The Centers for Disease Control and Prevention (CDC) is notifying clinicians about an increase in invasive meningococcal disease, mainly attributable to Neisseria meningitidis serogroup Y. In 2023, 422 cases were reported in the United States, the highest annual number of cases reported since 2014. As of March 25, 2024, 143 cases have been reported to CDC for the current calendar year, an increase of 62 cases over the 81 reported as of this date in 2023. A specific meningococcal strain, sequence type (ST) 1466, is responsible for most (101 of 148, 68%) serogroup Y cases with available sequence type data that were reported across the United States in 2023. Cases caused by this strain are disproportionately occurring in people ages 30–60 years (65%), Black or African American people (63%), and people with HIV (15%). In addition, most cases of invasive meningococcal disease caused by ST-1466 in 2023 had a clinical presentation other than meningitis: 64% presented with bacteremia, and at least 4% presented with septic arthritis. Of 94 patients with known outcomes, 17 (18%) died; this case-fatality rate is higher than the historical case-fatality rate of 11% reported for serogroup Y cases in 2017–2021.
Healthcare providers should 1) have a heightened suspicion for meningococcal disease, particularly among populations disproportionately affected by the current increase, 2) be aware that patients may present without symptoms typical of meningitis, and 3) ensure that all people recommended for meningococcal vaccination, including people with HIV, are up to date for meningococcal vaccines.
