Rare but severe cases of meningitis are on the rise, CDC warns

The spike is notable in part because infections are disproportionately affecting people ages 30 to 60, as well as African American individuals and those with HIV. Typically, infants younger than 1, teenagers and young adults ages 16 to 23 as well as individuals older than 85 have a higher risk of contracting meningococcal disease.

The agency says health-care experts should increase monitoring for meningitis symptoms, and the public should take steps to prevent its spread.

“We’re not recommending any unusual precautions,” said Lucy McNamara, an epidemiologist in the meningitis and vaccine-preventable diseases branch at the CDC.

“We would like for the general public to be aware of the symptoms of meningococcal disease and to contact their health-care provider if they or members of their family have those symptoms,” she said, adding that officials also “want to make sure that they’re up to date for meningococcal vaccinations.”

Meningitis is an inflammation of the protective membranes covering the brain and spinal cord, known as the meninges. It can be caused by various infectious agents such as bacteria, viruses, fungi or parasites, as well as certain medications or autoimmune conditions. Meningococcal disease is caused by the Neisseria meningitidis bacterium. Four of the six known subgroups of this bacterium circulate in the United States, and the rise in cases is mainly attributed to a strain of one called serotype Y.

Meningitis can lead to symptoms such as severe headache, fever, stiffness in the neck, sensitivity to light and confusion. In severe cases, it can result in neurological damage, coma or even death.

How is meningitis spread?

Meningococcal disease is spread mainly through close contact such as coughing, sneezing, kissing or living in close quarters with an infected person. It’s not spread through casual contact and requires close, prolonged exposure to an infected individual for transmission to occur.

Meningococcal disease is spread through larger droplets, so it’s not as contagious as the common cold or flu, but experts still recommend taking precautions to prevent its spread. Otto Yang, associate chief of infectious diseases at UCLA’s David Geffen School of Medicine, said distancing, masking, handwashing and vaccines are the standard prevention methods that should be implemented.

Is there a meningitis vaccine?

In the United States, a vaccine targeting serogroups A, C, W and Y as well as another targeting serogroup B are available and recommended for people with specific risk factors or medical conditions.

The CDC advises that all 11-to-12-year-olds receive the MenACWY vaccine, with a booster shot recommended at age 16 to maintain immunity. For high-risk groups, such as individuals with HIV, they advise a specialized vaccination regimen that includes regular booster doses for as long as they remain at risk.

For now, there are no changes to the recommended vaccine schedule.

Why is meningitis on the rise?

The reason this strain is on the rise among certain demographics is not yet fully understood, according to Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security and an adjunct assistant professor at the Johns Hopkins Bloomberg School of Public Health.

Adalja adds that the reason it seems to be affecting Black individuals could be related to genetics or how the infection is spreading among different groups.

“It’s not as if you get exposed to the bacteria and all of a sudden you’re infected,” Adalja said. The bacteria need to first colonize a host and then develop into an invasive disease, which takes time. This progression is probably influenced by the levels of colonization within specific demographics, which could be connected to the strain’s tendency to infect certain groups.

What can patients and health-care providers do to protect people from meningitis?

The CDC advises health-care providers to be on alert for meningococcal disease and start antibiotics treatments immediately for suspected cases. The agency also said health-care providers should be aware that some patients may have bloodstream infections or septic arthritis — and not have symptoms typical for meningitis.

“Individuals are not presenting with classic meningitis signs,” Adalja said, “so you should think about it even outside of meningitis.”

The CDC also recommends that patients seek immediate medical attention if they or a family member develop symptoms, because the disease can worsen quickly and become life-threatening within hours.