Meningococcal Disease Surveillance and Trends

U.S. cases of meningococcal disease have increased sharply since 2021 and now exceed pre-pandemic levels. In 2023, 422 confirmed and probable cases were reported (CDC preliminary data). This is the largest number of U.S. meningococcal disease cases reported since 2014.

Neisseria meningitidis serogroup Y drives much of this recent increase.

People disproportionately affected by the increase include:

• People between the ages of 30 and 60 years
• Black or African American people
• Adults with HIV

Health Alert Network Health Advisory‎

CDC issued a Health Alert Network (HAN) Health Advisory on March 28, 2024, about the increase in serogroup Y meningococcal disease in the United States.

Recommendations

Public health officials should encourage healthcare providers to:

• Maintain a heightened index of suspicion for meningococcal disease and recognize who can be affected
• Be aware of atypical presentations
• Ensure up-to-date vaccination

Heightened index of suspicion: This is particularly important among the disproportionately affected populations. However, meningococcal disease may affect people of any age or demographic group.

Atypical presentations: Patients with meningococcal bloodstream infection or septic arthritis may present without typical meningitis symptoms.

Vaccine recommendations: Ensure everyone who's recommended to receive meningococcal vaccination is up to date. For people with HIV, recommended MenACWY vaccination includes:

• A 2-dose primary series
• Booster doses every 3 to 5 years depending on age

Data systems

National Notifiable Diseases Surveillance System

Meningococcal disease is a reportable condition in all states.

CDC collects national information about meningococcal disease through the National Notifiable Diseases Surveillance System (NNDSS). CDC receives NNDSS data each week.

Active Bacterial Core surveillance

CDC also collects information from laboratories in 10 areas of the country through Active Bacterial Core surveillance (ABCs). ABCs is part of CDC's Emerging Infections Program.

Enhanced surveillance

Health departments from all 50 states and several large jurisdictions collect enhanced meningococcal disease data and isolates. This enhanced surveillance began in 2015 in order to

• Collect more complete data to monitor disease epidemiology
• Inform policy decisions
• Collect isolates from a broad and representative population

How the data are interpreted

Seasonal disease trends

The number of cases generally peaks each year in January, February, and March.

Disease trends overall

U.S. rates of meningococcal disease have declined sharply since the 1990s.

Some age groups have higher incidence rates

Anyone can get meningococcal disease. However, rates of disease are highest in children younger than 1 year old, followed by a second peak in adolescence. Among adolescents and young adults, those 16 through 23 years old have the highest rates of meningococcal disease.

Some serogroups cause more disease in certain age groups

The proportion of cases caused by each serogroup varies by age group.

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Antimicrobial resistance trends

Since 2019, CDC has detected penicillin- and ciprofloxacin-resistant serogroup Y meningococcal isolates in the United States.

Antibiotic-resistant N. meningitidis serogroup Y‎

Due to concern over antibiotic-resistant cases, CDC has updated information and guidance on treatment, prophylaxis, and surveillance activities.