Epidemics can occur in any country, are usually extensive in tropical regions and can be explosive in the arid regions of the sub-Saharan Africa (December through June). High risk areas include New Delhi, Nepal, Saudi Arabia and the "Lapeyssonie belt" in Africa, also called "African meningitis belt". Travelers at risk include hitchhikers, trekkers, those traveling rough and living in overcrowded conditions, as well as the long-term travellers living in close contact with the indigenous population.

Travellers to industrialized countries are mainly exposed to meningococcal B and C, with both sporadic cases and outbreaks (there is no vaccine effective against serogroup B). In sub-Saharan region, the most prevalent is the serogoup A. Vaccination against this disease is not mandatory for the entry into any country, except for pilgrims to Mecca for the annual Hajj (February-April) or for the Umrah.

The quadrivalent vaccine (ACYW) is currently required by Saudi Arabia for pilgrims; several outbreaks of meningococcal disease due to serogroups A and W135 have been reported recently. This vaccine may be administered by the deep subcutaneous or the intramuscuar route, at least ten days before departure and is valid for two years.

Four types of polysaccharide and conjugate vaccines are manufactured, the monovalent vaccines (A or C serogroups), the bivalent A+C serogroups and the quadrivalent A+C+Y+W135 vaccines. For the last two, the primary series consist in one dose (persons over the age of two years), with boosters every 2-5 years. These vaccines don’t protect against Neisseria meningitidis group B. They are not recommended during pregnancy and in children below two years of age. However, the monovalent A serogroup vaccine is mandatory for children between three months and two years of age that go to Saudi Arabia during the annual Hajj period (two doses with a three month interval); children over the age of two years and adults must receive one dose of the bivalent or quadrivalent vaccines. The conjugate monovalent C serogroup vaccine may be recommended for chidren above the age of two months.

Fernando Costa Silva, 1999 (last update: 2009)