Encephalitis and Meningitis
General Description: Infections affecting the central nervous system, caused by viruses or bacteria, characterized by headache, neck pain and stiffness, cognitive impairment, and loss of consciousness. These infections are considered medical emergencies; prompt diagnosis and early treatment are critical to reduce the risk of permanent disability or death.
Mode of Transmission: Person-to-person spread of most infectious agents typically cause colonization and not disease. In the U.S., Western and Eastern equine encephalitis viruses are transmitted by a mosquito bite, not person-to-person contact, except in unusual circumstances.
Efficiency of Transmission/Attack Rate: Person-to-person spread of some agents such as Streptococcus pneumoniae as a result of nasopharyngeal colonization. Progression to meningitis is a rare occurrence in persons with normal immune systems.
Period of Communicability: Varies depending upon infectious agent. With the exception of some unusual circumstances, the equine encephalitides are not transmitted person-to-person.
Effect on LEO Fitness for Duty: Sequelae of meningitis or encephalitis may include seizures, hearing loss, and neurocognitive impairment (forgetfulness, inability to concentrate, fatigue, changes in behavior). Based on reviewed outcome studies,15-20,22,23 the long-term risk of seizures for those who did not have a seizure during the acute illness, is unclear. LEOs who have recovered from viral meningitis without sequelae can be returned to duty without restrictions.
For LEOs who have had bacterial meningitis or one of the encephalitides, fitness for duty should be determined on a case-by-case basis. The assessment should characterize seizure risk, test hearing, evaluate for neurological deficit, and assess for neurocognitive impairment. This will usually require evaluation by a neurologist and a neuropsychologist.
LEO-specific Clinical Studies and Reports: See section on Meningococcal Meningitis and Meningococcemia (Neisseria Meningitidis).