Invasive Meningococcal Disease

What is invasive meningococcal disease?

Invasive meningococcal disease (IMD) is a severe, sometimes fatal, infection. It is caused by the bacterium Neisseria meningitidis (meningococcus). IMD can affect many body sites causing different syndromes such as meningitis (infection of the lining of the brain), sepsis (blood poisoning) and pneumonia (lung infection).

Who is at risk?

Anyone can get IMD. Infants under one (1) year of age traditionally have had the highest rates of disease, however, in recent years in NYC this has not been the case. Clusters of cases and outbreaks do occur but are rare in the United States.

What are the symptoms of IMD?

Early symptoms are flu-like with fever, chills, weakness and muscle aches. These symptoms can rapidly progress over the next day or so to include headache, stiff neck and widespread rash. People who experience these symptoms, especially those with HIV-infection, should seek medical care immediately.

How soon after infection do symptoms appear?

The symptoms may occur two (2) to 10 days after exposure, but usually within five (5) days.

How does IMD spread?

IMD is spread by prolonged close contact with nose or throat discharges from an infected person or carrier. Examples of prolonged contact include living in the same household or intimate activities, like kissing and sexual contact.

How is IMD diagnosed?

IMD is usually diagnosed by laboratory identification of the bacteria from either the blood or spinal fluid.

Is there a vaccine for IMD?

Yes. There are vaccines that will protect against a number of the strains of the meningococcal organism. Talk to your health care provider about which vaccine is right for you or your loved ones.

Who should get vaccinated?

It is recommended that the following groups get routinely vaccinated:

  • Children at age 11 through 12 years, with a booster dose at age 16 years.
  • Children aged 13 through 18 years, if not previously vaccinated.

In addition, vaccination is recommended for persons aged 2-55 who are increased risk of IMD:

  • All college freshmen living in dormitories
  • Persons with functional or anatomic asplenia, including sickle cell disease
  • People who may have an increased risk of IMD because of certain problems with their immune system (known as complement deficiencies)
  • People who work in labs where they may be exposed to Neisseria meningitidis
  • People who travel to parts of the world where IMD is epidemic (see
  • Military recruits

Who else should get vaccinated?

In addition to the groups listed above, the Health Department strongly recommends vaccination in men who have sex with men (MSM) who are either HIV-infected or regularly have intimate contact with other men they’ve met online, through a digital application (“app”) or at a bar or party. In NYC and some other cities, there have been outbreaks of IMD MSM that have been associated with use of web or handheld applications, as well as parties and other gatherings, focused on meeting potential sex partners. Many of these cases occurred in MSM living with HIV.

Talk to a doctor if you’re worried you might be at risk and should get vaccinated.

Where can I get vaccinated?

Adults at risk for IMD should ask their provider if they can get vaccinated in the office. If not, many pharmacies offer meningococcal vaccine. Locations are listed on the NYC Health Map. Most pediatric care providers will have meningococcal vaccine for their patients.

Is meningococcal vaccine required for school entry or for summer camp?

No. However, New York State public health law requires that all students attending college, university, boarding schools, or spending 10 or more nights at a children's sleep away camp be informed about IMD and be aware of vaccine.

Should people who have been in contact with a diagnosed case of IMD get preventive treatment?

Only people who have been in prolonged close contact (household members, intimate contacts, health care personnel performing mouth-to-mouth resuscitation, day care center playmates, etc.) need to be considered for preventive treatment. The Health Department will contact such people to advise them about the need for antibiotics. Casual contact that occurs in a regular classroom, office, factory or other work setting is not usually enough to cause concern.

What is the treatment for people with IMD?

Several antibiotics are very effective in eliminating the bacteria from the nose and throat. Penicillin remains the recommended treatment.


Center for Disease Control