CDC Issues Warning to Physicians Regarding Meningococcal Disease Risks During Hajj
In preparation for Hajj, the CDC advises healthcare professionals to stay vigilant for meningococcal disease risks associated with travel to Saudi Arabia. Stay informed to ensure traveler safety and prevent potential health threats.
The US Centers for Disease Control and Prevention is warning doctors to be vigilant for cases of meningococcal disease connected to travel to Saudi Arabia.
Since April, there have been 12 confirmed cases of meningococcal disease linked to journeys for Umrah, an Islamic pilgrimage to Mecca, the birthplace of the Prophet Muhammad in Saudi Arabia. Believers in the Muslim faith undertake Umrah trips to Mecca throughout the year to seek blessings. Muslims also participate in a longer, more structured pilgrimage to Mecca at least once in their lifetime during a specific time of year known as Hajj. This year’s Hajj will take place from June 14 to 19.
Meningococcus, Neisseria meningitidis, seen under a scanning electron microscope. (Photo by: BSIP/Universal Images Group via Getty Images)
Meningococcus, Neisseria meningitidis, seen under a scanning electron microscope. (Photo by: BSIP/Universal Images Group via Getty Images)
BSIP/Universal Images Group/Getty Images
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CDC is warning doctors to be on the lookout for a rare and serious bacterial infection that is showing up with unusual symptoms.
This year, five pilgrims from the United States have fallen ill from the infection. France has reported four cases, while the United Kingdom has had three. Out of those who have gotten sick, ten had recently visited Mecca, while two had been in close contact with someone who had.
Meningococcal disease, which includes meningitis, is a rare illness caused by the bacteria Neisseria meningitidis. This disease is highly contagious among individuals who have not received the necessary vaccination. Out of the patients whose vaccination status is known, nine were found to be unvaccinated.
This disease can result in an infection in the lining of the brain and spinal cord, leading to potential long-term medical issues such as memory and concentration problems, seizures, balance issues, hearing loss, and even blindness. In addition, meningococcal disease can progress to a severe blood infection known as septicemia or blood poisoning.
Research indicates that about 10% to 15% of cases result in death, even with the right treatment.
The CDC reports that the number of cases in the US has been increasing. As of the end of March, 143 cases have been reported this year, compared to 81 during the same period last year. In 2023, there were 422 cases in total, the highest number since 2014.
Meningococcal disease can be effectively treated with antibiotics if detected early. However, it is often challenging to diagnose promptly because the symptoms can resemble those of other common illnesses like Covid-19 or the flu. Symptoms may include fever, headache, nausea, vomiting, difficulty walking, stiff neck, skin rash, light sensitivity, and brain fog.
Recent tests on new cases of the disease revealed that in one case in the US and one in France, the bacteria were resistant to ciprofloxacin, a common antibiotic used as a first-line treatment. Fortunately, eight cases showed positive responses to treatment with penicillin or ciprofloxacin.
Vaccines and boosters are readily available for Umrah or Hajj pilgrims in Saudi Arabia. All pilgrims aged 1 and above are required to have received the quadrivalent meningococcal vaccine. This vaccine, also known as the meningococcal conjugate or MenACWY vaccine, provides protection against four different variations of the bacteria: A, C, W, and Y. It is important to note that most cases in the US are associated with serogroup Y.
In the US, doctors may suggest the MenB vaccine to safeguard against the B-type of the bacteria.
A vaccine called Penbraya, developed by Pfizer and approved in the US last year, provides protection against the five most common serogroups that can cause meningococcal disease.
Brussels, Belgium. 21st December 2020. Exterior view of Pfizer Pharmaceutical company's offices.
Brussels, Belgium. 21st December 2020. Exterior view of Pfizer Pharmaceutical company's offices.
Alexandros Michailidis/iStock Editorial/Getty Images/FILE
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Many of the sick pilgrims were found to have the W variation, while one case in the United States was due to serogroup C.
In the US, the vaccine is recommended for preteens, teens, and some younger children and adults in certain situations. For example, it is advised before traveling to countries where meningococcal disease is more common. Additionally, a booster shot is recommended if the last dose was received three to five or more years before the trip.
The CDC has stated that healthcare providers should assist individuals planning to travel for Hajj or Umrah. They should ensure that these individuals have received the MenACWY vaccine within the past five years or receive the shot at least 10 days before their departure.
In the latest update sent out via the CDC's Health Alert Network, healthcare providers were also advised to consider the possibility of meningococcal disease in individuals showing symptoms following a trip for Hajj or Umrah.
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The CDC recommended that health departments and providers should think about using a combination of preferred antibiotics for treating meningococcal disease in individuals who have traveled to Mecca.
People who have been in close contact with someone who has meningococcal disease should receive an antibiotic promptly after exposure, regardless of whether they have been vaccinated or not, according to the CDC. Ideally, this should be done within 24 hours of identifying the initial patient.
The most recent outbreak related to a large gathering occurred in 2000-01, the CDC reported, and it was mainly caused by the W strain of the bacteria. It was only after 2002 that Saudi Arabia started requiring all pilgrims to show proof of vaccination against meningococcal disease. However, the CDC noted that vaccination rates among these travelers are not complete.
Editor's P/S:
The recent surge in meningococcal disease cases among Umrah and Hajj pilgrims is a concerning development, highlighting the importance of vaccination and early detection. The disease can be severe, with potentially life-threatening consequences, and it's crucial for healthcare providers to be aware of the symptoms and consider meningococcal disease in individuals with relevant travel history.
The CDC's recommendation for healthcare providers to consider a combination of preferred antibiotics for treatment and the need for prompt antibiotic administration for close contacts emphasizes the urgency of managing the disease. Vaccination remains the most effective preventive measure, and all pilgrims should ensure they are up-to-date with the quadrivalent meningococcal vaccine. By raising awareness and promoting vaccination, we can help protect individuals from this potentially devastating illness.
