Suggest treatment for viral meningitis and precautionary measures for family members

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Posted on Mon, 8 Jun 2015 in Brain and Spine
Question: my 14 year old son was diagnosed with viral meningitis. what risk and precautions should I take with our 2 other sons (18 and 9)? My wife is thinking the worst. can I alleviate her concerns? is this more significant than any other virus?
doctor
Answered by Dr. Olsi Taka 42 minutes later
Brief Answer:
Only observation.

Detailed Answer:
I read your question carefully and I understand your concern.

Of course having been in contact with their brother there is the chance of them having contracted the virus. The good news is that even when having the virus it is rare to develop meningitis. Chances may vary according to the virus type, there are many viruses which can be responsible, perhaps cerebrospinal fluid tests can identify the virus. Outcome generally is better than bacterial meningitis.

They shouldn't stay in close contact but otherwise there is no special preventive measure. When the cause is bacterial, prophylactic antibiotics are given, but in viral cases only observation is recommended, unless they have some condition which supresses their immune system.

I remain at your disposal for further questions.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Olsi Taka 34 hours later
my wife and I are both showing some symptoms (burning head neck ache and slight nausea but no fever). it's uncomfortable but tolerable. assuming we have it as well, are we contagious since we don't have a fever?

also, the culture for my son is still negative (2 days). is it possible that he could ultimately have bacterial meningitis as well as viral? I believe they will watch it for 5 days.

thank you
doctor
Answered by Dr. Olsi Taka 13 hours later
Brief Answer:
Read below.

Detailed Answer:
If you have symptoms of headache and pain in the neck that certainly calls for medical attention. It would be atypical as fever is present in over 80% of cases with meningitis, but with the exposure history those symptoms can not be ignored. If you have it you are contagious, although in the absence of an identified virus it is difficult to assess the way it could spread.

However I think you should be evaluated. As I said before viral meningitis has a more benign course if the brain hasn't been involved and people who were in contact are rarely sick, but there being many possible viruses and different forms, if there is two of you being affected that would need particular attention as the virus would be particularly contagious. These are speculations though first the diagnosis should be confirmed by physical exam for meningeal signs and spinal tap, so I think you should report these symptoms to your doctors as soon as possible.

As for the possibility of it being bacterial, they are usually distinguished apart from the more serious condition in bacterial meningitis also from other characteristics of cerebrospinal fluid (mainly cell number and type, glucose and protein levels), not only from the culture (which should be done for bacteria as well). Also apart from cultures some viruses can be detected by PCR test. So it would be unlikely (though not impossible) for that to happen.

I hope to have been of help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Olsi Taka 32 hours later
How do we know when my son is no longer contagious?

Symptoms started early on the 16th. He was diagnosed late that night with viral meningitis. He hasn't needed meds for fever or head aches - going on 13 hours.

What is the protocol for this?
doctor
Answered by Dr. Olsi Taka 58 minutes later
Brief Answer:
Read below.

Detailed Answer:
Hello again. I wish you could have said something about how you and your wife are doing. Hopefully that means you turned out to be fine after all.

Regarding how long your son is contagious, to answer that question is difficult because as I told you viral meningitis can be caused by different types of viruses, with different characteristics and routes of infections, so you can't know for sure when he will be no longer contagious. He might not be contagious at all in some cases when the route of infection has been through some insect bite. In one third of the cases with viral meningitis the responsible virus can't be identified at all even after extensive testing.
Viral meningitis is very rarely transmitted even if contacted the virus, that's why no special preventive measures apart from common ones like washing hands or avoiding saliva exchange is recommended, so if you and your wife are well now, I don't think you should worry so much about that.

There is no particular protocol, since there is no specific treatment, management is simply supportive as needed, patient is simply observed, kept hydrated with medication for fever when necessary. When there are complications like seizures, brain involvement etc they will be treated accordingly but this doesn't seem to be your son's case. The course of viral meningitis is benign, usually patients recover in 7-10 days and apparently your son is fitting into that time frame since he's feeling well, with no fever or headache, most probably in a few days this episode will be behind you.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Olsi Taka

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Practicing since :2004

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