What Is Herpes Meningitis?

Herpes meningitis is a form of meningitis caused by the herpes virus. Meningitis is inflammation of the meninges, which are the protective membranes around the brain and spinal cord. This viral infection prompts flu-like symptoms, such as a headache, fever, and stiff neck.

While herpes meningitis often clears up on its own without medical treatment, it can sometimes lead to severe illness, particularly for babies and people who have weakened immune systems.

This article provides an overview of symptoms and treatment options for herpes meningitis as well as tips on preventing viral meningitis.

What Causes Herpes Meningitis?

Herpes meningitis is a viral meningitis, which means that the meningitis is caused by a virus.

A person may develop herpes meningitis if they’ve contracted a herpes virus, including:

• Herpes simplex virus 1 (HSV-1), which primarily causes cold sores 
• Herpes simplex virus 2 (HSV-2), which is usually responsible for genital herpes
• Varicella-zoster virus (VZV), the virus that causes chickenpox and shingles
• Epstein-Barr virus (EBV), a common virus that causes mononucleosis and other illnesses

The viruses that cause herpes meningitis enter the body through your skin, where they can travel through the central nervous system (CNS) and potentially cause problems in other parts of the body, like the tissues surrounding the CNS.

Once a herpes virus is in your system, it's possible to get herpes meningitis at any time. That's because the virus stays in your body for life and goes through periods of inactivity (in which there are no symptoms) and flare-ups (when symptoms are present).

Herpes Meningitis Symptoms

Symptoms of mild cases of herpes meningitis are similar to those of the flu or other viral infections. The most common symptoms are headache, fever, and stiff neck.

Other symptoms include:

• Nausea
• Vomiting
• Loss of appetite
• Fatigue or lack of energy
• Sleepiness
• Irritability
• Sensitivity to light

Is Herpes Meningitis Contagious?

Herpes meningitis by itself is not contagious, but the viruses that cause it are.

The viruses that cause herpes meningitis are transmitted through close contact with another person or their bodily fluids, such as saliva, urine, blood, genital fluids, or breast milk.

For example, a person who is infected with a virus that causes herpes meningitis can transfer it to another person by:

• Coughing or sneezing
• Kissing or touching
• Unprotected sexual contact
• Sharing personal products, like a razor or toothbrush
• Contact with contaminated surfaces
  

Keep in mind that just because you've contracted one of the common herpes viruses doesn't automatically mean you will develop herpes meningitis as a complication. Older research found that 36% of women and 13% of men with HSV-2 reported developing herpes meningitis.

Diagnosis

Herpes meningitis needs to be diagnosed by a healthcare provider. They’ll first review your vital signs, symptoms, and medical history before checking for the presence of a herpes virus.

The following tests may be used to help confirm herpes meningitis:

• Blood tests
• Throat or nasal swab
• Spinal tap to take a sample of cerebrospinal fluid that surrounds the brain and spinal cord

Treatment

Potential treatment for herpes meningitis will depend on your individual case and how severe it is.

Most mild cases of herpes meningitis will resolve on their own without any medical treatment, usually within seven to 10 days. If you’re recovering at home, your healthcare provider will likely advise you to take it easy by:

• Staying hydrated and drinking plenty of fluids
• Getting enough rest and sleep
• Taking over-the-counter (OTC) medications to help with pain or fever

People with a moderate to severe case of herpes meningitis—particularly babies, the elderly, and those who are immunocompromised—may need to be treated with medication and monitoring in a hospital setting.

This typically includes:

• An antiviral medication known as Zovirax (acyclovir) to help clear the infection
• Prescription medications to ease headache, fever, or nausea symptoms

Prevention

To help prevent herpes meningitis, experts recommend taking steps to avoid getting infected with herpes viruses in the first place.

This includes precautions such as:

• Washing your hands regularly
• Avoiding kissing or touching someone who has an active herpes virus infection
• Engaging in safer sex practices
• Keeping surfaces clean and disinfected

There are vaccines available to prevent some of the viruses that lead to herpes meningitis. For example, the shingles (herpes zoster) vaccine (Shingrix) for adults over the age of 50 and the chickenpox (varicella) vaccine recommended in early childhood can help protect against the varicella-zoster virus (VZV).

There are no approved vaccines to protect against Epstein-Barr (EBV) or HSV infections, though researchers have been working to develop them.

Complications

Most healthy adults will fully recover from a mild herpes meningitis case and not notice any further complications.

More severe herpes meningitis cases can sometimes lead to long-term effects, including:

• Fatigue
• Headaches
• Cognitive issues
• Hearing changes
• Seizures
• Meningoencephalitis (infection of both the brain and surrounding tissue)

Summary

Herpes meningitis is a form of viral meningitis, which is inflammation of the protective tissue around the brain and spinal cord. It can happen after infection with a herpes virus, including herpes simplex virus 1 and 2, varicella-zoster virus, and Epstein-Barr virus. Common symptoms include headache, fever, and neck pain.

For most people, herpes meningitis cases are mild with full recovery after seven to 10 days. More severe herpes meningitis cases—particularly in babies or people with a weaker immune system—may require medical treatment with antiviral medications or a hospital stay.

A Word From Verywell

Getting a herpes meningitis diagnosis may feel scary, but be assured that most healthy adults can safely recover from the infection. Herpes viruses are widespread, and everyone is at risk of contracting one. That doesn't necessarily mean it will turn into herpes meningitis, though. Do the best you can to practice healthy hygiene habits by avoiding contact with others when you're experiencing illness symptoms, keeping surfaces disinfected, and seeking medical care when necessary.