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6 Things to Know About Meningococcal Disease

Cases are increasing in the U.S., especially among adults. Do you know the warning signs?


spinner image collage of people using tissues and illustrations of neisseria meningitidis bacteria
Photo Collage: AARP; (Source: Shutterstock; GettyImages)

U.S. health officials are warning doctors about an uptick in cases of meningococcal disease, a rare but serious illness caused by the bacterium Neisseria meningitidis.

Its occurrence has been decreasing over the last decade, in large part due to vaccines that can help prevent the disease, says William Schaffner, M.D., an infectious disease expert and professor of preventive medicine and health policy at Vanderbilt University Medical Center in Nashville, Tennessee.  

But as of March 25, 143 cases of meningococcal disease have been reported this year, an increase of 62 cases over the 81 reported as of this date in 2023. A total of 422 cases were reported in the U.S. in 2023, which was the highest annual number of cases reported since 2014, the Centers for Disease Control and Prevention (CDC) said in its recent health advisory.

Different types of Neisseria meningitidis

There are different types (or serogroups) of N. meningitidis.

  • Serogroups A, B, C, W, X and Y are responsible for most meningococcal disease worldwide.
  • B, C, W and Y circulate in the U.S.
  • The current increase is mainly attributable to serogroup Y.
  • Vaccines against A, C, W, Y (MenACWY) and serogroup B (MenB) are available in the U.S.

Source: CDC

“That’s a surprise,” Schaffner says about the trends. What’s also puzzling, he says, is that cases of meningococcal disease, which can present as either meningitis or a bloodstream infection, ​are often seen in teens and young adults. However, the majority of cases being reported are among people ages 30 to 60. Black adults and people with HIV are also being disproportionately impacted by the disease.

Here are six things you need to know about meningococcal disease, including its warning signs and symptoms.

1. It spreads through close contact

Unlike the flu and COVID-19, which spread pretty easily from person to person, it takes close and lengthy contact — and a swap of saliva — to spread meningococcal bacteria, the CDC says.

“You usually get it from very close contact to infected people — especially if you’re kissing or if you’re around someone who is coughing a lot who has it,” says Barry Rittmann, M.D., an epidemiologist at VCU Health and assistant professor of medicine in the Division of Infectious Diseases at VCU School of Medicine in Richmond, Virginia. Sharing food and drinks can also spread the disease. Some people — about 1 in 10 — have N. meningitidis bacteria in the back of their nose and throat and never get sick, but they can pass it on to others. These people are referred to as carriers.

2. It can present in two different ways 

Meningococcal disease can come in two forms, the first being meningitis. This happens when the bacteria infect and inflame the lining of the brain and spinal cord. Common symptoms of meningitis include fever, headache and a stiff neck. People can also experience nausea, vomiting and confusion, the CDC says.

If the bacteria infect the bloodstream, they can multiply and damage the walls of the blood vessels and cause symptoms that range from fever to fatigue and vomiting to severe muscle pain. This is the second form of the disease, called meningococcal septicemia. In its later stages, some people with a bloodstream infection get a dark purple rash on their skin.

Often meningitis is the more common form of meningococcal disease. However, the specific strain of N. meningitidis contributing to the current increase is causing more bloodstream infections than meningitis, the CDC said in its health alert.  

3. Early warning signs can be subtle

It’s not uncommon for people with meningococcal disease to experience cold- and flu-like symptoms at first. “You can have a bit of a sore throat, you feel kind of down, your appetite goes off, you develop some fever and maybe even a few chills,” Schaffner says. “The big hazard with meningococcal disease is that the illness — which starts in such an innocuous, nonspecific fashion — can rapidly get more serious.”

In fact, the CDC says it can be deadly in a matter of hours, so it’s important to recognize the symptoms and seek medical care immediately if you experience them. If meningococcal disease is suspected, your doctor will likely prescribe antibiotics right away, before confirmation from blood or cerebrospinal fluid samples.

Even with treatment, between 10 and 15 percent of people with meningococcal disease will die, the CDC says, and up to 1 in 5 survivors will have long-term disabilities.

4. Close contacts are also treated

It’s not just people with meningococcal disease who get treated with antibiotics. Those who have come in close contact with someone who’s infected get them, too, to prevent the disease from spreading.

Health departments track cases of meningococcal disease, Rittmann says. “And when they have [reported cases], they actually look for people who were in close contact [with the infected person] so they can get these antibiotics as well.”

5. There are vaccines for meningococcal disease

The available meningococcal vaccines are recommended for preteens and teens and for some adults at increased risk for meningococcal disease, including people with HIV and individuals who are taking certain immune-suppressing medications.

The vaccines are also recommended for certain travelers and health care professionals (like microbiologists who are routinely exposed to N. meningitidis).

It is possible to get the shot as a catch-up vaccine, Rittmann says — most older adults have not received it — so talk to your doctor if you are concerned.

6. Health alert should prompt precautions, not panic 

Though cases are increasing, Schaffner says it’s important to keep in mind that meningococcal disease is still rare. For now, he says, the message is, “If you start to become ill in any way, please seek medical attention quickly.”  

Also, practice the same precautions you do for other illnesses, Rittmann says. If you’re sick, stay away from others so you don’t spread your germs. And if you know you were in contact with someone who was diagnosed with meningococcal disease, talk to your health care provider. “Just practicing reasonable precautions would be my recommendation,” says Rittmann.

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