The symptoms of viral meningitis often mimic those of bacterial meningitis. It is therefore required that individuals seek immediate medical attention whenever they notice preliminary signs and symptoms of the condition. Children infected with viral meningitis suffer from fever, reduced appetite, become irritable and lethargic. Children also experience extreme sleepiness so much so that it gets difficult to wake them up [6].

Adults with viral meningitis suffer from high fever along with severe headache, irritability, confusion, stiffness in neck and loss of appetite. Affected individuals also exhibit intolerance towards bright light and also experience extreme state of sleepiness.

Diagnosis of viral meningitis involves evaluation of routine chemical parameters and hematological tests. Arterial blood gas analysis, liver function tests and coagulation studies are carried out in children suspected of viral meningitis. In addition, swabs from nasooropharyngeal route and rectum are tested for the type of virus present. The blood and stool samples are also collected for analysis of the condition. Cerebrospinal fluid (CSF) may also be tested for HIV and CMV [7] [8].

Treatment of viral meningitis involves administration of medications to relieve fever and other related symptoms. No specific kind of antiviral agents are prescribed until the causative agent identified is herpes virus. In majority of the cases, individuals should do well within 7 to 10 days and usually hospital admission is not required until the patient is serious or has a low immunity profile. Affected individuals are advised to take plenty of rest and drink fluids as much as possible. These along with medications are the only available treatment for viral meningitis [9].

The prognosis of the disease condition is usually favorable and majority of the individuals tend to recover within 7 to 10 days. However, if viral meningitis has affected the infants or young children then the outcome can be fatal and can be a significant cause of morbidity.

Enteroviruses such as echovirus, enterovirus 71, coxsackie A virus and poliovirus are the major causative agents of viral meningitis. In addition to these types, some other groups of viruses are also known to play a role, which include mumps virus, human immunodeficiency virus (HIV), measles virus, West Nile virus, St. Louis Encephalitis virus, Herpes simplex virus, Epstein-Barr virus, La Cross virus and Lymphocytic choriomeningitis virus [3].

The exact incidence of viral meningitis is unknown due to underreporting of the cases. According to the CDC, there are estimated 25,000 to 50,000 cases of hospitalization each year due to viral meningitis. In addition, it has also been reported that 10,000 cases of viral meningitis occur globally; but the actual number of cases is more than 75,000. Based on the WHO reports, in the year 1997, enteroviral meningitis along with sepsis was recorded to be the 5th most frequent cause of neonatal mortality [4].

Viral meningitis is basically an infectious disease wherein the virus is spread through contact with the infected person. Enteroviruses are more commonly transmitted through the fecal route. Such a type of contamination can occur during diaper change or using the same toilet of an infected person without disinfecting it. Failure to wash hands properly after using toilet can also make individuals susceptible to contract enterovirus infections. In addition to fecal contamination, the virus can spread from respiratory secretions such as saliva, mucus or sputum of a person infected with the virus [5].

Many cases of viral meningitis cannot be prevented. Also, no vaccinations exist for the common viruses that cause the disease. Thus, the best way to prevent development of new cases is to stop the spread of the infection. The following steps can be taken to prevent the spread of viral meningitis:

• It is necessary to minimize contact with infected persons.
• Hand washing after diaper changing and using toilet should be made a habit.
• It is also necessary to appropriately disinfect surfaces that are frequently touched. These include the door knobs and the television remote.
• Certain vaccines are available which protect against specific viruses. Vaccination schedule designed for children can protect them from viral meningitis. The vaccines include MMR vaccine for mumps and measles and varicella-zoster vaccine for chickenpox [10].
• Individuals are also advised to protect themselves from mosquito bites as they are considered to be good carriers of viral agents.

Viral meningitis also known as aseptic meningitis is a less severe condition than bacterial meningitis. Children and immunecompromised population are at increased risk of developing this condition [2]. There is usually no specific treatment regime that helps in warding off the virus from the body. Methods are employed to relieve the symptoms with medications and rest. Typically individuals show signs of improvement within 7 to 10 days.

Definition

Viral meningitis is a viral disease characterized by inflammation of the meninges. Majority of the incidence of this viral disease take place during the summer season. It has been estimated that in the year 1988 – 1999 about 36,000 new cases of viral meningitis occurred in the US.

Cause

Enteroviruses are the major causative agent for viral meningitis. In addition, other type of viral infections can also lead to development of such a type of disease condition. These infections include mumps, measles, herpes simplex, influenza, arboviruses and lymphocytic choriomeningitis virus.

Symptoms

Symptoms of viral meningitis in children include high fever, poor appetite, irritability and extreme sleepiness. Adults who contract this viral infection suffer from severe fever accompanied by headache, stiffness in the neck, difficulty in waking up, nausea, vomiting and intolerance towards bright light.

Diagnosis

Diagnosis of viral meningitis includes testing of stool and blood samples for the type of viral agent. The swab samples of nose, saliva and rectum are also analyzed for the presence of virus. Arterial gas measurement and liver function test should be considered in severe cases of viral meningitis.

Treatment

Viral meningitis usually requires minimum treatment. Affected individuals begin to show improvement within 7 to 10 days. Antiviral agents are usually not prescribed if enteroviruses are the causative agent. Medications to relieve fever and associated symptoms along with plenty of rest are advised.

1. Rotbart H. Viral meningitis and the aseptic meningitis syndrome. In: Infections of the Central Nervous System, Scheld W, Whitley RJ, Durack DT (Eds), Raven, New York 1991. p.19.
2. Newland JG, Shah SS, Zaoutis TE. The child with aseptic meningitis. Pediatr Case Rev 2003; 3:218.
3. Hviid A, Rubin S, Mühlemann K. Mumps. Lancet. Mar 15 2008;371(9616):932-44
4. Centers for Disease Control and Prevention (CDC). Outbreaks of aseptic meningitis associated with echoviruses 9 and 30 and preliminary surveillance reports on enterovirus activity--United States, 2003. MMWR Morb Mortal Wkly Rep 2003; 52:761.
5. Johnson RT, Mims CA. Pathogenesis of viral infections of the nervous system. N Engl J Med 1968; 278:23.
6. Landry ML, Greenwold J, Vikram HR. Herpes simplex type-2 meningitis: presentation and lack of standardized therapy. Am J Med. Jul 2009;122(7):688-91.
7. King RL, Lorch SA, Cohen DM, Hodinka RL, Cohn KA, Shah SS. Routine cerebrospinal fluid enterovirus polymerase chain reaction testing reduces hospitalization and antibiotic use for infants 90 days of age or younger. Pediatrics. Sep 2007;120(3):489-96.
8. Ramers C, Billman G, Hartin M, et al. Impact of a diagnostic cerebrospinal fluid enterovirus polymerase chain reaction test on patient management. JAMA 2000; 283:2680.
9. Sawyer MH. Enterovirus infections: diagnosis and treatment. Semin Pediatr Infect Dis 2002; 13:40.
10. Canada Communicable Disease Report. International Note: Global Advisory Committee on Vaccine Safety, 11-12 June, 2003. April 1, 2004.