Meningitis: Definition, Causes and Nursing Management

Meningitis (bacterial and viral) among college age students is on the rise in college campuses due to the closeness of college students in residence halls. The causes can be viral or bacterial in origin. Bacterial meningitis is fast-moving, causing debilitating amputations, hearing loss and kidney damage and it can be fatal (CDC, 2019). Viral meningitis has similar symptoms to bacterial meningitis but is not as debilitating or as deadly as bacterial meningitis (National Meningitis Association, 2019). Three organisms mainly cause bacterial meningitis:

  • 1) Neisseria meningitidis (resulting in meningococcal disease),
  • 2) Streptococcus pneumoniae (resulting in pneumococcal disease),
  • 3) Haemiphilus inflenzae type b (resulting in Hib disease) (NMA, 2019).

Meningitis can also be caused by other microorganisms like fungi or parasites, as well as being caused by injury, cancer, or certain drugs (CDC, 2019). It should be noted, also, that Kwang (2018) states that Escherichia Coli (E. Coli) is the most common bacillary organism bacteria causing meningitis.

The symptoms of meningitis infecting the spinal cord and brain are sensitivity to bright light, seizures, high fever, confusion, delirium, sleepy, vacant, vomiting and the hallmark symptoms of severe headache and stiff neck (CDC, 2019).

Other late symptoms of meningitis are a pink or purplish skin rash, positive Kernig’s sign, positive Brudzinski’s sign, and turbid cerebrospinal fluid upon spinal tap (Badru, 2019). Mode of transmission is the exchange of respiratory secretions during close contact such as kissing or coughing on someone. Complications can be deadly or can lead to hearing loss, brain or kidney damage, or limb amputations (NMA, 2019). Treatment after diagnosis via lumbar puncture to culture cerebrospinal fluid must be swift as death and serious complications can occur within hours (Badru, 2018).

Treatment consists of antibiotics given right away to help reduce the risk of dying (CDC, 2019).

Dickinson & Perez (2005) cite the World Health Organization estimation of 1.2 million bacterial meningitis (BM) cases worldwide and of those 135,000 deaths. Mbaeyi, Joseph, Blain, Hariri, & MacNeil (2019) state that freshman college students in particular are at increased risk for meningococcal disease. Among college students age 18-24 years old, in the period from year 2014 to 2016, the incidence of meningitis was 1.74 per 100,000 for those living in dormitories vs. 0.96/100,000 for those students living off campus (Mbaeyi, et al., (2019). In the period of 1990-1991 and 1991-1992 school years, cases of meningococcal disease occurred 9-23 times more frequently in students residing in dormitories. Comparatively, university students living in catered hall accommodations (the UK term for dorms) in the United Kingdom also had an increased incidence of 13.2 per 100,000 versus 5.5 per 100,000 for those university students not living in catered hall accommodations (Dickinson & Perez, 2005). The prevalence of meningococcal disease (meningitis) among adolescents and young adults is higher in the 16-23 year old age group (CDC, 2019). Meningococcal disease is seasonal with peak number of cases in January, February, March.

Determinants of Health

Artiga & Hinton (2018) identify the social determinants of health as socioeconomic status, education, neighborhood, physical environment, employment, social support networks and access to health care. In college aged students, the social determinants of health in the area of physical environment and neighborhood contribute to the increased prevalence and incidence of meningitis. Dickinson & Perez (2005) state that the physical environment of sleeping in overcrowded dormitories contributes to the high incidence of meningitis in college age students. The incidence of meningococcal disease among US college students is low but college students are at increased risk for meningococcal disease compared with noncollege students aged 18-24 years as a higher incidence of meningococcal (Type B) disease accounts for three-fourths of all the cases in this group (Mbaeyi, et al, 2019).

