Cause: Neisseria meningitidis is a gram-negative bacteria classified in at least 12 serogroups based on its capsule. Serogroups B, C, W and Y, are the primary serogroups that cause invasive disease in the United States. Serogroups A, B, C, W, X, and Y cause the most in invasive disease worldwide.
Illness and treatment: Invasive meningococcal disease most commonly results in meningitis with symptoms including fever, headache, stiff neck, vomiting, light sensitivity and confusion. These symptoms develop quickly and require immediate medical attention. Bloodstream infection (meningococcemia) can occur with or without meningitis, usually causing fever and often shock, as well as a characteristic rash or bruise-like skin lesions (petechiae/purpura) from blood vessel damage. Pneumonia and joint infections can also occur.
Treatment includes supportive care for severe symptoms and immediate high-dose antibiotics; these may be given before lab results confirm the diagnosis. Even with appropriate antibiotic treatment and supportive care, the case fatality rate is 10-15%. Among survivors, as many as one in five will have permanent disabilities, including hearing loss, brain damage, limb amputations or kidney damage.
Sources: Humans, including asymptomatic carriers, are the reservoir. Transmission is person-to-person through close or prolonged contact with a colonized or infected person’s respiratory and throat secretions. Secondary cases are rarely documented but can occur, especially in those in the same household, roommates, and others with close contact to the primary case.
Additional risks: Rates are highest for infants under 12 months. An increasing proportion of cases are in adolescents and young adults and people over the age of 65. Certain conditions have been identified as risk factors for meningococcal disease including crowded living conditions such as college dormitories or military barracks, certain immune deficiencies including asplenia, those living with sickle cell disease, those living with HIV, as well as those who have complement component deficiency or take certain immune-suppressing drugs that block the complement system.
Prevention: Vaccines are the best protection against meningococcal disease. Respiratory hygiene can reduce the likelihood of transmission.
Purpose of Reporting and Surveillance
- To identify persons who have been significantly exposed to the index case, in order to recommend antibiotic prophylaxis (chemoprophylaxis) and to inform them about signs and symptoms of illness.
- Under very rare circumstances, to recommend prophylactic immunization in a defined population or community.
Legal Reporting Requirements
- Health care providers and health care facilities: immediately notifiable to local health jurisdiction.
- Laboratories: immediately notifiable to local health jurisdiction; submission required – isolate from a normally sterile site, within 2 business days; submission on request – if no isolate available, specimen associated with positive result, within 2 business days.
- Local health jurisdictions: notifiable to Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.
Resources
- Meningococcal Facts
- Reporting Form (PDF)
- Meningococcal Guideline (PDF)
- Meningococcal Disease Surveillance (CDC)
- Meningococcal Disease Clinical Information (CDC)
- Meningococcal Vaccination: Information for Healthcare Professionals (CDC)
- Increase in Invasive Serogroup Y Meningococcal Disease in the United States