The US Centers for Disease Control and Prevention (CDC) recommends that doctors be aware that invasive meningococcal ulcers caused by Neisseria bacteria attack middle-aged people instead of young people as before.
The CDC warning came after the Virginia Department of Health confirmed five deaths from severe meningococcal disease. In cases identified up to March this year, the death rate was one in six, higher than typically seen in meningococcal cases. The cases are also unusual because the bacteria attack middle-aged people instead of infants and teenagers as before.
Last year, the US recorded 422 cases of this disease, with at least 17 deaths, the highest since 2014. Since the beginning of the year, 143 cases have been reported, meaning the number is on track to exceed through 2023, the CDC said. Patients are mainly between 30 and 60 years old, black people and HIV patients.
Typical symptoms of meningitis include fever, headache, stiff neck, photophobia and nausea. However, many recently reported cases do not have these symptoms. About two-thirds of patients had sepsis, and 4% had joint pain and infection.
The initial symptoms are similar to those of other common infections, but they quickly become worse, becoming life-threatening within hours. Patients need immediate treatment with antibiotics. Survivors may suffer long-term effects such as deafness and loss of limbs.
Neisseria meningitidis bacteria are spread from person to person through respiratory and throat secretions. Secretions spread when kissing, coughing, sneezing or close contact. The disease can cause blood infection, symptoms such as chills, fatigue, cold hands and feet, rapid breathing, and diarrhea. In the later stages, the patient has symptoms such as a dark purple rash.
There are four groups of meningococcal bacteria circulating in the US: B, C, W and Y. The 2023 cases were all caused by strain ST-1466, which belongs to subgroup Y.
Bacterial meningococcal disease now has a vaccine to prevent it. The vaccine is used for children from 11 to 12 years old, with a booster dose at age 16. People with underlying medical conditions, immunodeficiency due to cancer treatment or HIV are also recommended to be vaccinated.