The Centers for Disease Control and Prevention (CDC) is working with state and local health departments around the United States to investigate cases of serogroup W-135 meningococcal disease among pilgrims returning from the Hajj in Mecca and their close personal contacts.

Three cases have been reported by the New York City Department of Health among persons with a travel history to Mecca, their family members who did not travel to Mecca or close community contacts. Several European countries report more than 3 dozen cases of meningococcal disease among these pilgrims.

Today, the CDC notified state health departments to be aware of the possibility of meningococcal disease among individuals who recently (since March 1, 2000) traveled to Saudi Arabia or their household contacts who may not have traveled. In addition, CDC is asking states to enhance monitoring for cases of meningococcal disease in individuals who may have had contact with returning pilgrims or their families within the past four weeks.

Meningitis is an infection of the fluid and membranes covering a person’s brain and spinal cord. The bacteria that cause meningitis (one is Neisseria meningitidis) are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). All returning pilgrims and their close contacts should be aware of the signs and symptoms of meningitis including:

• fever
• intense headache
• stiff neck or neck pain
• pain when looking at bright lights
• nausea and vomiting

If someone is experiencing these symptoms they should see their doctor or go to the nearest clinic or emergency room as soon as possible.

According to the basic tenants of Islam, all Muslims should perform the Hajj at least once in their lifetime and this includes a pilgrimage to the holy places of Islam in Saudi Arabia. Every year more than a million pilgrims throughout the world gather in Saudi Arabia. It is not currently known how many traveled from the United States. All pilgrims to Mecca are required by Saudi Arabian law to be vaccinated against meningococcal disease caused by Neisseria meningitidis. Those pilgrims vaccinated in the United States most likely received a vaccine that includes some protection against "W-135." However, the vaccine does not offer full protection and it does not prevent someone from carrying the germ and spreading it to their family members after their return.