Crying baby at doctor's office

What Child Care Providers Should Know About Meningitis

What is meningitis? 
Meningitis is an infection of the thin lining that covers the brain and spinal cord. The infection is usually caused by a type of bacteria or virus.  Any child with symptoms of meningitis should receive immediate medical attention. Bacterial meningitis is a serious illness that may require hospitalization. 

Viral Meningitis: 
Meningitis infections are caused by many different viruses.  Only a small number of people who get infected with these viruses will develop the meningitis. Viral meningitis is less severe than bacterial meningitis and often resolves on its own.  Viruses that cause this type of meningitis are spread in different ways, depending on the virus.

Bacterial Meningitis: 
Bacterial meningitis is rare but more severe. Several types of bacteria can cause meningitis, and they spread in different ways.  Some bacteria are spread from respiratory secretions (snot, mucus) through close contact like sharing drinking cups and eating utensils. Other bacteria are spread through a child’s stool (bowel movement). For example, a child may not wash their hands after using the bathroom and then may touch a toy, which another child touches and then puts their hands in their mouth. This spreads the bacteria from the first child’s stool to the second child’s saliva. 

Blood and spinal fluid tests can reveal the type of meningitis. 

What are the symptoms of meningitis? 
Young children with meningitis may have: 

  • Fever 
  • Headache or sensitivity to light 
  • Nausea, vomiting, or loss of appetite 
  • Irritability, confusion, or drowsiness 
  • Excessive, loud crying 
  • Stiff neck, especially when looking down 
  • Red or purple spotted rash 

Children with mild symptoms may slowly or quickly change to having seizures or becoming unconscious.  Children with bacterial or viral meningitis usually recover fully, but sometimes the disease is severe and can cause long-term effects such as brain damage, hearing loss, or learning disabilities. Severe meningitis can lead to death.  

Should children with meningitis stay home? 
Children with symptoms of suspected meningitis should not attend child care. They should be seen by a health care provider right away.  While viral meningitis usually clears up within a week or two without specific treatment, bacterial meningitis is a medical emergency.

People in close contact with a child diagnosed with meningitis should be seen by a health care provider. Examples of close contact include living with the child or caring for the child at child care. 

Report a child with meningitis to the local health department, just in case they do not know the child goes to child care.  Close contacts of the child can then be given advice and antibiotics if needed.

After they have recovered, when should children with meningitis return to child care? 
Children with meningitis generally feel too ill to attend child care. After some time, they can return when: 

  • A health care provider clears the child to return. 
  • The child feels well enough to participate. 
  • Care can be provided without impacting the care of the other children. 

Tips to reduce the risk of meningitis 

Immediately call your health care provider if you or the children in your care come in to close contact with anyone with meningitis.  You may be given antibiotics to prevent infection.

Since different viruses and bacteria can cause meningitis, there is no one way to prevent the spread.  Follow practices to prevent the spread of infectious disease:

  • Keep immunizations up to date. 
  • Practice good hand washing. 
  • Teach children to cough or sneeze into their elbow and away from people. 
  • Prevent children from sharing bottles, toys, or other items placed in the mouth. 
  • Wear gloves and wash hands for diaper changes or contact with body fluids. 
  • Follow the routine schedule for cleaning, sanitizing, and disinfecting in Caring for Our Children Appendix K 

Where can I get more information? 

Updated March 2024, UCSF California Childcare Health Program