More viral meningitis cases reported in Washoe County

Good hygiene, environmental cleaning and exclusion encouraged by health officials

The unusually high number of viral meningitis cases recently recorded in Susanville, CA and in Washoe County, NV continues to rise according to health officials. Of specific concern is the large percentage of cases in one particular age group, children age 5 to 17 years-old. Since July 15, 2017 the 5 to17 year-old age group makes up over 53% of the locally-reported cases of meningitis, an inflammation of the tissue that covers the brain and spinal cord, which can have serious health implications.

“While we continue to investigate this outbreak with our public health partners in California and at the Centers for Disease Control and Prevention (CDC), we need to stress the importance of good hygiene, environmental cleaning, and personal exclusion in slowing down the spread of the virus,” said Washoe County Health District Epidemiologist Dr. Randall Todd. “Because this outbreak is so widespread throughout the area in a specific age group that may not practice the best hygiene habits, our prevention message needs to be community-wide and needs to stress some key points.” Todd referenced basic measures that need to be practiced by everyone to reduce the chances of contracting viral meningitis:

• 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 common playing areas for children such as inflatable bounce houses and slides;
• Avoid close contact such as kissing, hugging, or sharing cups, water bottles, sports drinks or eating utensils with others who may be 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 doorknobs, handrails, light switches, desks, keyboards, computer mice, phones, toys, playground equipment, bathrooms, etc.; and,
• Always stay home when you are sick. 

In addition to these steps the Washoe County Health District highly recommends organizations that host group activities for children conduct deep environmental cleanings using a bleach solution (1/2 cup of bleach to 1 gallon of water) or other disinfectants proven to be effective against enterovirus, one of common causes for viral meningitis. Environmental surfaces should include frequently-touched areas such as doorknobs, handrails, 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 and social clubs that involve children;
• Daycare facilities, group homes, and extended care facilities;
• Public museums, especially those for children; and,
• Organizations and businesses with recreational equipment, play grounds and other activities for children (e.g., churches, after school programs, etc.). 

While viral meningitis is rare enough to be a disease reportable to health officials and the CDC, 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.  

For more information on viral meningitis visit www.cdc.gov/meningitis/viral.html.