Meningococcal Disease Around the World: The Meningitis Belt and Beyond

Key points

• Meningococcal disease occurs worldwide.
• It is most common in the meningitis belt of sub-Saharan Africa.
• Other regions have lower overall rates and occasional outbreaks.

The meningitis belt, stretching across Africa from Senegal to Ethiopia. CDC map.

The meningitis belt

The belt has historically had major epidemics of meningococcal disease every 5 to 12 years, with attack rates reaching 1,000 cases per 100,000 people.

What drives outbreaks in Africa isn't fully understood, but these conditions favor epidemics:

• dry, dusty weather in the dry season, December to June;
• a population's immunological susceptibility;
• travel and large population displacements;
• crowded living conditions.

What vaccines changed

Outbreaks in the belt were once mainly serogroup A. Since a single-serogroup A conjugate vaccine (MenAfriVac) was introduced in the region from 2010, outbreaks have mainly been caused by serogroups C and W, and some serogroup X outbreaks have been reported too.

A newer vaccine, Men5CV, protects against five serogroups — A, C, W, Y and X. It was first used in 2024 in Nigeria and Niger, in response to outbreaks there.

CDC's role

Aiming to end meningitis epidemics in sub-Saharan Africa, CDC works with African ministries of health and other partners to:

• strengthen meningitis surveillance;
• evaluate the impact of Men5CV.

Outside Africa

• In Europe, the Americas and Australia, serogroups B, C, W and Y together cause the large majority of cases.
• In temperate regions, cases rise in winter and spring.
• The annual Hajj and Umrah pilgrimages to Saudi Arabia have been linked to outbreaks among returning pilgrims and their contacts — including six cases among Umrah travelers and their contacts in the United States in 2024.

Travelers: see CDC's travel guidance on meningococcal disease.

Sources

Based on "Meningococcal Disease in Other Countries," Centers for Disease Control and Prevention; a work of the United States government in the public domain.