Meningitis is a dreadful word and an even more dreadful condition.

The central nervous system of your body, that is, your brain and spinal cord, has a special lining, call the meninges. When these meninges become inflamed or infected, you develop meningitis. This condition can cause a wide range of signs and symptoms, from a headache, fever or stiff neck to coma or death, which can occur quite rapidly, even within 24 hours.

There are many different germs which can cause this illness. Meningitis is usually due to an infection with a virus, bacteria or fungus. Some forms of meningitis can be epidemic — that is, spread rapidly from person to person — particularly meningococcal meningitis, a bacterial form of germ. This is more likely in certain situations, such as with students living in dormitories, military recruits in barracks or travelers visiting countries where meningitis is endemic.

Some of the countries well known for meningococcal meningitis include those in sub-Saharan Africa. In 2005, large outbreaks also occurred in India, China and the Philippines. Other large outbreaks in the past have occurred in Brazil, Mongolia and the Himalaya.

The diagnosis of meningitis is done by a spinal tap, the very thought of which makes most people cringe. In reality, this procedure, when done by an experienced person, is as safe as drawing blood from the arm. Then again, who wants to have it done if it can be avoided? Furthermore, in the developing world it is estimated that up to 70% of the medical equipment (such as needles) is not clean, and there is a potential risk of catching a disease such as HIV or hepatitis from their use.

Once diagnosed, bacterial and fungal meningitis requires hospitalization and antibiotics, whereas someone with viral meningitis could be treated as an outpatient.

Avoiding all forms of meningitis is not possible, but there is a safe and effective vaccine against four forms of the epidemic meningococcal meningitis. There are two versions, one available from age two onward which lasts three years and a new one which is only for those ages 11 to 55 and for which the duration of protection has not yet been fully established but may be 10 years or more. Many colleges are now making vaccination against meningococcal meningitis a requirement for their incoming students in order to prevent outbreaks on campus.

Consultation with a travel medicine specialist is wise, particularly before traveling to the developing world. If you could be at risk for meningococcal meningitis, getting a vaccine would be a smart move.

A list of qualified doctors and nurses in this field who can provide meningococcal immunization can be found on the website of the International Society of Travel Medicine ( or the American Society of Tropical Medicine & Hygiene ( The latter site also lists specialists who are qualified to diagnose and treat diseases from travel, especially from the developing world.

Healthy travels!

Coming up: Avian flu and the (lack of) harm it realistically poses to travelers in Asia.