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. The type of meningitis (bacterial or viral) impacts the severity of the disease. Any child with symptoms of meningitis should receive immediate medical attention. Bacterial meningitis is a serious illness that may require hospitalization. 

Who gets meningitis and how? 
Young children more commonly get viral meningitis, which is less severe than bacterial meningitis. Viruses that cause this type of meningitis spread in different ways. The viruses spread when children cough or sneeze, or when they touch or share used drinking cups and eating utensils. Only a small number of people who get infected with a virus will develop the meningitis illness. The illness usually happens in the summer and early fall. 

Bacterial meningitis is more rare but more severe. Several types of bacteria can cause meningitis, and they spread in different ways. Close contact like sharing drinking cups can spread the bacteria. Meningitis also spreads 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. Immunizations help prevent bacterial 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 

Meningitis is scary because children with mild symptoms may slowly or quickly change to having seizures or being 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 meningitis should not attend child care. They should be seen by a health care provider right away. 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. 

While viral meningitis usually clears up within a week or two without specific treatment, bacterial meningitis is a medical emergency.

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 
The best ways to prevent the spread of meningitis are to: 

  • Make sure children are appropriately immunized, including with pneumococcal and Haemophilus influenzae type b (Hib) vaccines. 
  • Practice good hand washing. 
  • Immediately call your health care provider if you or children come into close contact with people infected with meningitis. You may be given antibiotics to prevent infection. 
  • Teach children to cough 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 July 2023, UCSF California Childcare Health Program