CASES: There have been 13 cases of Neisseria meningitidis reported in MSM in New
York City since 2010; eight of these cases were in 2012. All cases were men between
21 and 59 years old. Eight cases are HIV-infected. Four patients have died, 3 were HIVinfected.
This is neither a gay – specific disease, nor it is a sexually transmitted disease.
BACKGROUND: A bacteria called Neisseria meningitidis, also known as
meningococcus can cause a range of diseases, and the illness most people are familiar
with is meningococcal meningitis, often called just “meningitis”. This usually means the
lining of the brain and spinal cord have become infected with these bacteria. But these
bacteria can also cause other severe illnesses, like bloodstream infections.
TRANSMISSION: Meningococci are carried only by humans in the nasopharynx—their
only reservoir. Overall 5%-10% of the population carries the bacteria. Meningococcus
bacteria are spread through the exchange of respiratory and throat secretions like spit
(e.g., living in close quarters, kissing). Transmission occurs when close, face-to-face
contact permits the exchange of salivary secretions from people who are ill or are
carriers. Fortunately, these bacteria are not as contagious as what causes the common
cold or the flu. Also, the bacteria are not spread by casual contact or by simply
breathing the air where a person with meningococcal disease has been.
CLINICAL: Symptoms are usually sudden onset of fever, headache, and stiff neck. It
can start with symptoms similar to influenza (flu), and will often also cause nausea,
vomiting, increased sensitivity to light, rash, and confusion. Quick medical attention is
extremely important if meningococcal disease is suspected.
VACCINE: Meningococcal vaccines protect against most types of meningococcal
disease, although they do not prevent all cases. There are two kinds of vaccines that
protect against Neisseria meningitidis available in the United States: (1) meningococcal
polysaccharide vaccine (Menomune®) which is recommended for individuals aged over
55 years, and (2) meningococcal conjugate vaccine (Menactra® and Menveo®) for
persons 9 months–55 years of age.
RECOMMENDATIONS by NYC – DOH (10/4/2012): Meningococcal vaccine should
be administered to HIV-infected men who are NYC residents and who had
intimate contact with a man met either through an online website, digital
application, or at a bar or party since September 1, 2012. HIV-infected patients
should receive two doses; the second dose should ideally be administered eight weeks
after the first dose but no less than six weeks.
These vaccines are available to our patients at 155 West 19th
Street, 4th Floor, NY, NY. Call 212/929.2629