An urgent health alert has been issued by the Centers for Disease Control and Prevention as the United States witnesses a sharp increase in the incidence of invasive meningococcal disease.
The disease has been particularly prevalent among Black or African American individuals, who represent 63% of cases, and people with HIV, comprising 15% of the total.
Meningococcal disease most often presents as meningitis, with symptoms that may include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status; or as meningococcal bloodstream infection, with symptoms that may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a dark purple rash.
While initial symptoms of meningococcal disease can at first be non-specific, they worsen rapidly, and the disease can become life-threatening within hours.
Of the six N. meningitidis serogroups - A, B, C, W, X, and Y - responsible for most meningococcal disease worldwide, the four serogroups B, C, W, and Y circulate in the United States.
Cases of invasive meningococcal disease caused by this strain occurred in both males and females and disproportionately occurred in people ages 30-60 years, Black or African American people, and people with HIV. In addition, most cases of invasive meningococcal disease caused by ST-1466 had a clinical presentation other than meningitis: 64% presented with bacteremia, and at least 4% presented with septic arthritis.
The serogroup Y ST-1466 strain has contributed to previously reported increases in meningococcal disease in people with HIV. Based on updated surveillance data, 24 ST-1466 cases have now been reported in people with HIV in 2022-2023; only four were previously vaccinated with MenACWY and none were up to date on recommended doses.
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