Meningococcal Disease Page

Meningococcal Disease

May 20, 2024: Health Advisory and Travel Health Notice - Kingdom of Saudi Arabia

The Centers for Disease Control and Prevention (CDC) issued a Health Advisory and Travel Health Notice on May 20, 2024, to alert healthcare providers and the public to cases of meningococcal disease linked to Umrah travel to the Kingdom of Saudi Arabia (KSA). Umrah is an Islamic pilgrimage to Mecca, Kingdom of Saudi Arabia, that can be performed any time in the year; the Hajj is an annual Islamic pilgrimage this year taking place June 14–19, 2024.

Persons considering travel to perform Hajj or Umrah should ensure they are up to date on all travel related vaccines, including meningococcal vaccine. Healthcare providers should also maintain increased suspicion for meningococcal disease in anyone presenting with symptoms of meningococcal disease after recent travel to KSA for Hajj or Umrah pilgrimage.

Meningococcal disease is a rare, but serious bacterial illness.

Meningococcal disease is a rare, but serious illness caused by the bacterium Neisseria meningitidis. The two most common types of meningococcal infections are infections of the lining of the brain and spinal cord (called meningitis), and bloodstream infections (septicemia). Both of these types of infections are very serious and can be deadly in a matter of hours. Keeping up to date with recommended vaccines is the best protection against meningococcal disease.

Meningococcal bacteria are spread by sharing respiratory and throat secretions.

The bacteria that cause meningococcal disease are spread by exchanging respiratory and throat secretions (saliva or spit) during close (for example, coughing or kissing) or lengthy contact, especially if living in the same household. People do not catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been.

Most people exposed to N. meningitidis do not become ill and are called “carriers”. A small proportion of infected people can develop serious illness. Symptoms can first appear flu-like and quickly become more severe.

Health departments investigate each case of meningococcal disease to identify all close contacts and make sure they receive antibiotics to help prevent them from getting the disease.

The two most common types of meningococcal infections are meningitis and septicemia.

You should not delay seeking care if you experience the following symptoms of meningococcal disease: 

  • Meningitis: sudden fever, headache, stiff neck, and light sensitivity. 
  • Bloodstream infection: sudden fever, chills, muscle aches, nausea, vomiting, and diarrhea. 

Symptoms can differ in infants and may include: 

  • Inactivity, irritability, vomiting, poor feeding, or a bulging soft spot on their head. 

The best way to prevent meningococcal disease is to get vaccinated.

Vaccines can help prevent meningococcal disease. There are 3 types of meningococcal vaccines available in the United States: 

  • Meningococcal conjugate or MenACWY vaccines (Menveo® and MenQuadfi®) 
  • Serogroup B meningococcal or MenB vaccines (Bexsero® and Trumenba®) 
  • Pentavalent meningococcal or MenABCWY vaccine (PenbrayaTM) 

All adolescents should receive a MenACWY vaccine at 11 to 12 years of age and a booster dose at 16 years of age. MenACWY vaccination is also recommended for children and adults at increased risk for meningococcal disease. Teens and young adults (16 through 23 years old) also may get a MenB vaccine. Those who are getting MenACWY and MenB vaccines at the same visit may instead get a MenABCWY vaccine. Talk to your healthcare provider or local health department if you have questions about accessing meningococcal vaccine. 

Guidance for Healthcare Providers
  • Immediately notify your local health department (LHD) if meningococcal disease is suspected based on clinical findings or laboratory results of gram-negative diplococci or N. meningitidis from a normally sterile site.
      
  • Maintain a heightened index of suspicion for meningococcal disease. 
    • There is an ongoing outbreak of meningococcal disease in Virginia and a national increase in invasive meningococcal disease, mainly attributable to Neisseria meningitidis serogroup Y. 
    • Be aware that patients with meningococcal septicemia or septic arthritis might present without typical symptoms of meningitis.   
  • Because of the risks of severe morbidity and death, effective antibiotics should be administered promptly to patients suspected of having meningococcal disease. 
    • Empirical therapy for suspected meningococcal disease should include an extended-spectrum cephalosporin, such as cefotaxime or ceftriaxone.  
    • Ascertain susceptibility of N. meningitidis isolates to penicillin before using penicillin or ampicillin for treatment. Isolates of N. meningitidis that are ciprofloxacin and penicillin-resistant have been detected in northern Virginia. 
  • Northern Virginia healthcare providers should suspend use of ciprofloxacin as post-exposure prophylaxis (PEP) to prevent PEP failure in contacts.  
    • Ciprofloxacin-resistant strains of N. meningitidis have been reported in Northern Virginia. Administration of ciprofloxacin to contacts may result in PEP failure. 
    • Alternative PEP options for northern Virginia include rifampin, ceftriaxone, or azithromycin. 
  • Ensure that all patients who are at increased risk for meningococcal disease are up to date on MenACWY vaccine.  
    • The meningococcal vaccination is recommended for people at increased risk due to certain medical conditions, including a booster every five years to maintain protection.  
    • Those at increased risk include people with HIV, those whose spleen is damaged or removed, people with sickle cell disease, anyone with a rare immune condition called complement deficiency, or people taking complement inhibitors. 
  • Continue to encourage routine administration of MenACWY vaccine in adolescents.  
    • As a reminder, a dose of MenACWY vaccine is required for students prior to 7th and 12th grade.