By the numbers: Rising case fatality rate.
This disease is caused by an infection with a bacterium called Neisseria meningitidis. There were 422 cases of invasive meningococcal disease reported in the United States last year, the highest number since 2014, according to the Centers for Disease Control and Prevention.
But as of Monday, 143 cases had been reported to the CDC so far this year, 62 more than were reported during the same period last year.
This disease is extremely dangerous. Even with appropriate treatment, 10 to 15 percent of patients who develop meningococcal disease die. Many of the recent cases were caused by a rare meningococcal strain called ST-1466. This strain caused 17 deaths among 94 patients with known outcomes, for a case fatality rate of 18%.
Survivors of meningococcal disease can be left with long-term disability, hearing loss, amputations, or brain damage.
Mystery: What is the cause of the epidemic?
The majority of people affected in the recent outbreak were Black people and adults between the ages of 30 and 60.
Other susceptible populations include people with HIV, who make up 15 percent of patients. A person who had their spleen removed. People with sickle cell disease. Patients with certain rare immune conditions.
The meningitis vaccine, which protects against four of the six types of meningococcal bacteria, including group Y, which includes ST-1466, is recommended for adolescents as well as people with medical conditions such as HIV. Most older people have not received the vaccine.
Virginia has seen 35 meningococcal cases and six deaths since summer 2022, but public health officials have found no epidemiological link to explain the outbreak. , said Dr. Laurie Forlano, the state's epidemiologist.
“We're always trying to find the golden ticket of common risk factors,” Dr. Forlano said. “Did they all go to a party together or a family event?” Were they all at some facility? Are there social networks they share? Just not here. ”
The disease is spread not through casual contact but through activities that involve exposure to saliva, respiratory secretions, and throat secretions, such as kissing, sharing food and drink, and cigarettes.
A ticking clock: Treatment must occur quickly.
Infection can cause meningitis, an inflammation of the membranes that cover the brain and spinal cord. Typical symptoms include fever, headache, stiff shoulders, vomiting, photosensitivity, and changes in mental status.
The bacteria can also enter the bloodstream and cause a complication called sepsis, which appears to be a more common outcome in serogroup Y cases today. Symptoms include fever and chills, fatigue, vomiting, cold hands and feet, severe pain, diarrhea, rapid breathing, and in later stages, a dark purple rash.
Symptoms worsen rapidly and can become life-threatening within hours. Antibiotics must be administered promptly.
“When people think of meningococcal disease, they think of meningitis, which is a very scary disease,” Dr. Forlano said. “But what we want to appeal to the clinical community is that these cases are presenting differently than we've seen before. So, hey, think about this. ”
However, she stressed that despite the risks, the disease remains rare. “The threat to the general public is low,” she said.
