New York City health officials are increasing public awareness about a meningitis outbreak, urging gay men to get vaccinated for the infection in advance of as many as 1 million visitors for gay pride events in June.
Though meningitis is not limited to the gay community, a man in New York City who has sex with men is 50 times more likely to contract meningitis than the general population, according to a research paper published in the Annals of Internal Medicine yesterday. Since the onset of the outbreak in August 2010, 22 gay men have been diagnosed with the same strain of meningococcal disease in New York City, with seven fatalities, the paper said.
Twelve of the 22 New York victims tested positive for HIV, which has helped fuel parallels between the recent outbreak and the period following the discovery of the AIDS virus in the early 1980s. Another 4 cases have been reported in Los Angeles since December 2012. The average age of the victims is 34.
“It’s very understandable why people might draw links between HIV and this outbreak,” Jay Varma, deputy commissioner for disease control in the New York City Department of Health and Mental Hygiene, said in an interview. “Both appeared at the beginning to be exclusively among men who have sex with men, both are associated with people dying. The main difference is, of course, in this situation we know exactly what is causing people to get sick.”
Many of the victims were HIV positive, making them more susceptible to the infection, Varma said. Even when someone with HIV is controlling it through medications, his or her immune system will never be fully functional, he said. The U.S. Centers for Disease Control and Prevention recommends that those with HIV take extra precaution against pneumonia and hepatitis B, for example. Public health authorities may increase the recommendations for HIV-positive inoculation against meningitis in light of this outbreak, Varma said.
The last reported case of bacterial meningitis in the New York gay community was in February, after the city’s Department of Health and Mental Hygiene began an aggressive immunization campaign in October 2012.
Meningococcal disease infects the lining around the brain and spinal cord, and is usually fatal without treatment. The bacterial infection is treated with antibiotics, though vaccination against is the most effective way to protect against meningitis. While viral meningitis is the most common form of the illness, the rare bacterial meningitis can be deadly, according to the National Institutes of Health.
Mass gatherings are often dangerous for meningitis outbreaks since the disease is transmitted by close social contact. Vaccinations are now required to attend the Hajj, the yearly Muslim pilgrimage to Saudi Arabia, after outbreaks in 1987 and 1992
Dr. Matthew S. Simon, a resident in general preventive medicine at Weill Cornell Medical College and lead author on the report released yesterday, said the departments of health of several cities, including San Francisco and Toronto, have warned gay men traveling to New York for the pride events to get inoculated against the bacteria.
To diminish the chance of the events promoting a bacterial spread, the health department has undertaken a campaign of awareness and vaccination. Events in Manhattan are fewer than two weeks away, but at pride rallies earlier this month in Queens and Brooklyn officials inoculated 59 and 44 men, respectively.
What distinguishes this outbreak from other public health challenges is the role that social and mobile networking tools have played in its spread and the response, said Varma of the health department. Websites and geographically based phone applications to find short-term sexual partners have become especially popular in the gay community in the past four years. Because of the inherent anonymity and lack of central location, it is very difficult to track the spread of an outbreak. But public health officials have sought to harness the power of these tools to combat the outbreak.
“When we have had cases that have died, we used their phones and computers to find out who their friends are to warn and alert them,” Varma said. “We’ve been very happy to have partnered with the social media apps to allow us to reach out to their customers and warn them.”
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