The Centers for Disease Control (CDC) recently issued a health advisory regarding an increase in meningococcal disease cases in the U.S. and Europe linked to travel to the Kingdom of Saudi Arabia (KSA) for Umrah, an Islamic Pilgrimage to Mecca that can be performed any time in the year. A majority of the recent cases have been in unvaccinated travelers and close contacts, and most of the cases have been caused by Neisseria meningitidis serogroup W, which is often associated with more severe disease than other serogroups. The Hajj, an annual pilgrimage to Mecca that often attracts more than 2 million visitors, will take place this year from June 14-19, 2024.
In addition to recommendations for health departments and members of the public, the health advisory includes the following recommendations for clinicians:
Recommendations for Healthcare Providers
- Recommend vaccination with MenACWY conjugate vaccine for people aged one year or older considering travel to KSA to perform Hajj or Umrah (pilgrims) in addition to routine meningococcal vaccination for adolescents and other people at increased meningococcal disease risk.
- Maintain a heightened index of suspicion for meningococcal disease among symptomatic people who have recently been in KSA and among close contacts of people who have recently been in KSA, regardless of vaccination status.
- Immediately notify state, tribal, local, or territorial health departments about any suspected or confirmed cases of meningococcal disease in the United States.
- Preferentially consider using rifampin, ceftriaxone, or azithromycin instead of ciprofloxacin as prophylaxis for close contacts in the United States of meningococcal disease cases associated with travel in KSA.
If you have any questions or if you become aware of any suspected meningococcal cases in your jurisdiction, please contact KDPH Division of Epidemiology and Health Planning.
