Invasive disease caused by Neisseria meningitidis has an average annual incidence of one case per 100,000 in the United States. The disease can be rapidly fatal or result in severe neurologic and vascular sequelae despite
antibiotic therapy.
Antibiotic chemoprophylaxis with
rifampin,
ciprofloxacin, or
ceftriaxone is required for household and other close contacts. Although the majority of cases of
meningococcal disease are sporadic, outbreaks can occur, and vaccination of the affected population often is necessary. Serogroup B accounts for the highest incidence of disease in young infants but is not contained in any
vaccine licensed in the United States. Adolescents and young adults 15 to 24 years of age have a higher incidence of disease and a higher fatality rate than other populations. Because 70 to 80 percent of these
infections in the United States are caused by meningococcal serogroups C, Y, and W-135, which are contained in the tetravalent
meningococcal vaccines, they are potentially preventable. The U.S. Food and Drug Administration recently approved a meningococcal
conjugate vaccine containing serogroups A, C, Y, and W-135. This T-cell-dependent
vaccine induces bactericidal antibody production and promotes immunologic memory that should result in a longer duration of immunity. The Advisory Committee on Immunization Practices recommends that this
vaccine be given to 11- and 12-year-old adolescents, to adolescents entering high school, and to college freshmen living in dormitories. The
vaccine also may be given to persons 11 to 55 years of age who belong to certain high-risk groups.