Bacterial Meningitis in the Child Care Setting
Resources for Child Care Givers
Provided by All Family Resources

Meningitis caused by a bacterial infection (sometimes called spinal meningitis) is one of the most serious types, sometimes leading to permanent brain damage or even death. Bacterial meningitis is most commonly caused by bacteria called Neisseria meningitidis (meningococcal meningitis), Streptococcus pneumoniae, or Haemophilus influenzae serotype b (H. flu meningitis). These bacteria are carried in the upper back part of the throat (called the nasopharynx) of an infected person and are spread either through the air (when the person coughs or sneezes organisms into the air) or by direct contact with secretions from the nasopharynx of the infected person. However, transmission usually occurs only after very close contact with the infected person.

Symptoms of bacterial meningitis include sudden onset of fever, headache, neck pain or stiffness, vomiting (often without abdominal complaints), and irritability. These symptoms may quickly progress to decreased consciousness (difficulty in being aroused), convulsions, and death. For this reason, if any child displays symptoms of possible meningitis, he or she should receive medical care immediately.

Meningitis caused by Haemophilus influenza serotype b (Hib) can be prevented with Hib vaccine, which is part of routine childhood immunizations. Some cases of meningococcal meningitis can also be prevented by vaccine. However, this vaccine is not used routinely, and usually only during outbreaks or in high risk children.

Children with bacterial meningitis are almost always hospitalized. Providers are often told only that the child has meningitis and may not know the exact type.

If a child or adult in your child care facility is diagnosed with bacterial meningitis:

• Verify the type of meningitis involved. If a child in your care is diagnosed, contact the child’s physician, explain that the child attends your facility, and you need to know the type of meningitis.
• If H.flu is involved, review immunization status of children to identify children who have not received their Hib vaccine.
• Immediately contact your local health department. Many states require that child care facilities report suspected or known cases of bacterial meningitis. Your health department should also be able torecommend that you notify parents and potentially exposed persons as well as preventive antibiotics to reduce the risk of infections in exposed persons who may not be adequately vaccinated.
• Closely observe all remaining children and staff for any possible early signs of illness.
• IMMEDIATELY refer to a physician any exposed child or adult who develops fever, headache, rashes, spots, unusual behavior, or other symptoms of concern regardless of whether they have taken preventive antibiotics.
• Encourage close cooperation, support, and information sharing with staff and parents regarding measures being taken to reduce the risk of further transmission.