Meningitis in Seniors: Symptoms, Risks and Prevention

Symptoms of Meningitis

Common meningitis symptoms include:

• Fever.
• Headache.
• Stiff neck.

There are often other symptoms as well:

• Nausea and vomiting.
• Photophobia, meaning the eyes are more sensitive to light.
• Altered mental status, such as confusion or drowsiness.

Anyone with symptoms of meningitis should see a healthcare provider right away. A provider can determine if you have meningitis, what is causing it, and the best treatment. If symptoms come on suddenly, are severe, or are paired with confusion or a seizure, seek emergency care immediately.

Causes and Types of Meningitis

Several bacteria can cause bacterial meningitis. Leading U.S. causes include Streptococcus pneumoniae, Group B Streptococcus, Escherichia coli, Haemophilus influenzae, Neisseria meningitidis, and Listeria monocytogenes. Mycobacterium tuberculosis, which causes tuberculosis, is a less common cause. Viral meningitis is usually milder and often resolves on its own, but it shares the same early symptoms, so an accurate diagnosis is essential because treatment depends on the cause. Fungal and parasitic meningitis are rare but serious.

Risk Factors for Older Adults

Certain factors increase a person’s risk of bacterial meningitis, and age is one of them. For older adults, the most common bacterial causes are Streptococcus pneumoniae, Group B Streptococcus, Haemophilus influenzae, Listeria monocytogenes, and Neisseria meningitidis. Medical conditions and treatments that raise risk include having a weakened immune system, having a cerebrospinal fluid leak, and not having a spleen.

Older adults living in group settings, such as long-term care facilities, are also at higher risk because infectious diseases spread where large groups gather. Travelers to sub-Saharan Africa during the dry season or to the Hajj pilgrimage may face higher meningococcal risk, and everyone should avoid close contact with people known to have tuberculosis in crowded, enclosed spaces.

How Meningitis Spreads

The bacteria and viruses that cause meningitis spread in different ways. Some, such as Neisseria meningitidis and Streptococcus pneumoniae, spread through droplets from the nose and throat of an infected person, for example by coughing, sneezing, or kissing. Listeria, which is especially dangerous for older adults, is usually acquired by eating contaminated food such as unpasteurized dairy products, soft cheeses, and deli meats. Good hygiene, including handwashing and not sharing utensils, cups, or toothbrushes, helps reduce the spread of many causes of meningitis.

Complications of Bacterial Meningitis

Bacterial meningitis can progress quickly and can cause complications including seizures, coma, and death. Many of the bacteria that cause meningitis are also associated with sepsis, a life-threatening whole-body response to infection. Survivors may face permanent disabilities such as hearing loss, vision problems, memory difficulties, and limb loss. Because outcomes depend on how quickly treatment begins, seeking care at the first sign of symptoms is critical.

Prevention: Vaccines and Good Habits

Vaccines are the most effective way to protect against certain types of bacterial meningitis. There are vaccines for 4 types of bacteria that can cause meningitis, and all but the last are widely used in the United States:

• Hib vaccines, which protect against Haemophilus influenzae serotype b.
• Meningococcal vaccines, which protect against Neisseria meningitidis.
• Pneumococcal vaccines, which protect against Streptococcus pneumoniae and are recommended for all adults 65 and older.
• Bacille Calmette-Guerin vaccine for tuberculosis, used in some countries.

Ask your doctor which vaccines are recommended for you, especially the pneumococcal vaccine, which is routinely recommended for seniors. Practicing good hygiene, avoiding close contact with sick people, and following food safety guidance for high-risk foods such as soft cheeses and deli meats also reduce risk. If you have been around someone with bacterial meningitis, your healthcare provider or health department may recommend preventive antibiotics.

Diagnosis and Treatment

If healthcare providers suspect meningitis, they may collect samples of blood or cerebrospinal fluid, the fluid surrounding the spinal cord, using a procedure called a lumbar puncture or spinal tap. Laboratories then perform specific tests to identify the cause, because treatment differs depending on the cause. Healthcare providers treat bacterial meningitis with antibiotics, and it is important to start treatment as soon as possible, usually in the hospital with supportive care such as intravenous fluids and oxygen.

Viral meningitis typically improves with rest, fluids, and over-the-counter pain relief.

Frequently Asked Questions

Is meningitis the same as meningococcal disease? No. Meningitis and meningococcal disease are related but not the same. Meningococcal disease is any illness caused by Neisseria meningitidis, and it can, but does not always, include meningitis.

Can seniors get the meningitis vaccine? Meningococcal vaccines are recommended for certain adults at increased risk, and the pneumococcal vaccine is recommended for all adults 65 and older. Ask your doctor what is right for you.

How quickly does bacterial meningitis become dangerous? It can be fatal within hours, which is why anyone with symptoms should seek medical care immediately.

Can you recover fully from bacterial meningitis? Most people recover when treated promptly, but survivors can have permanent disabilities such as hearing loss, so prevention and early treatment both matter.