Host Factors

The epidemiological triad consists of the host, environmental factors, and the agent (the bacteria or virus causing the disease). In the host (the college student with a common cold), the pharyngeal and respiratory epithelium act as barriers to pathogens (NMA, 2019). When this mucosa is irritated by a respiratory illness (such as the common cold) the barrier is broken down or irritated allowing more invasive disease such as the Neisseria meningitidis bacterium (agent) to enter the bloodstream causing bacteremia which in turn allows bacterium entry into the human brain microvascular endothelial cell (NMA, 2019). Meningitis-causing bacteria such as N meningitidis or, specifically, E Coli can invade the tight blood brain barrier (Kwang, 2018).

Environmental factors consist of socio-economic elements and physical elements. Socio-economic elements are overcrowding, access to health services, and unsanitary conditions (Kwang, 2018). Physical elements characteristics are climate, geology, fauna, flora, ecosystem, and geographic areas (Kwang, 2018).

The ideal physical conditions for meningitis to proliferate among college students is the time of year, ecosystem, and geography. It should be noted that meningococcal bacteria commonly exist in the throat and nasal areas without being sick (AANP, 2019). January, February, and March (winter months) are peak times for meningitis contagion. College students are indoors studying in overcrowded dorms and study areas during these cold winter months. The ecosystem is cold weather not allowing for fresh air circulation indoors. The geography is northern climates where most remain indoors during inclement weather.

College students are prone to dating (spending lots of time with each other) and often share bodily fluids (knowingly or unknowingly) by kissing, sharing utensils, food or drinking cups and the organism is easily transmissible due to these college student habits (NMA, 2019).

Role of FNP

To promote quality healthcare and improve clinical outcomes, NP’s participate in health care forums, participate in nursing research and apply evidence-based practice to clinical practice (AANP, 2019). Nurse practitioners have an enormous role to prevent and treat meningitis.

Surveillance activities by FNP’s involve mandatory reporting of meningococcal disease to local and state health departments (CDC, 2019). The Council of State and Territorial Epidemiologists (CSTE) classify meningococcal disease as 1) suspected (clinical purpura in the absence of a + blood culture); 2) probable (detection of Neisseria meningitidis); 3) confirmed (detection of Neisseria meningitidis via lab test or isolation of Neisseria meningitidis from sterile body sites (such as blood or cerebrospinal fluid) (CDC, 2019).

Primary prevention practices are educating students and their parents on the existence, causes, signs and symptoms (beyond a head cold), prevention of meningitis, personal and environmental hygiene and how meningitis is spread (Badru, 2018). Nurse practitioners can disseminate culturally-sensitive information via churches, mosques, markets, and areas where college students gather (coffeeshops, vegan/smoothie shops) (Badru, 2019). Additionally, The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control recommends that the MenB vaccine be given to adolescents entering high school (prior to entrance to colleges with dormitories) and to college freshmen living in dormitories (Banzhoff, 2017).

Secondary prevention involves treating family and friends in close contact with meningitis patients with antibiotic prophylaxis (Badru, 2018). Also, the FNP screens college students for potential exposure to meningitis bacteria asking questions about overcrowded living arrangements and sanitation and hygienic practices (CDC, 2019).

Tertiary prevention by APN’s involves Badru’s (2018) recommendation to report to the hospital as early as possible to curtail the infection. After successful treatment with antibiotics, tertiary prevention involves hearing tests to detect and treat the degree of hearing loss from hearing loss complications (Mbaeyi, et al, 2019). Amputation after infection can be attended to by referrals for physical therapy and occupational therapy (Mbaeyi, et al, 2019). Kidney disease can be followed by referrals for nephrology care and follow-up primary care (Mbaeyi, 2019).

Hale, Harper, & Dawson (1996) developed a model of practice for advanced practice nursing primary care of college students at George Mason University Student Health Center (SHC). The SHC is staffed by faculty who are practicing nurse practitioners implementing evidence-based practice for primary care. They are applying these evidence-based practices to the care of college students on campus. By providing comprehensive primary care to students on campus, the focus of care is managing current health care needs by emphasizing prevention, wellness, and quality of life (Hale, et al, 1996).


