Viral Meningitis

Recent reports from Kalamassery, Kerala, indicate that five students have shown symptoms of viral meningitis. Health authorities confirm their condition is stable. This situation marks the importance of understanding viral meningitis, its causes, symptoms, and preventive measures.

What Is Meningitis?

Meningitis is the inflammation of the protective membranes covering the brain and spinal cord, known as the meninges. It can be caused by viral, bacterial, or fungal infections. Viral meningitis is the most common form and is generally less severe than bacterial meningitis.

Severity of Viral Meningitis

Viral meningitis typically resolves without complications. In contrast, bacterial meningitis is a medical emergency that requires immediate treatment. Delays in treatment can lead to serious complications, including hearing loss and cognitive impairment.

Symptoms of Viral Meningitis

Common symptoms include fever, headache, nausea, vomiting, and sensitivity to light (photophobia). In young children, symptoms may be less specific, such as irritability and poor feeding.

Diagnosis of Viral Meningitis

Diagnosis involves early suspicion and testing. A lumbar puncture is performed to collect cerebrospinal fluid (CSF). This fluid is analysed to identify the cause of meningitis. RT-PCR can detect specific viral genetic material if viral meningitis is suspected.

Treatment of Viral Meningitis

Treatment is primarily supportive. Antibiotics are not effective against viral infections. Management includes pain relief, fluid support, and nutritional care. Most cases resolve within one to two weeks.

Recovery Chances

Recovery from viral meningitis is typically complete, with nearly all patients experiencing no long-term effects. This contrasts sharply with bacterial meningitis, which can lead to severe complications or even death if untreated.

Causes of Viral Meningitis

Enteroviruses are the most common cause, responsible for over 85% of cases. Other viruses include Herpes simplex, Varicella-zoster, Mumps, and Cytomegalovirus. Some enteroviruses can also cause encephalitis, a more severe condition.

Transmission of Enteroviruses

Enteroviruses spread through the mouth or respiratory tract. They can be transmitted via direct contact or through contaminated food and surfaces. They are resilient and can survive outside the body for weeks.

Prevention of Viral Meningitis

Preventive measures include keeping sick children at home and practising frequent handwashing. Avoid sharing personal items and maintain proper cough etiquette. Regular cleaning of high-touch surfaces and ensuring safe food and water are also crucial.

Vaccination Against Meningitis

Vaccines are effective against the main bacterial causes of meningitis, including pneumococcus and meningococcus. Vaccination against mumps and chickenpox can prevent viral meningitis caused by these viruses.

Questions for UPSC:

1. Critically analyse the impact of viral infections on public health in India.
2. Explain the differences between viral and bacterial meningitis with suitable examples.
3. What are the preventive measures for enterovirus infections? How can they be effectively implemented in schools?
4. Comment on the role of vaccination in controlling viral diseases. What are the challenges faced in vaccination campaigns?

Answer Hints:

1. Critically analyse the impact of viral infections on public health in India.

1. Viral infections, including influenza and COVID-19, strain healthcare resources and increase morbidity and mortality rates.
2. Outbreaks can lead to economic losses due to decreased workforce productivity and increased healthcare costs.
3. Public health systems often face challenges in surveillance, response, and vaccination coverage.
4. Viral infections disproportionately affect vulnerable populations, including children and the elderly.
5. Education and awareness programs are essential for prevention and early detection of viral infections.

2. Explain the differences between viral and bacterial meningitis with suitable examples.

1. Viral meningitis is typically less severe and often resolves without treatment, while bacterial meningitis is a medical emergency requiring antibiotics.
2. Common viral causes include enteroviruses, while bacterial causes include Streptococcus pneumoniae and Neisseria meningitidis.
3. Symptoms may overlap, but bacterial meningitis often presents with more severe symptoms and rapid progression.
4. Diagnosis involves lumbar puncture, with CSF analysis revealing different markers for viral and bacterial infections.
5. Treatment for viral meningitis focuses on supportive care, whereas bacterial meningitis requires immediate antibiotic therapy.

3. What are the preventive measures for enterovirus infections? How can they be effectively implemented in schools?

1. Encourage frequent handwashing with soap and water, especially before meals and after using the restroom.
2. Implement policies for sick children to stay home to prevent outbreaks in schools.
3. Promote proper cough etiquette, such as sneezing into tissues or elbows.
4. Regularly disinfect high-touch surfaces like doorknobs, desks, and playground equipment.
5. Educate parents and staff on recognizing symptoms and the importance of vaccinations.

4. Comment on the role of vaccination in controlling viral diseases. What are the challenges faced in vaccination campaigns?

1. Vaccination reduces the incidence of viral diseases, including those causing meningitis, by building herd immunity.
2. Vaccines against mumps and chickenpox can prevent viral meningitis caused by these viruses.
3. Challenges include vaccine hesitancy, misinformation, and logistical issues in reaching remote populations.
4. Cold chain maintenance is crucial for vaccine efficacy, posing challenges in rural areas.
5. Public awareness campaigns are vital to encourage vaccination uptake and address community concerns.