Meningococcal disease ID'd in men who have sex with men

(HealthDay)—Following reports of invasive meningococcal disease (IMD) among men who have sex with men (MSM), the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) has recommended that MSM who have engaged in intimate contact with another man should undergo vaccination, according to a report published online June 17 in the Annals of Internal Medicine.

Matthew S. Simon, M.D., from Weill Cornell Medical College in NYC, and colleagues analyzed reports of IMD among MSM from NYC and Los Angeles, focusing on incidence, patient and disease characteristics, prevalence, and mortality. Referencing the lessons learned from the initial reports of HIV cases in the early 1980s, they looked at the public health responses needed to the stem the spread of infection.

The researchers note that 22 cases of IMD have been reported in NYC since August 2010, seven of which have resulted in death. Cases had a mean age of 34 years, 50 percent were African-American, and 55 percent were infected with HIV (median CD4 count, 525 × 10⁹ cells/L). In 2012, the incidence of meningococcal disease was 50-times higher among NYC MSM than the age-adjusted rate for the general population. All isolates were serogroup C, and by pulsed-field gel electrophoresis, most were indistinguishable. The NYC DOHMH is recommending vaccination for all NYC MSM, regardless of their HIV status, who have engaged in intimate contact with a man. Since December 2012, four cases of IMD have been reported in Los Angeles.

"Parallels have been drawn between this meningococcal outbreak and the initial reports of HIV cases in 1981 from Los Angeles and NYC," the authors write. "The lessons learned from the previous HIV epidemic suggest that a successful response requires the coordinated efforts of public health authorities, the government, clinicians, researchers, the pharmaceutical industry, the media, and the community."