Viral Meningitis

What is viral meningitis?

Viral meningitis is an inflammation of your meninges specifically caused by a viral infection. Your meninges are the areas surrounding your brain and spinal cord.

Viral meningitis is more common in young children than adults. It’s also called aseptic meningitis.

What’s the difference between viral meningitis and bacterial meningitis?

Viral meningitis and bacterial meningitis both cause inflammation of your meninges, but different infectious agents (germs) cause them. Viral meningitis usually resolves on its own. Bacterial meningitis can be fatal. There’s no way to know the difference without being evaluated by a healthcare provider. Go to the ER or seek emergency medical attention right away if you think you have meningitis.

What are the symptoms of viral meningitis?

Symptoms of viral meningitis can come on suddenly and include:

• Fever.
• Chills.
• Headache.
• Neck stiffness.
• Nausea or vomiting.
• Sensitivity to light (photophobia).
• Lack of appetite.
• Difficulty focusing.
• Double vision.

Sometimes, but not always, you’ll have symptoms of a viral infection (like a runny nose, cough, body aches or rash) before meningitis symptoms start.

Viral meningitis signs in infants

It can be hard to tell if a baby or young child has symptoms of viral meningitis. Some signs you can look for include:

• Fever.
• Vomiting.
• Bulging “soft spot” (fontanelle) on baby’s head.
• Irritability.
• Eating less.
• Sleepiness or trouble waking up from sleep.
• Low energy or slower responses (lethargy).

What causes viral meningitis?

Viruses that can cause meningitis include:

• Non-polio enteroviruses (like those that cause hand, foot and mouth disease).
• Herpes simplex virus.
• Epstein-Barr virus, which also causes mononucleosis.
• Varicella zoster virus, which can also cause chickenpox and shingles.
• Mumps.
• Measles.
• Arboviruses, such as West Nile virus and Zika virus.
• HIV.
• Influenza viruses, which cause the flu.
• Lymphocytic choriomeningitis virus (LCMV).

How do you get viral meningitis?

The kinds of viruses that cause viral meningitis usually spread from person to person. This can be through:

• Coughing.
• Sneezing.
• Close contact.
• Sharing food or personal items.
• Touching contaminated surfaces.

Some causes of viral meningitis you get through the bite of an infected mosquito.

Is viral meningitis contagious?

The viruses that cause meningitis are contagious. But most of the time, they don’t lead to meningitis. Instead, they cause other illnesses. For instance, influenza viruses are much more likely to cause respiratory illnesses than meningitis.

What are the risk factors for viral meningitis?

Anyone can get viral meningitis, but you’re at higher risk if you:

• Are younger than 5.
• Have a weakened immune system. You might have a weakened immune system if you have certain conditions (like autoimmune disorders, HIV or cancer) or if you’re on medications that suppress your immune system.
• Live in a group setting, like in a college dorm.

What are the complications of viral meningitis?

Viral meningitis is less likely to cause complications than bacterial meningitis. But there’s still a risk of serious short- and long-term effects, especially in young children, including:

• Vision loss.
• Hearing loss.
• Trouble with memory and concentration.
• Movement and balance issues.
• Learning difficulties.

How is viral meningitis diagnosed?

Healthcare providers diagnose viral meningitis with a neurological exam and by testing your cerebrospinal fluid (the fluid that surrounds your brain and spine). They may also get a blood or poop (stool) sample, swab your nose or throat or get imaging of your brain.

Specific tests

Some tests your healthcare provider may use to diagnose viral meningitis include:

• Lumbar puncture/spinal tap.
• Blood tests.
• Nasal or throat swab. Your provider swabs your nose or throat to get a sample of mucus. A lab will test your sample to look for viruses or other infections.
• Imaging. Your healthcare provider may use a CT scan (computed tomography scan) or MRI (magnetic resonance imaging) to take pictures of your brain. They’ll look for inflammation and other changes caused by meningitis.
• Stool sample. Sometimes, your provider may have you provide a sample of your poop (stool). A lab will test your sample to look for viruses or other infections.

How is viral meningitis treated?

How your provider treats viral meningitis depends on which virus is causing it. Antiviral medications are available for a few of the viruses that cause meningitis. Your provider may also use medications to reduce swelling or to treat symptoms like pain or dehydration.

Specific medications and procedures

Medications and other treatments your provider might use to treat viral meningitis include:

• Antibiotics. Antibiotics can’t cure a viral infection, but your provider may start you on them while they investigate the cause of meningitis. This is because bacterial meningitis is usually more serious than viral meningitis and needs to be treated right away.
• Antivirals. Acyclovir can treat viral infections caused by herpes simplex and varicella zoster. Several antiviral medications can treat influenza.
• Corticosteroids. Medications like dexamethasone or prednisone reduce inflammation.
• Pain relievers.
• IV fluids.

Can viral meningitis be prevented?

Ways to reduce your risk of catching the viruses that can cause meningitis include:

• Getting vaccinated. Vaccinations are available for chickenpox, influenza, measles and mumps.
• Washing your hands frequently. Good hand-washing hygiene is especially important during cold and flu season, before eating and after going to the bathroom or changing diapers.
• Disinfecting frequently touched surfaces.
• Using a condom or dental dam during any kind of sex.
• Protecting yourself from bug bites. Wear protective clothing, use bug spray and sleep under mosquito netting if necessary.
• Avoiding being around other people if you’re sick. If you can’t avoid others, wearing a mask may help prevent the spread of disease. Don’t share personal items (like drinking glasses) with other people.
• Getting information before traveling. Learn how to reduce your risk of infectious diseases that are common in your destination.

What can I expect if I have viral meningitis?

Viral meningitis usually has a good prognosis (outlook). Depending on how sick you are, you might be treated at home or in the hospital. If you’re hospitalized, expect to stay at least a few days. Since there’s no specific cure for viral meningitis, providers will most likely treat you with supportive care that manages your symptoms.

How long does viral meningitis last?

Viral meningitis usually goes away on its own in a week or two. Some people can take weeks or longer to feel completely recovered.

When should I see my healthcare provider?

See a healthcare provider if you or your child has symptoms of viral meningitis. They’ll determine how serious your condition is and whether they need to treat you with antibiotics.

When should I go to the ER?

Go to the emergency room if you have signs of serious illness, including:

• Severe neck pain or stiffness — you can’t turn your head or tuck your chin toward your chest.
• Severe headache.
• Double vision.
• Confusion or other mental changes.

What questions should I ask my doctor?

It might be helpful to ask a healthcare provider:

• What are my treatment options?
• How can I manage my symptoms?
• When should I follow up with you or another provider?
• What signs and symptoms should prompt me to go to the ER?
• Am I contagious to others?

A note from Cleveland Clinic

Viral meningitis might sound scary, but it’s a less serious form of meningitis that usually goes away on its own. However, other forms of meningitis can be very serious and there’s no way to know the cause without seeing a provider. Go to the emergency room right away if you have a severe stiff neck or headache, double vision, confusion or mental changes.