Meningitis is an inflammation of the membranes (meninges) surrounding the brain and spinal cord. Meningitis has several causes including bacteria, chemical irritation, drug allergies, and most commonly viruses. Most cases of meningitis in the United States are caused by a viral infection and not bacteria. Viral meningitis results in approximately 25,000-50,000 hospital visits, and more than 10,000 of these cases are diagnosed as meningitis each year. Each year, approximately 4,000 Americans are diagnosed with bacterial meningitis, 500 of which are fatal. If you suspect any symptoms of meningitis or have been in contact with someone who has meningitis you should always seek medical attention immediately. The first recorded case of meningitis was in Geneva in 1805 by Gaspard Vieusseux, but the first evidence showing that bacterial infections could cause meningitis came in 1887 from Anton Vaykselbaum who described meningococcal bacteria. During the second half of the 20th century, influenza A and B were also linked as a cause of meningitis, but in 1968 AA Smorodintsev demonstrated that there are more than two hundred viruses that can cause meningitis. The definitive diagnosis of meningitis comes after undergoing a lumbar puncture, this procedure has been performed for centuries to diagnose meningitis; Heinrich Quincke devised this procedure to collect cerebrospinal fluid (CSF) in 1891. Many signs and symptoms were thought to be related to meningitis, but Russian physician Vladimir Kernig (1884) and Polish physician Jozet Brudzinski (1899) found definite symptoms that include leg extension causing pain (Kering) and pain when flexing the head (Brudzinski). In 1944 penicillin was reported as the first effective treatment... half of paper...... The worst meningitis epidemic in the United States occurred in July 2013, 15 states were involved, including 214 cases and 15 deaths. There were many states involved including Tennessee, Ohio, Virginia, Michigan, Minnesota, Maryland, Texas and Indiana. These cases of meningitis were linked to methylprednisolone-based steroid injections used for back, knee and joint pain. The drug was recalled but had already been shipped to 23 states and may have been administered to 14,000 patients. Tennessee was the hardest hit state with 53 cases, followed by Michigan with 46 cases. The fungi that caused the outbreak were Exserohilum and Aspergillus, which are common in the environment, not cases of meningitis. Fungi are found in soil and grass, but somehow got into the drug via injections. These strains were not contagious, and patients in the outbreak were given two strong antibiotics.