In a recent advisory, the US Centers for Disease Control and Prevention (CDC) has urged doctors to remain vigilant for cases of meningococcal disease. This warning comes in light of 12 confirmed cases of meningococcal disease associated with travel for Umrah, an Islamic pilgrimage to Mecca, Saudi Arabia, since April.

Meningococcal disease is highly contagious, particularly among individuals who are unvaccinated. Among the patients whose vaccination status is known, a concerning nine were unvaccinated. It is crucial for healthcare providers to be aware of the potential risks associated with travel to Mecca, especially with the upcoming Hajj pilgrimage scheduled for June 14 to 19.

The cases of meningococcal disease have affected pilgrims from various countries, including the United States, France, and the United Kingdom. Five pilgrims from the US, four from France, and three from the UK have fallen ill. Ten of the patients had visited Mecca directly, while two had close contact with someone who had.

Meningococcal disease, caused by the bacteria Neisseria meningitidis, can result in severe infections in the lining of the brain and spinal cord. The disease can have long-lasting effects, including memory and concentration issues, seizures, balance problems, hearing loss, and even blindness. In some cases, it can lead to a life-threatening blood infection known as septicemia, or blood poisoning.

The CDC has reported an increase in the number of meningococcal disease cases in the US. By the end of March this year, there were already 143 cases, compared to 81 during the same period last year. In 2023, there were a total of 422 cases, the highest since 2014.

Diagnosing meningococcal disease can be challenging, as its symptoms can mimic those of other infectious diseases such as COVID-19 and the flu. Symptoms to look out for include fever, headache, nausea or vomiting, trouble walking, a stiff neck, skin rash, sensitivity to light, and brain fog.

Of the recently confirmed cases, two were found to be resistant to ciprofloxacin, one of the standard antibiotics used for treatment. However, the majority of cases responded well to penicillin or ciprofloxacin.

Saudi Arabia mandates that all Umrah or Hajj pilgrims aged 1 and older receive the quadrivalent meningococcal vaccine, which protects against four prevalent variations of the bacteria (A, C, W, and Y). However, vaccination coverage among these travelers is known to be incomplete.

In light of these developments, the CDC advises healthcare providers to ensure that patients considering travel for Hajj or Umrah have received the MenACWY vaccine within the past five years or receive the shot at least 10 days before the trip. Additionally, healthcare providers should suspect meningococcal disease in anyone who exhibits symptoms after recent pilgrimages.

Close contacts of individuals with meningococcal disease should be promptly administered antibiotics, regardless of their vaccination status, ideally within a day of identifying the initial patient.

The CDC's alert emphasizes the importance of remaining cautious about meningococcal disease, particularly among individuals traveling to Mecca. By taking necessary precautions and ensuring vaccination, both the risks and spread of this potentially deadly disease can be minimized.