LAC DPH Health Advisory: Meningococcal Disease—Ciprofloxacin Resistance in Southern California and Cases Linked to Travel to the Kingdom of Saudi Arabia

The Los Angeles County Department of Public Health (LAC DPH) issued a health advisory on May 21, 2024. This advisory shares information about ciprofloxacin-resistant strains of Neisseria meningitidis that have been increasing both nationally and internationally in recent years.
 

Key Messages

  • Ciprofloxacin should no longer be used in LA County for invasive meningococcal disease (IMD) post-exposure prophylaxis (PEP) due to resistance. Rifampin, ceftriaxone, or azithromycin are recommended for IMD PEP.
     
  • The Centers for Disease Control and Prevention (CDC) is reporting cases of IMD linked to Umrah travel to the Kingdom of Saudi Arabia (KSA).
     
  • Healthcare providers should ensure that patients age one year or older considering travel to perform Hajj or Umrah have received a MenACWY vaccine.
     
  • Healthcare providers should have a heightened index of suspicion for IMD. Be aware that patients with IMD may present with bloodstream infection or septic arthritis and without symptoms typical of meningitis.
     
  • Immediately report all patients suspected and confirmed to have IMD to LA County Department of Public Health (LAC DPH) by calling 213-240-7941. After hours call 213-974-1234.

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