Meningococcal disease is uncommon but very serious. Its two most common forms are meningitis and septicemia. Cases in the U.S. have risen sharply since 2021 and are now above pre-pandemic levels.
Neisseria meningitidis. CDC
Cause
The disease is caused by Neisseria meningitidis, gram-negative diplococcal bacteria. Of its many serogroups, B, C and Y cause most U.S. disease; serogroup W and nongroupable strains cause a small share.
Who's at higher risk
Anyone can get it, but risk is higher for:
| Close contacts | household and other close contacts of a patient |
| Medical conditions | functional or anatomic asplenia; HIV; persistent complement component deficiencies (C3, C5–9, properdin, factor H, factor D) |
| Complement inhibitors | people taking drugs such as eculizumab (Soliris) or ravulizumab (Ultomiris) — usually prescribed for atypical hemolytic uremic syndrome, generalized myasthenia gravis, neuromyelitis optica spectrum disorder or paroxysmal nocturnal hemoglobinuria |
| Age | infants under 1; adolescents and young adults 16–23; adults 85 and older |
| Settings | microbiologists routinely handling N. meningitidis; people at risk in an outbreak; travelers to certain countries; first-year college students in residence halls; military recruits |
Two clinical notes:
- Meningococcal disease is often the first sign of a complement deficiency, and such patients can get it again — consider complement testing in patients with the disease.
- For patients on eculizumab or ravulizumab, vaccines and preventive antibiotics likely give incomplete protection. They should seek care immediately for symptoms, whatever their vaccination or antibiotic status. See CDC's guidance on complement inhibitors.
How it spreads
Through respiratory and throat secretions, during close or lengthy contact. Both people who are sick and those who carry the bacteria in the nose and throat without symptoms can spread it. Humans are the only host. For travelers, see the Yellow Book chapter.
Prevention
- Prophylaxis: CDC recommends it for close contacts of patients, whatever their vaccination status. If ciprofloxacin-resistant strains have been reported in your state in the past 2 years, consider susceptibility testing to guide the choice (antibiotic-resistant N. meningitidis).
- Vaccination: recommended for all preteens and teens, and for children and adults at increased risk (vaccine recommendations).
Diagnosis and treatment
Because it can cause severe illness and death, prompt diagnosis and treatment matter. See CDC's clinical guidance.
Meningococcal disease is reportable in the U.S. More: surveillance and trends · surveillance manual chapter · communication and print resources.
Sources
Based on "Clinical Overview of Meningococcal Disease," Centers for Disease Control and Prevention; a work of the United States government in the public domain.
Licence: CC0 1.0 (public domain) · Adapted from www.cdc.gov
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