A message from Erica Wilson, MD, MPH, North Carolina Department of Health and Human Sources

The North Carolina Division of Public Health (NC DPH) is alerting clinicians in North Carolina to an increase in ciprofloxacin- and penicillin-resistant strains of invasive meningococcal disease caused by Neisseria meningitidis serogroup Y (NmY) in the Charlotte Metropolitan region.

 Since February 2023, two cases of invasive meningococcal disease have been found to be resistant to ciprofloxacin and penicillin in residents of Mecklenburg County and one case in a resident of neighboring York County, South Carolina. These cases meet the threshold to recommend discontinuing the use of ciprofloxacin for prophylaxis of close contacts per CDC’s updated guidance.

Providers in the Charlotte Metropolitan region including Cabarrus, Gaston, Iredell, Lincoln, Mecklenburg, Rowan, and Union Counties should discontinue the use of ciprofloxacin for prophylaxis of close contacts of invasive meningococcal disease cases and prescribe rifampin, ceftriaxone, or azithromycin instead. Providers treating residents from Chester, Lancaster, or York counties in South Carolina should also follow this guidance for patients being treated in North Carolina medical facilities.

Clinicians should contact their local health departments or the Communicable Disease Branch epidemiologist on-call 24/7 number (919-733-3419) for questions.