Before the start of Hajj, the CDC urges physicians to be vigilant for meningococcal illnesses related to travel to Saudi Arabia.
Since April this year, there have been 12 recorded cases of meningococcal disease linked to those traveling for Umrah, an Islamic pilgrimage to Mecca. This journey is made regularly by Muslims from all over the world to seek divine blessings. A more extensive journey known as Hajj takes place annually during a specific time of year. This year's Hajj is set for June 14-19.
Out of these 12 cases, five occurred in the United States, while France recorded four and the UK saw three. Ten individuals had been to Mecca, while two had associations with someone who did.
Meningococcal disease is highly contagious among those who aren't immunized. Of the individuals with known vaccination status, nine were unvaccinated.
Meningococcal disease (including meningitis) is an infrequent infection resulting from Neisseria meningitidis bacteria. It can cause infection in the brain and spinal cord's lining, leading to lifelong medical issues such as memory and concentration problems, seizures, balance problems, hearing loss, and blindness. Also, it can result in a serious blood infection called septicemia or blood poisoning.
Research shows that about 10-15% of cases can end in death, even with timely treatment.
Meningococcal cases in the US have been on the rise, as per the CDC. By the end of March, they recorded 143 cases this year, up from 81 in the same period last year. The most cases in a single year in the US since 2014 were 422.
Meningococcal disease can be treated with antibiotics if diagnosed early. However, early diagnosis is often delayed due to symptoms resembling other infectious diseases like COVID-19 or the flu. Symptoms include fever, headache, nausea or vomiting, difficulty walking, stiff neck, skin rash, sensitivity to light, and brain fog.
Tests on the bacteria from the most recent cases showed that one in the US and one in France was resistant to ciprofloxacin – an antibiotic usually used for meningococcal disease treatment. In other cases, individuals responded to treatment with penicillin or ciprofloxacin.
Saudi Arabia has had a requirement for all Umrah or Hajj pilgrims aged 1 and above to be vaccinated against all four of the prevalent meningococcal strains (A, C, W, and Y). This MenACWY vaccine is widely used. The majority of cases in the US are related to serogroup Y.
In the US, the MenB vaccine is also recommended to protect against the B-variation of the bacteria. Recently, a Pfizer shot approved in the US safeguards against all five of these most common strains causing meningococcal disease. This is called Penbraya.
In the US, the MenACWY vaccine is suggested for all preteens and teens and some younger children and adults under specific conditions. One such instance is before traveling to countries with higher rates of meningococcal disease. Additionally, a booster should be taken if the individual's last shot was three to five or more years prior to their trip.
The CDC urged health care providers to ensure patients planning to travel for Hajj or Umrah have received the MenACWY vaccine within the past five years and administer the shot at least ten days before they leave.
The CDC advised using various antibiotics to treat meningococcal disease in those associated with travel to Mecca. Those who were in close contact with the infected person should receive an antibiotic as soon as possible after exposure, regardless of their vaccination status, ideally within a day of the initial patient's identification.
The most significant outbreak connected to a mass gathering was from 2000-01, with the primary cause being the W strain of the bacteria. Since 2002, Saudi Arabia has compelled all pilgrims to provide proof of vaccination against meningococcal disease. However, vaccine coverage among these travelers is "known to be incomplete," according to the CDC.
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In light of the 12 reported meningococcal disease cases linked to Hajj or Umrah travelers, the CDC recommends that physicians administer the MenACWY vaccine to individuals planning to participate in Hajj, ensuring they receive the shot at least ten days prior to departure. Due to the highly contagious nature of meningococcal disease among unvaccinated individuals, it's crucial for travelers to be adequately immunized to protect themselves and others.
Source: edition.cnn.com
