Colorado Travel Health
World Class Travel Medicine

Written by Roxanne Royce from Colorado Travel Health
You should follow me on twitter

Incidence in India

In Northeast India, at least 257 deaths were reported in 2009 due to meningitis.

Infectious Agent

Meningococcal disease is caused by a bacteria, Neisseria meningitides. The five major serogroups of the disease are A,B,C, Y and W-135 of which all but B can be prevented with quadrivalent meningococcal vaccines.

Mode of Transmission

It is spread person-to-person by respiratory droplets.


Meningitis is found worldwide and is highest in a section of Africa called the “meningitis belt.” It is clustered more in areas where people are in close proximity to one another such as cities. Dry seasons are more conducive than wet seasons for transmission of the illness . 5-10% of the population worldwide may be carriers of N. meningitides. Invasive disease is less common and accounts for up to 1,000 cases per 100,000 in epidemic territory and 0.5-10 cases per 100,000 in nonepidemic areas. Young children are more susceptible to contracting the disease.

Clinical Presentation

After an incubation period of 1- 14 days, 50% of the infections will develop into meningitis whereby a sudden onset of fever and neck stiffness develop. Sometimes nausea, vomiting photophobia and/or altered mental status also emerge. And, 20% of people will present with something called meningoccal sepsis characterized by a sudden fever and a petichial or purpuric rash. Petichial is characterized by red or purple discolorations on the skin that do not turn white with pressure. (It is caused by bleeding underneath the skin). Petechiae and purpura differ only in size, purpura measuring 0.3-1 cm, and petechiae measuring less than 3 mm. Hypotension, adrenal hemorrhage and multiorgan failure can ensue with meningococcal sepsis.


Early detection is critical in preventing serious sequelae including possible death. Blood or CSF samples can reveal presence of N. meningitides. Haemophilis influenza and Streptococcus pneumoniae are also characteristic of the disease and these organisms can also be isolated and detected.


If antibiotic treatment is instituted soon after infection one’s odds of survival increases significantly.


Although the risk for international travelers is low (~ 0.4 per 100,000) when traveling to countries where N. meningitides is hyperendemic or epidemic, precaution with vaccination is recommended (especially if prolonged contact with the locals is expected). Travel advisories on epidemics can be found at the CDC’s website: And, travel during the dry season to the meningitis belt of Africa warrants vaccinnation.

Requirement for Travel

Travel to Mecca for the annual Hajj and Umrah pilgrimage requires proof of vaccination.


CDC. Meningococcal Disease. [Cited 2010 April 30]. Available from:
Copyright 2008 Colorado Travel Health. All Rights Reserved
Contact us with questions or comments
Website design by Studio 785