Health Advisory

Summary

• The Centers for Disease Control and Prevention (CDC) recently issued a Health Alert Network (HAN) Health Advisory to alert healthcare providers to cases of meningococcal disease linked to Umrah travel to the Kingdom of Saudi Arabia (KSA). The full HAN is linked below this Advisory.
• The focus of the HAN is to emphasize vaccination prior to travel to KSA and to increase clinical suspicion of meningococcal disease for all recent KSA travelers with clinically compatible symptoms.

Suggested Actions

• Patients considering travel to KSA to perform Hajj (June 14-19, 2024) or Umrah should be current on vaccination with MenACWY vaccine as required by KSA. All travelers aged one year or older performing Hajj or Umrah should have received either a) a MenACWY polysaccharide vaccine (MPSV4, no longer available in the United States) within the last 3 years administered at least 10 days prior to arrival, or b) a quadrivalent MenACWY conjugate vaccine within the last 5 years administered at least 10 days prior to arrival.
• Maintain a heightened index of suspicion for meningococcal disease among symptomatic patients who have recently been in KSA or their close contacts, regardless of vaccination status.
• Meningococcal disease is immediately reportable to the health department. Contact the Health Department’s Communicable Disease/Epidemiology Unit immediately at 703-246-2433 (normal business hours) or 703-409-8449 (evenings and weekends) to report the suspected case and for guidance on testing, treatment, and appropriate infection control measures.

Additional Information

• Meningococcal disease, caused by the bacterium Neisseria meningitidis, is a rare but severe illness with a case-fatality rate of 10–15%, even with appropriate antibiotic treatment. Meningococcal disease often presents as meningitis with symptoms that include fever, headache, stiff neck, nausea, vomiting, photophobia, or altered mental status. Meningococcal disease may also present as bacteremia with symptoms that may include fever, chills, fatigue, vomiting, cold hands and feet, severe aches and pains, rapid breathing, diarrhea, or, in later stages, a petechial or dark purple rash (purpura fulminans).
• Since April 2024, 12 cases of meningococcal disease linked to KSA travel for Umrah have been reported to national public health agencies in the United States (5 cases), France (4 cases), and the United Kingdom (3 cases). Ten cases were in patients who traveled to KSA, and two were in patients who had close contact with travelers to KSA.
• Umrah is an Islamic pilgrimage to Mecca, Kingdom of Saudi Arabia, that can be performed any time in the year; the Hajj is an annual Islamic pilgrimage this year taking place June 14–19, 2024.

See full Health Advisory: Meningococcal Disease Cases Linked to Travel to the Kingdom of Saudi Arabia (KSA): Ensure Pilgrims are Current on Meningococcal Vaccination.