Bacterial Meningitis Is On the Rise in the U.S. - Everyday Health

An increase in cases of bacterial meningococcal disease has prompted federal health officials to issue a health alert, warning healthcare providers in the United States to be on the lookout for people with symptoms of the rare but potentially fatal illness.

Last week, the Centers for Disease Control and Prevention (CDC) reported that 143 people in the country had been infected with a rare invasive meningococcal bacterial strain so far this calendar year — an increase of 62 cases over the number reported as of this date in 2023.

Of 94 patients with known outcomes from 2023, 18 percent died. This fatality rate is higher than the historical 11 percent reported between 2017 and 2021.

"This rise in cases is unexpected because meningococcal disease, which causes meningitis and bloodstream infections, has been on a steady downward course in the United States for 10 years now," says William Schaffner, MD, an infectious disease specialist and a professor of preventive medicine and health policy at the Vanderbilt University School of Medicine in Nashville, Tennessee.

Meningitis is the term for swelling of the membranes surrounding the brain and spinal cord. It is most often caused by viral infections but can also be the result of bacterial, parasitic, and fungal infections.

Vaccination Has Kept Meningitis in Check

Meningococcal disease can be prevented by vaccines, which are recommended for adolescents ages 11 to 12 and unvaccinated college freshmen living in residence halls. Since protection wanes, the CDC recommends a booster dose at age 16.

A meningococcal vaccine protects against several different types of bacteria that cause illness, including the unusual strain ST-1466 that is behind many of the recent infections. It's uncertain from the latest CDC details how many of those infected this year have received the vaccination.

A decline in cigarette smoking may have also contributed to lower susceptibility and a drop in meningococcal illness in recent years.

Who Is Most at Risk for Meningitis?

Federal health officials have cautioned that current increases in disease are disproportionately affecting people ages 30 to 60, Black Americans, and people with human immunodeficiency virus (HIV).

The CDC notes that because individuals with HIV have weakened immune systems, infections occur more frequently and are more severe.

Although it's unclear why the illness appears more likely to affect Black Americans, research has suggested that a gene mutation more common among this group may make them more likely to get infected.

Is Meningitis Contagious? How Does It Spread?

Meningococcal bacteria is spread from person to person through respiratory and throat secretions (saliva or spit), generally when there is close contact (for example, coughing or kissing). The illness may also transmit through the sharing of drinks or cigarettes, smoking devices, or marijuana.

"Young adults may be more susceptible if they go to bars where there's a lot of close, very personal interaction with other people, such as vigorous talking," says Dr. Schaffner.

The CDC stresses, however, that meningococcal disease doesn't transmit easily through casual contact or by breathing air where someone with the disease has been, as with the flu.

What Are the Symptoms of Meningitis?

The most common symptoms of meningococcal disease are fever, headache, and stiff neck, but patients may also experience nausea, vomiting, sensitivity to light, and confusion.

The bacteria can also cause meningococcal bloodstream infections, with symptoms that may include fever and chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, and in later stages, a dark purple rash.

Patients with bloodstream infections or septic arthritis (another infection caused by meningococcal bacteria, in the joint fluid and joint tissues) can sometimes have no signs of illness.

"Because people can carry these meningococcal bacteria back in their nasal pharynx and in their throat without knowing it, the illness is thought to often spread from a person without symptoms," says Schaffner.

Bacterial Meningitis Requires Prompt Treatment

If caught early, meningococcal disease can be successfully treated with antibiotics. The infection, however, can advance rapidly and damage the body so severely that antibiotics are unable to prevent serious long-term problems or death. Survivors may experience enduring effects such as deafness or limb amputations.

That's why federal health officials are calling on healthcare providers to be on high alert for signs of the disease, particularly among vulnerable groups. They are also urging the public to be up-to-date on their vaccinations, and encouraging those who may have been in close contact with an infected person to take an antibiotic as a preventive measure.

While the overall risk of contracting meningococcal illness is low, Schaffner warns that we all should be mindful of the situation.

"We're not entirely sure why this increase in cases is going on, but we need to be aware and respond to keep transmission as low as possible," he says.

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