Public Health Advisory – Increase in Invasive Serogroup Y Meningococcal Disease in the United States, CDC Health Advisory
What You Need To Know
On March 28, the CDC issued the attached Health Advisory through the CDC Health Alert Network to alert healthcare providers about an increase in invasive serogroup Y meningococcal disease in the United States.
Please also see the NJLINCS Health Alert Message that was sent with NJ-specific information about invasive meningococcal disease and is available on the NJDOH meningococcal disease website.
Meningococcal disease, which typically presents as meningis or meningococcemia, is a sudden-onset, life-threatening illness caused by the bacterium Neisseria meningitidis. Prompt antibiotic treatment can reduce morbidity and mortality among patients and antibiotic prophylaxis can prevent secondary disease in close contacts.
Cases of meningococcal disease in the United States (US) have increased sharply since 2021 and now exceed pre-pandemic levels. In 2023, 415 confirmed and probable meningococcal disease cases were reported in the US (preliminary data); this is the largest number of US cases reported since 2014. In many jurisdictions, the increase is attributable to NmY ST-1466.
N. meningitidis isolates in the US have been largely susceptible to the antibiotics recommended for treatment and prophylaxis. However, 11 meningococcal disease cases reported in the US during 2019–2020 from nine states, including NJ, had isolates containing a blaROB-1 β-lactamase gene associated with penicillin resistance, as well as mutations associated with ciprofloxacin resistance. These cases represented a substantial increase in penicillin-resistant and ciprofloxacin-resistant meningococci in the US since 2013.
Providers should consider performing amicrobial susceptibility testing (AST) to determine the susceptibility of all meningococcal isolates to penicillin before changing from empirical treatment with cefotaxime or ceftriaxone to penicillin or ampicillin. AST can also be helpful in assessing ciprofloxacin resistance which will help to inform prophylaxis recommendations.
Providers should ensure that all persons who are eligible be immunized with the meningococcal vaccine. All adolescents should be routinely immunized with a 2-dose series. People at high risk including people living with HIV infection should be immunized.
Cases of invasive meningococcal disease are immediately reportable. NJ Communicable Disease reporting requirements are available here.
Cases should be reported to the local health department where the patient resides. If you are unsure which local health department should be contacted, use the locator tool.