Cases of Meningococcal Disease Are Increasing in the United States

Cases of meningococcal disease are on the rise. As of March 25, 143 cases of meningococcal disease have been reported in the United States, compared with 81 for the same period last year. For all of 2023, 422 cases were reported, the highest annual figure since 2014.

This increase in cases is mainly caused by a particular type—serogroup Y—of Neisseria meningitidis bacteria, also known as meningococcus. CDC issued an advisory on March 28 alerting healthcare providers to an increase in meningococcal disease. The health alert advises clinicians to maintain a heightened suspicion for meningococcal disease due to the high number of cases. The alert also informs clinicians to recognize:

• who is most affected by the increase
• what symptoms to be aware of
• the importance of being up to date with meningococcal vaccination

Meningococcal disease can be life threatening

Meningococcal disease is a serious bacterial infection that requires immediate medical attention. It develops rapidly, often among previously healthy people. The disease is rare but has a high fatality rate (10 to 15%), even with appropriate antibiotic treatment. The cases reported since last year have an even higher fatality rate of 18%.

Initial symptoms of meningococcal disease can at first be non-specific, like having the flu, but symptoms can worsen rapidly. The disease can become life threatening within hours. Immediate antibiotic treatment for meningococcal disease is critical. Long-term outcomes faced by survivors include deafness or amputation of the extremities.

Most cases of serogroup Y meningococcal disease are causing bloodstream infection

The most common type of meningococcal disease is meningitis, an infection of the lining of the brain and spinal cord. Symptoms of meningitis may include:

• fever
• headache
• stiff neck
• nausea
• vomiting
• eyes being more sensitive to light
• confusion

But most cases of serogroup Y meningococcal disease reported in the last year have presented as bloodstream infection, which is when bacteria get into the blood. This can lead to sepsis, the body’s extreme response to infection. Symptoms of meningococcal bloodstream infection may include:

• fever and chills
• fatigue
• vomiting
• cold hands and feet
• severe aches or pains
• rapid breathing
• diarrhea
• in later stages, a dark purple rash

How the bacteria spread

People spread meningococcal bacteria to other people by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close (e.g., coughing, kissing) or lengthy (e.g., roommates) contact to spread these bacteria. Fortunately, meningococcal bacteria aren’t as contagious as germs that cause the common cold or the flu. People don’t catch the bacteria through casual contact or by breathing air where someone with meningococcal disease has been.

Who’s at risk?

Meningococcal disease can affect anyone. Some populations more at risk of getting meningococcal disease include babies younger than 12 months old, adolescents, and young adults.

But the strain that’s primarily responsible for the increase in cases is disproportionately affecting the following groups of people:

• people ages 30–60 years
• Black or African American people
• people with HIV

Seek immediate medical attention

It’s important to be aware that people with meningococcal disease may develop a bloodstream infection or severe joint infection. They may not show symptoms typical of meningitis (e.g., headache, stiff neck).

People should seek medical attention immediately if symptoms of meningococcal disease develop.

Vaccines can help prevent meningococcal disease

There are six serogroups, or types, of Neisseria meningitidis that cause most meningococcal disease worldwide. In the United States, there are vaccines against five of those: serogroups A, C, W, and Y (MenACWY) and serogroup B (MenB).

CDC routinely recommends MenACWY vaccine for preteens and teens and for adults with risk factors or underlying medical conditions, such as HIV. In certain situations, younger children (down to 2 months old) should get a MenACWY vaccine. Teens and young adults ages 16 through 23 years may also receive a MenB vaccine.

All people who are recommended meningococcal vaccination should be up to date on their vaccines. Talk to a healthcare provider about meningococcal vaccines that may be recommended for you and your household or family members, including any recommended booster doses.