In a follow-up to a report on the invasive meningococcal disease outbreak in gay men in Los Angeles and Orange Counties, the Los Angeles County Department of Public Health (Public Health) reports that the number of Invasive Meningococcal Disease cases has recently increased. The newest case is confirmed in a young adult, gay man who works in LA County. He is currently hospitalized and receiving appropriate medical treatment. This brings the total number of cases in LA County in 2016 to 11, of which seven have occurred within the last two months.
Of particular concern, this is the fourth recent case within LA County’s Public Health jurisdiction to occur among self-identified gay men/men who have sex with men (MSM). To date, the reason for the high proportion of cases in this population is unknown, but the majority are among HIV negative men. Two female cases of Invasive Meningococcal Disease have also been confirmed within the same time frame. No deaths have occurred in LA County due to these infections.
Meningococcal disease is a rare, but serious disease that can lead to swelling in the brain and spinal cord, loss of a limb (arm or leg), deafness, brain damage or even death. Meningococcal disease is caused by a type of bacteria known as Neisseria meningitidis. The illness most people are familiar with is meningitis. It can be spread to others through the respiratory secretions of people who carry the bacteria without symptoms in their nose and throat.
“The number of infections among men, most of whom identify as gay or bisexual, is substantially more than would be expected,” said LA County Interim Health Officer, Jeffrey Gunzenhauser, MD, MPH. “This is of great concern, and we want to ensure that individuals who are at risk get vaccinated and take other precautions to stop the spread of this deadly disease.”
Public Health has asked the State and the Centers for Disease Control and Prevention (CDC) to assist in the local investigation. This is especially important because there have been Invasive Meningococcal Disease outbreaks among MSM in other jurisdictions across the country.
Including cases from Long Beach and Orange County, this most recent case from LA County brings the total to seven MSM cases in Southern California since the beginning of May. In LA County, there are an estimated 300,000 MSM in a population of more than 10 million people.
The meningococcal vaccination is recommended for:
- All HIV-infected people.
- All gay/MSM, regardless of HIV status, who regularly have close or intimate contact with multiple partners or who seek partners through digital applications (“apps”), particularly those who share cigarettes/marijuana or use illegal drugs.
Vaccinations are free of charge at Public Health clinics for all people at higher-risk, regardless of health insurance status. Vaccination can also be obtained from providers who serve the LGBT community and at other healthcare settings. For people who are not HIV infected, a single dose is protective, whereas people with HIV require a second dose.
Decrease the Risk of Infection:
- Vaccination is the best way to prevent this disease.
- Limit activities that spread saliva:
- Don’t share drinks, utensils, food, or toothbrushes.
- Don’t have multiple kissing partners.
- Don’t share things you smoke, like cigarettes, e- cigarettes, cigars, pipes and hookahs.
Meningococcal disease can start with flu-like symptoms, and progress to high fever, headache, stiff neck, confusion and rash. People who experience these symptoms should seek medical care immediately.
Investigation of the meningococcal disease cases is ongoing. The bacteria identified from the majority of patients are serogroup C, which is preventable with vaccines. To date, no common social linkages have been identified among the gay/MSM LA County cases and cases identified in neighboring jurisdictions. Public Health continues working closely with the California Department of Public Health (CDPH) and neighboring health departments as well as the CDC to promote education and awareness, and to increase the ease and availability of vaccination.