Viral meningitis on the rise in Washoe County

Health officials and CDC investigate regional spike in reported viral meningitis cases

An unusually high number of viral/aseptic meningitis cases have health officials in Washoe County concerned, particularly since the outbreak coincides with a similar outbreak of viral meningitis in Susanville, CA.  A rare disease, meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord. A bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling. However, injuries, cancer, certain drugs, and other types of infections also can cause meningitis. It is important to know the specific cause of meningitis because the treatment differs depending on the cause. According to official reports, over thirty cases of viral meningitis have been reported in Washoe County in 2017, with 27 cases reported just since July 15.

The meningitis case count in Susanville prompted closure of Lassen High School and Lassen Community College by officials in order to prevent further spread. In Washoe County 12 of the 27 cases of meningitis are among school students; however, closure of Washoe County schools is not anticipated at this time due to the fact that no single school has more than two cases. “We are seeing a pretty broad distribution of this rare disease throughout the county, not only in area but also in age, sex, race, and ethnicity, ” said Dr. Randall Todd, Director of Washoe County Health District’s Epidemiology Division. “The youngest case has been less than one-year old, with the oldest being 81. The median age is 13 years-old.” In Washoe County, ten cases were laboratory-confirmed with enterovirus, a common cause of viral meningitis.

According to Todd the Health District is working with California health officials and the Centers for Disease Control and Prevention (CDC) to determine if there is a connection between the two outbreaks. Additional laboratory tests are underway to investigate this epidemiological link.  “We will investigate this outbreak event to the best of our ability in order to protect the public health,” said Todd. “ We do know that while uncomfortable and worrisome, it is fortunate that all of our cases are the least dangerous type of meningitis. Most of those cases were hospitalized for an average two days and have recovered. We will continue to monitor their progress and hopefully determine how this outbreak started and how to prevent a similar incident in the future.”

Viral meningitis is the most common type of meningitis, an inflammation of the tissue that covers the brain and spinal cord. It is often less severe than bacterial meningitis, and most people get better on their own (without treatment). However, it is very important for anyone with symptoms of meningitis to see a healthcare provider right away because some types of meningitis can be very serious, and only a doctor can determine if you have the disease, the type of meningitis, and the best treatment, which can sometimes be lifesaving. Babies younger than 1 month old and people with weakened immune systems are more likely to have severe illness from viral meningitis.  Healthcare providers seeing patients with viral meningitis are highly encouraged to order laboratory tests for enterovirus and, depending on mosquito bite exposure history, to also order tests for West Nile Virus. 

Symptoms

Common meningitis symptoms in babies include: fever, irritability poor eating, sleepiness or trouble waking up from sleep, and lethargy (a lack of energy). Common symptoms in adults can include: fever, headache, stiff neck, sensitivity to bright light, sleepiness or trouble waking up from sleep, nausea, vomiting, lack of appetite, and lethargy (a lack of energy). Most people with viral meningitis usually get better on their own within 7 to 10 days.  If you think your baby or child has any of these symptoms, call the doctor right away. 

Treatment

In most cases, there is no specific treatment for viral meningitis. Most people who get viral meningitis completely recover on their own within 7 to 10 days. However, people with meningitis caused by certain viruses such as herpesvirus and influenza, will usually need and get better if treated with an antiviral medicine. 

Antibiotics do not help viral infections, so they are not useful in the treatment of viral meningitis. However, antibiotics do fight bacteria, so they are very important when treating bacterial meningitis. 

People who develop severe illness, or who are at risk for developing severe illness, such as babies and people with weakened immune systems, may need to be hospitalized. 

Transmission

Direct contact with ill persons or contaminated environmental surface is the primary route for disease spread. You can get exposed to the virus by:

• Having close contact, such as touching or shaking hands, with an infected person,
• Touching objects or surfaces that have the virus on them, then touching your eyes, nose, or mouth before washing your hands,
• Changing diapers of an infected person, then touching your eyes, nose, or mouth before washing your hands, or
• Drinking water that has the virus in it.  

Prevention

There are no vaccines to protect against non-polio enteroviruses, which are the most common cause of viral meningitis. You can take the following steps to help lower your chances of getting infected with non-polio enteroviruses or spreading them to other people:

• Wash your hands often with soap and water, especially after changing diapers, using the toilet, or coughing or blowing your nose.
• Avoid touching your face with unwashed hands.
• Avoid close contact such as kissing, hugging, or sharing cups or eating utensils with people who are sick.
• Cover your coughs and sneezes with a tissue or your upper shirt sleeve, not your hands.
• Clean and disinfect frequently touched surfaces, such as toys and doorknobs, especially if someone is sick.
• Stay home when you are sick.

Washoe County Health District highly recommends organizations that host group activities for children conduct a deep environmental cleaning using a bleach solution (1/2 cup of bleach to 1 gallon of water). Environmental surfaces should include frequently-touched areas such as doorknobs, rails, light switches, desks, keyboards, computer mice, phones, toys, playground equipment, bathrooms, etc. The following groups should consider performing a deep cleaning:

• Households with any ill person recently diagnosed with viral meningitis
• Community sports clubs
• Daycare facilities
• Group home daycare
• Public museum for children
• Play grounds for children
• Any other facilities which host activities for children (e.g., church, etc.) 

Some vaccinations can protect against diseases such as measles, mumps, chickenpox, and influenza that can lead to viral meningitis. Make sure you and your child are vaccinated on schedule.