Prevention of Meningitis

Your risk of meningitis can be substantially decreased by taking both practical and medical approaches. All of this, importantly, starts with vaccination, which can protect you from the most common causes. Keeping up good hygiene habits and limiting exposure to or the sharing of items with someone with meningitis are also essential, since most cases of meningitis are infectious.

The infections that cause meningitis are spread by coughing, sneezing, kissing, and touching contaminated objects. While it is impossible to completely avoid contact with contaminated fluids that are spread this way, you can try to avoid getting "sprayed" whenever possible. 

There are vaccines that can help prevent the most common causes of meningitis. Unfortunately, vaccines for certain causes of meningitis, such as E. coli and Staphylococcus aureus bacteria, are not available.

• Haemophilus influenzae type b (Hib) vaccine: The Hib vaccine protects young children against pneumonia, bacteremia (a blood infection), epiglottitis, and some other infections that are caused by the shot's namesake bacteria. Children routinely start getting the Hib vaccine when they are 2 months old, ending with a booster dose when they are 12 to 15 months old.
• Meningococcal vaccines prevent many Neisseria meningitides infections (see below).
• MenHibrix combines a vaccine for both Hib and meningococcal groups C and Y for certain high-risk infants who are at increased risk for meningococcal disease (see below).
• Pneumococcal (Prevnar) prevents many Streptococcus pneumoniae infections and is recommended for infants age 2, 4 and 6 months, and again at 12-15 months.
• Mumps vaccine: Two doses are recommended for children—one between12 to 15 months of age and another between ages 4 to 6. The mumps vaccine is given as part of the measles, mumps, rubella (MMR) vaccine or the measles, mumps, rubella, varicella (MMRV) vaccine. 

Meningococcal Vaccines

The meningococcal vaccines protect against several strains of Neisseria meningitidis bacteria, which can cause meningitis and meningococcemia, a life-threatening bloodstream infection. These quadrivalent vaccines protect against the meningococcal serogroups A, C, Y, and W-135. 

Meningococcal vaccines include:

• Menactra: MCV4 vaccine covering serogroups A, C, W, Y
• Menveo: MCV4 vaccine covering serogroups A, C, W, Y
• MenHibrix: Hib plus serogroups C and Y only
• Bexsero: MenB vaccine covering serogroup B only
• Trumenba: MenB vaccine covering serogroup B only

It is currently recommended that either Menactra or Menveo be given to all children at their routine visit when they are 11 or 12 years old. Teens should also get it when they start high school or if they are going to be living in a dorm at college and haven't gotten a meningococcal vaccine yet.

Most younger children will not get a meningococcal vaccine, but may if they are in a high-risk group. Ages at which these vaccines can be given, if needed, are:

• MenHibrix beginning at 6 weeks
• Menveo beginning at 2 months
• Menactra beginning at 9 months
• Bexsero or Trumenba beginning at 10 years

According to the CDC, Menactra or Menveo are also recommended for the following groups:

• People who might have been exposed to meningitis during an outbreak (MenB vaccines are also recommended)
• U.S. military recruits
• Anyone traveling to or living in a part of the world where meningococcal disease is common, such as parts of Africa
• Anyone who has a damaged spleen or whose spleen has been removed
• Anyone who has terminal complement component deficiency (an immune system disorder)
• Microbiologists who are routinely exposed to meningococcal bacteria

Like most vaccines currently given to children, Menactra, Menveo, Bexsero, and Trumenba are all free of thimerosal and other preservatives. Although there is no proven link between thimerosal, mercury, and autism, the fact that these new vaccines have no preservatives is likely welcome news to some parents.

The infectious organisms that cause meningitis are fairly common in the environment. You can take measures to reduce your chances of developing meningitis by avoiding these germs as much as possible. 

Infants, people who have a weak immune system, and the elderly are at a higher risk of developing meningitis and may have a worse disease course with more complications than others. If you are taking care of someone who is in one of these at-risk groups, attention to lifestyle aspects of prevention is particularly important. 

• Practice good hygiene: Habits and routines, such as hand washing and wiping counters, can help keep the infectious organisms that cause meningitis away. If you shake hands with many people in, say, a business setting, periodically washing up throughout the day is a worthy practice.
• Avoid close contact/sharing items: The infections that cause meningitis are contagious, but you don't necessarily need to be exposed to someone with meningitis to get it. For example, someone may have chickenpox and transmit it to you. While they may not develop meningitis, you may. If you are able to avoid becoming infected by avoiding co-workers who might be sick, encouraging your colleagues or friends of your children to stay home when they are sick, you can help reduce the spread of infections. 
• Choose your residence wisely: Close living quarters, such as in a college or military setting, can increase your chances of getting a meningitis infection. Living alone or changing your residence may not be realistic or desirable. That said, if you have an immune deficiency, it is worth thinking twice about living with large groups of people—especially if you have obvious alternatives.

Medication use can reduce or increase your chances of developing meningitis, although the impact of medications on meningitis is not as strong as that of vaccination and lifestyle factors. 

Treating Infections

The infections that cause meningitis may also affect other systems of the body, such as the respiratory system. Treating other infections early on, before they progress, can reduce your chances of developing meningitis. Antibiotics or antivirals can prevent some infections from becoming exceptionally aggressive in some instances.

In general, bacterial and viral infections are not likely to cause meningitis, and viral meningitis normally improves on its own without antiviral treatment.

Bacterial meningitis also may improve on its own without treatment, but treatment is recommended because bacterial meningitis can progress and cause serious complications. Whether or not your doctor is concerned that an infection could progress and cause meningitis is based on your overall health, your infection, and the likelihood of meningitis exposure (like during an outbreak). 

Medication Precautions

There are some medications that can cause meningitis. Developing meningitis in response to medications is not common, but it's good to be aware of this potential effect so you can bring any suspect symptoms you may experience while taking them to your doctor's attention. In general, it is not a good idea to use prescription or over-the-counter drugs excessively, especially if you have a condition for which medication has not been shown to be effective. 

Medications that have caused rare cases of meningitis:

• Nonsteroidal anti-inflammatories (NSAIDs)
• Antimicrobials, such as trimethoprim-sulfamethoxazole
• Immunoglobulins
• Immunosuppressants
• Chemotherapeutic medications
• Intrathecal injections (medications administered through spinal fluid)