  • Badru, F.A. (2017). The role of the nurse in curtailing cerebrospinal meningitis. West African Journal of Nursing, 28(1), ii-iii. Retrieved online
  • Banzhoff, Angelika. (2017). Multicomponent meningococcal B vaccination (4CMenB) of adolescents and college students in the United States. Therapeutic Advances in Vaccines and Immunotherapy, 5(1), 3-14.
  • Centers for Disease Control and Prevention. (2019). Meningococcal Disease. Retrieved from
  • Dickinson, F. O., & P?rez, A. E. (2005). Bacterial meningitis in children and adolescents: an observational study based on the national surveillance system. BMC infectious diseases, 5, 103. doi:10.1186/1471-2334-5-103
  • Grantome. National Institutes of Health. (2018). Host factors and bacterial meningitis (NIH Publication No. R01-NS091102-03). Retrieved from
  • Hale, J. F., Harper, D. C., & Dawson, E. M. (1996). Original Article: Partnership for a nurse practitioner-directed student health primary care center. Journal of Professional Nursing, 12, 365-372.
  • Mbaeyi, S., Joseph, S., Blain, A., Wang, X., Hariri, S. and MacNeil, J. (2019). Meningococcal disease among college-aged young adults 2014-2016. Pediatrics, 143(1), 1-10. DOI:
  • National Meningitis Association. (2019). Is it viral, bacterial, or fungal? (Issue Brief). Fort Meyers, FL. Retrieved from
Calculate the price
Make an order in advance and get the best price
Pages (550 words)
*Price with a welcome 15% discount applied.
Pro tip: If you want to save more money and pay the lowest price, you need to set a more extended deadline.
We know how difficult it is to be a student these days. That's why our prices are one of the most affordable on the market, and there are no hidden fees.

Instead, we offer bonuses, discounts, and free services to make your experience outstanding.
How it works
Receive a 100% original paper that will pass Turnitin from a top essay writing service
step 1
Upload your instructions
Fill out the order form and provide paper details. You can even attach screenshots or add additional instructions later. If something is not clear or missing, the writer will contact you for clarification.
Pro service tips
How to get the most out of your experience with Boom Grades
One writer throughout the entire course
If you like the writer, you can hire them again. Just copy & paste their ID on the order form ("Preferred Writer's ID" field). This way, your vocabulary will be uniform, and the writer will be aware of your needs.
The same paper from different writers
You can order essay or any other work from two different writers to choose the best one or give another version to a friend. This can be done through the add-on "Same paper from another writer."
Copy of sources used by the writer
Our college essay writers work with ScienceDirect and other databases. They can send you articles or materials used in PDF or through screenshots. Just tick the "Copy of sources" field on the order form.
See why 20k+ students have chosen us as their sole writing assistance provider
Check out the latest reviews and opinions submitted by real customers worldwide and make an informed decision.
Classic English Literature
Awesome Job... you are the best!
Customer 452531, November 27th, 2021
English comp
Got a 94% thank you!
Customer 452509, June 27th, 2021
English 101
perfect! thanks!
Customer 452543, December 1st, 2021
Absolutely LOVE having help especially from the person who wrote this last one. THANK YOU
Customer 452529, November 19th, 2021
english comp
Great paper and done before the deadline. Thank you
Customer 452509, June 15th, 2021
Exercise Science
Thank you so much for your time.
Customer 452545, December 5th, 2021
Religious studies
I recommend this service they always help. I got an A in this project thanks.
Customer 452507, October 5th, 2021
world civilization
Thank you for the quick response
Customer 452509, June 27th, 2021
Great content.
Customer 452549, February 8th, 2022
Classic English Literature
Great Work as Usual. Thank you . I received an A on the paper!
Customer 452531, November 9th, 2021
Classic English Literature
Absolutely LOVE the essay I received. I really appreciate it so much.
Customer 452529, October 25th, 2021
english comp
Thank you for all your hard time.
Customer 452509, June 27th, 2021
Customer reviews in total
Current satisfaction rate
3 pages
Average paper length
Customers referred by a friend
15% OFF your first order
Use a coupon FIRST15 and enjoy expert help with any task at the most affordable price.
Claim my 15% OFF Order in Chat