| Clinical Features |
Fever, headache and stiff neck in meningitis cases, and sepsis and rash in meningococcemia. |
| Etiologic Agent |
Multiple serogroups of Neisseria meningitidis. |
| Incidence |
In the United States, 0.3-1.0/100,000. Worldwide in distribution. Incidence during epidemics in sub-Saharan Africa can be as high as 2%. |
| Sequelae |
10%-14% of cases are fatal. Of patients who recover 11%-19% have permanent hearing loss, mental retardation, loss of limbs, or other serious sequelae. |
| Transmission |
N. meningitidis colonizes mucosal surfaces of nasopharynx and is transmitted through direct contact with large droplet respiratory secretions from the patients or asymptomatic carriers. Humans are the only host. |
| Risk Groups |
Risk groups include infants and young children (for endemic disease), refugees, household contacts of case patients, military recruits, college freshmen who live in dormitories, microbiologists who work with isolates of N. meningitidis, patients without spleens or with terminal complement component deficiencies. |
| Surveillance |
Surveillance is conducted worldwide through International Disease Notification and in the United States by NETSS, and NCID Emerging Infection Program's Active Bacterial Core surveillance (ABCs). |
| Trends |
Devastating epidemics will continue to occur in countries throughout the meningitis belt of Africa; emergence of epidemics due to a new serogroup (W-135) in Africa; in the United States, decreasing disease incidence from 1997-2006 and implementation of routine meningococcal conjugate vaccination of adolescents 11-18 years. |
| Challenges |
Establishing surveillance and early detection of epidemics in Africa, followed by emergency mass vaccination campaigns reaching high vaccine coverage; implementation of mass vaccination with conjugate vaccine in the African meningitis belt; integration o meningitis surveillance with surveillance for other epidemic-prone diseases; and introduction of conjugate meningococcal vaccines into routine childhood immunization programs in the United States. |
| Opportunities |
Incorporation of meningococcal conjugate vaccine in U.S. routine vaccination programs. Routine vaccination of infants in selected African countries and mass vaccination of children and adults using new conjugated meningococcal vaccines. |
