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Clinical Information

Meningococcal Disease: Technical & Clinical Information

Clinical Features

Fever, headache and stiff neck in meningococcal meningitis cases, and sepsis and rash in meningococcemia.

Etiologic Agent

There are multiple serogroups of Neisseria meningitidis. Serogroups B, C, and Y cause the majority of disease in the United States and serogroup W causes a small portion of disease. Serogroup A causes disease in developing countries and the meningitis belt of sub-Saharan Africa.

Burden of Disease

Rates of meningococcal disease have been declining in the United States since the late 1990s (see graph at top right). In 2013, there were about 550 total cases of meningococcal disease reported (incidence rate of 0.18 cases per 100,000 persons). Anyone can get meningococcal disease, but rates of disease are highest in children younger than 1 year, followed by a second peak in adolescence (see graph at bottom right). Among adolescents and young adults, those 16 through 23 years have the highest rates of meningococcal disease.

Sequelae

About 10 to 15 out of 100 people infected with meningococcal disease will die. About 11 to 19 out of every 100 survivors will have long-term disabilities, such as loss of limb(s), deafness, nervous system problems, or brain damage.

Transmission

Meningococcal disease is spread from person to person. The bacteria are spread by exchanging respiratory and throat secretions during close or lengthy contact, especially if living in the same household. Humans are the only host. Asymptomatic nasopharyngeal carriers who are not a close contact of a patient with meningococcal disease do not require prophylaxis.

Risk Groups

Groups at increased risk for meningococcal disease include household or close contacts of case patients, patients without a functioning spleen or with terminal complement component deficiencies, microbiologists who are routinely exposed to isolates of Neisseria meningitidis, people identified as being at increased risk because of an outbreak of meningococcal disease, persons traveling to a country where meningococcal disease is epidemic or highly endemic, first-year college students who live in residence halls, and military recruits. Infants less than one year and adolescents ages 16 through 23 years have higher rates of disease than other age groups, but cases occur in all age groups including the elderly.

Surveillance

Meningococcal disease is a reportable condition in all states. The state and local health department will conduct an investigation to ensure all close contacts are provided prophylaxis. See more about meningococcal disease surveillance.

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