Outbreaks of meningococcal disease are rare in the United States; only about 2 to 3 out of every 100 cases are related to outbreaks. However, the onset of an outbreak is unpredictable and the outcomes can be emotionally devastating to affected communities and organizations. In certain outbreaks, vaccination against meningococcal disease is recommended to help stop the disease from spreading.
Outbreaks can occur in communities, schools, colleges, prisons, and other populations. An outbreak occurs when there are multiple cases of the same serogroup ("strain") in a community or institution over a short period of time. Depending on the size of the institution and specific circumstances, having just two cases of the same serogroup may be considered an outbreak.
Outbreak Control Measures
State and local health departments take the lead in investigating outbreaks and implementing control measures to reduce spread of the disease. They often work closely with CDC which has published guidelines to assist with this. In the setting of an outbreak, such recommendations often include:
- Vaccinating people identified as being at increased risk
- Making sure all close contacts of a patient receive antibiotics to prevent them from getting the disease; this is known as prophylaxis
State and local health departments, or an institution, are the best source of information for a specific outbreak, their specific recommendations, and case details.
During an outbreak caused by serogroup A, C, W, or Y meningococcal disease, vaccination with a quadrivalent meningococcal conjugate vaccine is routinely recommended for those 2 months or older identified as being at increased risk because of the outbreak.
Newly licensed serogroup B meningococcal vaccines are an important step forward for controlling serogroup B meningococcal disease, especially in outbreak settings. For outbreaks caused by serogroup B meningococcal disease, vaccination with a serogroup B meningococcal vaccine is recommended for those 10 years or older identified as being at increased risk because of the outbreak.
There are two vaccines that provide protection against serogroup B meningococcal disease: Bexsero® (GlaxoSmithKline) and Trumenba® (Pfizer). In the setting of an outbreak, two doses are needed for Bexsero® and three doses are needed for Trumenba®. Both vaccines are expected to help protect against most serogroup B meningococcal strains circulating in the United States. The same vaccine brand must be used for all doses — Bexsero® and Trumenba® are not interchangeable. If someone received one brand and decides to switch to the other, it is recommended they wait at least 1 month between products and then get the full series of the second vaccine.
Generally, it does not matter which brand someone receives. Neither of these vaccines will prevent all cases and each vaccine may perform better against some strains than others. In some outbreak situations, there may be a stated preference for one brand over the other if lab testing suggests that one vaccine may provide better protection against the specific strain causing the outbreak. However, there is a limited understanding of how well laboratory test results correspond to the actual effectiveness of each vaccine against any particular strain. Until these vaccines are used more broadly in response to outbreaks, actual effectiveness against specific strains remains unknown.
Close contacts include people in the same household, roommates, or anyone with direct contact with the patient's saliva (such as a boyfriend or girlfriend through French kissing). CDC supports state and local health departments in identifying a response that best protects their residents' health.Top of Page
- Evaluation and Management of Suspected Outbreaks of Meningococcal Disease
- Use of Serogroup B Meningococcal Vaccines in Persons Ages ≥10 Years at Increased Risk for Serogroup B Meningococcal Disease: Recommendations of the Advisory Committee on Immunization Practices, 2015
- Interim Guidance for Control of Serogroup B Meningococcal Disease Outbreaks in Organizational Settings [6 pages]
- NNDSS Case Definition for Meningococcal Disease
- Southern California Meningococcal Disease Outbreak
- Page last reviewed: June 11, 2015
- Page last updated: October 20, 2016
- Content source:
- Content source: National Center for Immunization and Respiratory Diseases