Meningococcal Disease

What is Meningococcal Disease?

Meningococcal disease is a rare, but serious infection that can cause meningitis (brain infection) and/or bacteremia (blood infection), and can lead to death. Recently, there has been an increase in meningococcal disease among gay, bisexual, and other men who have sex with men (MSM) in Southern California.

How do you get it?

Meningococcal disease is caused by a bacteria that is transmitted from person-to-person through respiratory droplets (like saliva or spit) during face-to-face or prolonged contact, or by sharing utensils, drinks, or cigarettes.

What can I do to protect myself?

Orange County Health Care Agency recommends that all gay, bisexual, and other men who have sex with men get vaccinated for meningococcal disease.

How can I get the vaccine?

You can talk to your doctor about getting vaccinated or you can get vaccinated at 1725 W. 17th Street in Santa Ana, CA 92706:

  • If you just need the vaccine, go to the Immunization Clinic:
    Monday - Friday: 7:30 a.m. to 4:30 p.m. (closed 11:45 a.m. - 12:45 p.m.)
  • If you need the vaccine and STD and/or HIV testing, go to Testing, Treatment and Care Clinic:
    Monday, Wednesday, Thursday, Friday, 8 a.m. to 4 p.m.
    Tuesday: 10 a.m. to 4 p.m.

Call (800) 564-8448 for more information.

July/August 2016 – Flyer available for download (PDF)

Latest News

Three New OC Meningococcal Disease Cases, Including a Fatality, Confirmed in Past 7 Days

August 3, 2016
The OC Health Care Agency strongly encourages men who have sex with men (MSM) in Orange County to get meningococcal vaccination as an outbreak of meningococcal disease, which has disproportionately affected MSM, has led to three new cases and another death here within the past 7 days. More...

New Orange County Immunization Recommendation for Meningococcal Disease For Men Who Have Sex with Men (MSM)

July 28, 2016
The California Department of Public Health is reporting an increase of serogroup C invasive meningococcal disease among men living in Southern California. No direct social connection has been found between the cases, but the majority are men who have sex with men (MSM). One of these cases occurred in an Orange County resident whose illness resulted in death. Because of this local increase in risk, the Orange County Health Care Agency, in conjunction with the Los Angeles County Department of Public Health and City of Long Beach Department of Health and Human Services, is expanding vaccination recommendations for meningococcal disease to include all gay, bisexual, and other men who have sex with men, in addition to all persons with HIV infection. More...

General Information

EXCERPTED FROM: Morbidity and Mortality Weekly Report, May 27, 2005 / 54(RR-7);16-17
(See www.cdc.gov/mmwr/preview/mmwrhtml/rr5407a1.htm for entire statement, including references).

Prevention and Control of Meningococcal Disease

ANTIMICROBIAL CHEMOPROPHYLAXIS

Antimicrobial chemoprophylaxis of close contacts of sporadic cases of meningococcal disease is the primary means for prevention of meningococcal disease in the United States (see Table). Close contacts include a) household members, b) day care center contacts, and c) anyone directly exposed to the patient's oral secretions (e.g., through kissing, mouth-to-mouth resuscitation, endotracheal intubation, or endotracheal tube management). For travelers, antimicrobial chemoprophylaxis should be considered for any passenger who had direct contact with respiratory secretions from an index-patient or for anyone seated directly next to an index-patient on a prolonged flight (i.e., one lasting >8 hours). The attack rate for household contacts exposed to patients who have sporadic meningococcal disease has been estimated to be four cases per 1,000 persons exposed, which is 500-800 times greater than for the total population. Because the rate of secondary disease for close contacts is highest during the first few days after onset of disease in the primary patient, antimicrobial chemoprophylaxis should be administered as soon as possible (ideally within 24 hours after the case is identified). Conversely, chemoprophylaxis administered greater than 14 days after onset of illness in the index case-patient has little value. Oropharyngeal or nasopharyngeal cultures are not helpful in determining the need for chemoprophylaxis and may unnecessarily delay institution of this preventive measure.

Rifampin, ciprofloxacin, and ceftriaxone are 90%–95% effective in reducing nasopharyngeal carriage of N. meningitdisand are all acceptable antimicrobial agents for chemoprophylaxis. See the table below for recommended dosages and select comments about the medications. Consult a drug handbook or pharmacist for a complete list of contraindications and adverse effects.

Systemic antimicrobial therapy of meningococcal disease with agents other than ceftriaxone or other third-generation cephalosporins may not reliably eradicate nasopharyngeal carriage of N. meningitidis. If other agents have been used for treatment, the index patient should receive chemoprophylactic antibiotics for eradication of nasopharyngeal carriage before being discharged from the hospital.

TABLE. Schedule for administering chemoprophylaxis against meningococcal disease

Drug

Age group

Dosage

Duration and route of administration

Rifampin*

Children <1 month

5 mg/kg every 12 hrs



2 days, oral

Children ≥ 1 months

10 mg/kg (max 600 mg) every 12 hrs



2 days, oral

Adults

600 mg every 12 hrs



2 days, oral

Ciprofloxacin§

Adults

500 mg

Single dose, oral

Ceftriaxone

Children <15 years



125 mg

Single dose, intramuscular (IM)

Adults (including pregnant women)

250 mg

Single dose, intramuscular

Azithromycin Children and adults. Limited data; not recommended routinely; consider only if resistance to other agents suspected. 10 mg/kg (maximum 500 mg) Single dose, oral

* Rifampin is not recommended for pregnant women, because it is teratogenic in laboratory animals. Rifampin changes the color of urine to reddish-orange and is excreted in tears and other body fluids; it may cause permanent discoloration of soft contact lenses. Because the reliability of oral contraceptives may be affected by rifampin therapy, consideration should be given to using alternate contraceptive measures while rifampin is being administered.

§ Ciprofloxacin is not generally recommended for persons less than 18 years of age or for pregnant and lactating women because the drug causes cartilage damage in immature laboratory animals. However, ciprofloxacin may be used for chemoprophylaxis of children when no acceptable alternative therapy is available.

Table adapted from: Morbidity and Mortality Weekly Report, May 27, 2005 / 54(RR-7);16-17
(See www.cdc.gov/mmwr/preview/mmwrhtml/rr5407a1.htm for entire statement, including references).