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CDC Outbreak Notice - India - Meningococcal Disease

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  • CDC Outbreak Notice - India - Meningococcal Disease

    Outbreak Notice

    Meningococcal Disease in India

    This information is current as of today, March 10, 2009 at 15:42

    Updated: March 10, 2009

    Meningococcal disease (commonly referred to as meningitis or epidemic meningitis) is a serious, sometimes fatal bacterial infection that occurs worldwide. Since January 2009, local health officials in India have reported 230 deaths and 2,000 possible cases of meningitis in the northeastern states of Tripura, Meghalaya, and Mizoram. These states are in the part of India bordered by Bangladesh to the west and Myanmar (Burma) to the east.
    Recommendations for Travelers

    Travelers to this part of India or to any other area currently experiencing meningitis epidemics should get a meningococcal vaccine. Protection develops 7-10 days after receiving the vaccine, so travelers should get vaccinated at least 10 days before travel, if possible. Travelers leaving in less than 10 days still need to get vaccinated before travel.
    Transmission and Treatment of Meningitis

    The bacteria that cause meningitis are spread by close, direct, or prolonged contact with an infected person through saliva or respiratory and throat secretions. This kind of contact includes intimate kissing or living in the same home. These bacteria are not spread by casual contact or by simply breathing the air where a person with meningitis has been.
    Anyone who develops signs and symptoms of meningitis should seek medical care immediately. Antibiotics can treat the infection but need to be started as soon as possible.
    Symptoms of meningitis:
    • High fever
    • Headache
    • Stiff neck
    • Nausea
    • Vomiting
    • Discomfort looking into bright lights
    • Confusion
    • Sleepiness

    Information for Health-Care Providers

    The infectious agent of meningococcal disease is a gram-negative diplococcus, Neisseria meningitidis. Five meningococcal serogroups are associated with the majority of disease: A, B, C, Y, and W-135. The strain of meningococcal disease in this Indian outbreak has been reported as serogroup A.
    Two meningococcal vaccines are currently available in the United States. Both protect against meningococcal disease caused by serogroups A, C, Y, and W-135:
    • Quadrivalent meningococcal conjugate vaccine (MCV4) is licensed for use among people 2Ė55 years of age and is the preferred vaccine for this age group. One dose is currently recommended for travelers. Revaccination may be recommended at a later date, as more information on duration or protection becomes available.
    • Quadrivalent meningococcal polysaccharide vaccine (MPVS4) is licensed for people 2 years of age or older. This vaccine should be used for people aged 55 years and older. Revaccination with MPSV4 is needed after 3-5 years for travelers or others who continue to require vaccination. MCV4 may be given to people who have received MPSV4 previously.

    Travelers should, if possible, be vaccinated 7-10 days before travel to allow for the development of protective antibody levels.
    To prevent secondary cases, CDC recommends preventive antibiotics (chemoprophylaxis) for close contacts of a person with meningococcal disease. Antibiotics for chemoprophylaxis include rifampin, ciprofloxacin, and ceftriaxone. Ceftriaxone is recommended for pregnant women.
    For more information, see ó

    For additional resources, including the most up-to-date recommendations from the Advisory Committee on Immunization Practices (ACIP), see Meningococcal Disease: Resources and Publications.
    Additional Information

    For more information on travel to India, see the India destination page from CDCís Travelersí Health website.