CDC: Increase in Meningococcal Disease Among Persons with HIV

The CDC is reporting there was a significant increase in meningococcal disease diagnosed in 2022 compared to several years previously.

The findings were published in the CDC Morbidity and Mortality Weekly Report.

“During 2017–2021, five to 15 meningococcal disease cases were reported each year among persons with HIV, representing 1.5%–4.3% of all meningococcal disease cases annually,” the authors wrote. “Based on preliminary data, 29 meningococcal disease cases have been reported among persons with HIV in 2022, accounting for 9.8% of all cases.”

The CDC also notes this case count could be higher when the reporting is complete later this year.

According to the Florida Department of Health, the state had a reported outbreak of the disease in 2022 with 12 people succumbing to it among 48 cases from January 1, through July 21, 2022.

“The overall case-fatality ratio of meningococcal disease is 10% to 15%, even with appropriate antibiotic therapy, and can be higher in persons with meningococcemia,” the CDC reports.¹

A study conducted by investigators found that people with HIV were at a 4.5- to 12.9-fold increased risk of meningococcal disease compared to an otherwise healthy population. ²

The meningococcal conjugate (MenACWY) vaccines Menactra and Menveo are indicated for people 2 months of age up to 55 years depending on the vaccine. In addition, a newer meningococcal conjugate vaccine, MenQuadfi (MenACWY-TT), is a prophylaxis measure against invasive meningococcal disease caused by Neisseria meningitidis in individuals beyond the traditional cutoff at age 55 years.³

The MMWR report also says vaccine coverage in people with HIV is low, so they are recommending that health care providers should make sure this patient population should be up to date with their MenACWY vaccine.

CDC reminds the public that symptoms can appear suddenly and include high fever, headache, stiff neck, nausea/vomiting, or a dark purple rash. Symptoms can first appear as a flu-like illness, but typically worsen very quickly. People spread meningococcal bacteria to others by sharing respiratory and throat secretions (saliva or spit). Generally, it takes close or lengthy contact, such as kissing or being near someone coughing, to spread these bacteria.

References

1. Mbaeyi S, Duffy J, McNamara L. Epidemiology and Prevention of Vaccine-Preventable Diseases. CDC. Last updated August 18, 2021 Accessed June 16, 2023 https://www.cdc.gov/vaccines/pubs/pinkbook/mening.html

2. Lutz R. Meningococcal vaccine uptake low for new HIV patients. Contagion. June 7, 2022. Accessed June 24, 2022. https://www.contagionlive.com/view/meningococcal-vaccine-uptake-low-for-new-hiv-patients

3.Bach A, Lee H, Lewis J. What’s new with non–COVID-19 vaccines. Contagion. February 2022 (Vol. 07, No. 1). https://www.contagionlive.com/view/what-s-new-with-non-covid-19-vaccines