The Commonwealth of Massachusetts
Executive Office of Health and Human Services Department of Public Health
Bureau of Infectious Disease and Laboratory Sciences,305 South Street, Jamaica Plain, MA 02130
Division of Epidemiology and Immunization Tel: (617) 983-6800
Fax: (617) 983-6840
November 16, 2017
TO: Healthcare Providers in Massachusetts
FROM: Alfred DeMaria, Jr., MD
Medical Director and State Epidemiologist
Bureau of Infectious Disease and Laboratory Sciences
RE: Invasive Meningococcal Cases at the University of Massachusetts (UMass) Amherst
Two students at UMass Amherst have been diagnosed with invasive meningococcal disease serogroup B within the past few weeks. An advisory describing the two cases was circulated to students at UMass Amherst on 11/14/17 by George A. Corey, M.D., Executive Director, UMass Amherst University Health Services.
Although the risk of invasive meningococcal disease in any single university student is very low, and known close contacts of the two cases have been identified and provided chemoprophylaxis, Massachusetts healthcare providers are asked to be alert for cases compatible with meningococcal disease.
Prompt recognition and antibiotic treatment of meningococcal disease is critical. Symptoms of meningitis may include sudden onset of fever, headache, and stiff neck, accompanied by nausea, vomiting, photophobia, and altered mental status. Symptoms of bacteremia or septicemia may include fatigue, nausea, vomiting, cold hands and feet, chills, severe muscle aches or abdominal pain, rapid breathing, diarrhea, and appearance of a petechial or purpuric rash.
UMass Amherst students will soon be leaving campus for Thanksgiving holidays and will be dispersing across the state and the country.
ACTIONS REQUESTED OF ALL CLINICIANS:
1. Be alert for cases compatible with meningococcal disease in UMass Amherst students and their close contacts.
2. Immediately report all suspect cases of meningococcal disease to the MDPH at (617) 983-6800 (Suspect cases in Boston should be reported to the Boston Public Health Commission at (617) 534-5611). Do not wait for laboratory confirmation to report a clinically suspected case.
3. Obtain blood and CSF cultures prior to administration of antibiotics, if possible, to enhance detection of N.meningitidis.
4. Consider vaccinating the UMass Amherst students with meningococcal B vaccines (MenB) vaccine for short-term protection against group B meningococcal disease.
The Advisory Committee on Immunization Practices (ACIP) recommends that those at increased risk of meningococcal disease can be vaccinated with either Bexsero (MenB-4C) or Trumenba (MenB-FHbp) vaccines. Guidance about the schedules for these two MenB vaccines can be found at:
· Meningococcal Serogroup B Vaccines by Age and Risk Factor, Immunization Action Coalition http://www.immunize.org/catg.d/p2035.pdf
Additional guidance for providers about meningococcal vaccines can be at:
· CDC Meningococcal Vaccine Website: https://www.cdc.gov/vaccines/vpd/mening/hcp/index.html
A fact sheet about serogroup B meningococcal disease can be found at: https://www.cdc.gov/meningococcal/downloads/17-275138D-MeningococcalDis-B-Outbreak-FS.pdf
An MDPH fact sheet concerning invasive meningococcal disease and college students is available at http://www.mass.gov/eohhs/docs/dph/cdc/factsheets/m-o/meningococcal-college-students.pdf.
For questions and concerns about invasive meningococcal disease and these recommendations in Massachusetts please call the Division of Epidemiology and Immunization at 617-983-6800.