED AND TREATED?  Meningitis is diagnosed by a medical exam and spinal tap.  In most cases of viral meningitis, there is no special treatment.  The person usually gets better within 1-2 weeks with rest, nutrition, and plenty of fluids.  Acetaminophen may help relieve symptoms of headache and fever.

Hospitalization and intravenous antibiotic treatment are necessary when symptoms of viral meningitis are severe or when the meningitis is caused by bacteria, parasites or fungi.  Close follow-up is important to diagnose and treat any disabilities that might result (e.g., hearing/speech, learning, and movement disorders).

For people in child care and at home who have been recently exposed to meningitis caused by HIB or meningococcus, they may be treated with antibiotics to prevent the illness.

SHOULD THE CHILD STAY HOME?  A child with meningitis should stay home until the symptoms are resolved and s/he is well enough to participate and the health provider determines that the illness is no longer contagious.

HOW CAN WE LIMIT THE SPREAD?

• All children under age 5 should be immunized against haemophilus influenza B (HIB).  Immunization should begin a 2 months of age.
• Report cases of meningitis to the local health department.  They will determine who has been exposed and infected, how the disease has spread, who needs to be sent home and treated, and other measures to stop the spread of the disease.
• Cough and sneeze into your elbow and away from people.  If you cough or sneeze into your hand or a tissue, wash your hands afterwards.
• Wipe runny noses with a clean tissue, throw the tissue away, then wash your hands.
• Don't share food, pacifiers, bottles or drinking cups.  Wash eating utensils and cups well between uses.
• Clean and disinfect mouthed toys and dining tables after each use.  Clean and disinfect water fountains, telephone receivers, and other frequently handled items daily.
• Discourage nose picking.  Try to limit touching the eyes, nose and mouth.
• Don't kiss children on the mouth - hug them and kiss them on the forehead instead.
• Wash hands well after diapering and toileting, and before cooking and eating.
• Clean and disinfect diapering areas, mouthed toys, and dining tables after each use.  Clean and disinfect toileting areas, hand washing sinks, and telephone receivers daily.
• Use sprinklers instead of wading pools.  Use individual water play basins instead of water play tables.

More sites:
American Academy of Pediatrics  (scroll down to the heading Meningitis)
http://www.aap.org/policy/re9709.html

Center for Disease Control
http://www.cdc.gov/ncidod/dbmd/diseaseinfo/meningococcal_g.htm

National Institute of Health  http://search.nih.gov/s97is.

Child Care Health Program  Exposure Notice  http://ericps.crc.uiuc.edu/cchp/factshet/exposure-dis.html
 

Information provided on this page is not intended to provide medical advice or take the place of medical treatment.  The recommendations do not indicate a course of treatment or medical care.

These are guidelines to develop policies and procedures for preventing, recognizing and managing communicable disease in child care.  If the children in your care have been exposed to this disease, you may copy this exposure notice and hand out to your day care parents.

This Exposure Notice has been copied from "Keeping Kids Healthy, Preventing and Managing Communicable Disease in Child Care", a project of the The Center for Health Training funded by the California Department of Education, Child Development Division.