Issue:  Vol. 48 / No. 12 / 22 March 2018

CA health officials again advise gay, transgender, and HIV positive people to get meningococcal vaccine

meningococcus-meningitis_702685California health officials are again advising gay and bisexual men, as well as transgender people and HIV positive individuals, to get vaccinated against meningococcal disease after another outbreak was reported in Los Angeles.

Meningococcal disease is caused by the bacteria Neisseria meningitidis and can cause meningitis and bloodstream infections (sepsis). Although rare, meningococcal disease is serious and potentially fatal.

Symptoms begin a few days after exposure and may include fever, chills, vomiting, severe headache, stiff neck, confusion, rash, nausea or vomiting, and generalized muscle pains. Anyone who develops these symptoms, especially those with HIV, should immediately seek medical care, warn health officials, by calling 911 or going to the nearest emergency room.

Since the beginning of May, nine meningococcal disease cases have been identified in men living in Los Angeles and Orange Counties, most of whom were gay or bisexual men, according to the California Department of Public Health.

One patient has died as a result of the infection, according to an advisory the CDPH issued this morning (Friday, June 24). Six of the cases are known to be caused by a particular strain (serogroup C) of meningococcal bacteria and one other case is awaiting serogroup confirmation.

“We are concerned that gay and bisexual men in Southern California may be at increased risk for meningococcal disease,” stated CDPH Director and State Public Health Officer Dr. Karen Smith. “We encourage men who partner with other men to be aware of the risk of meningococcal disease and consider getting vaccinated.”

As San Francisco is set to celebrate Pride this weekend, and welcome an influx of visitors from Southern California and other locales, San Francisco’s Department of Public Health issued its own advisory recommending that HIV-positive people, gay men and other men or transgender people who have sex with men get vaccinated.

“Here in San Francisco it is Pride week, with lots of visitors from around the state, the country and the world coming to town to celebrate,” stated Dr. Naveena Bobba, deputy health officer for the City and County of San Francisco. “There will be many parties and festivities. We encourage revelers to consider the meningococcal ACWY vaccine as a way to take charge of their health. The vaccine is widely available and very effective in preventing this disease from spreading.”

According to health officials, gay men and other men or transgender people who have sex with men who have close or intimate contact with multiple partners, or who regularly visit crowded venues such as bars or parties, or who vape or smoke cigarettes, e-cigarettes, marijuana, hookahs or illegal drugs may be at increased risk of meningococcal disease.

Meningococcal bacteria are transmitted from person-to-person through close personal contact involving secretions from the nose and throat. Smoking or being around smokers increases the risk of transmission.

HIV-infected people are particularly at increased risk of contracting meningococcal disease, noted health officials. Because of this increased risk, the U.S. Advisory Committee on Immunization Practices recommended this week that all HIV-infected persons aged 2 months and older be routinely vaccinated with the meningococcal vaccine that protects against serogroups A, C, W and Y disease (MenACWY).

The advisory about the deadly disease has become a near yearly occurrence since 2012, when a meningitis outbreak infected a dozen men who have sex with men in New York City that year. In December of that year, San Francisco public health officials encouraged gay men planning to travel to New York City to get vaccinated.

In 2013 reports of the death of a gay West Hollywood man who contracted meningitis raised fears about an outbreak on the West Coast. But at the time, San Francisco reported no cases and did not advise gay and bi men traveling to the Los Angeles area to be vaccinated.

That changed in 2014 after Los Angeles County authorities reported eight confirmed cases of invasive meningococcal disease, half of which were in gay and bi men. Los Angeles’s health department recommended vaccination for all local gay and bi men, while San Francisco’s health department advised gay and bi men, as well as transgender women, to get vaccinated if they expected to have close or intimate contact with gay or bi men from Los Angeles.

Last year ahead of Pride weekend, health officials released a warning about a cluster of invasive meningococcal disease cases in Chicago.

In San Francisco vaccination is available to everyone through their primary care providers, at the health department’s Adult Immunization and Travel Clinic and at many pharmacies. San Francisco residents who cannot access those options can get vaccinated at San Francisco City Clinic.

Protection usually begins seven to 10 days after vaccination.  All HIV-infected adults should receive two doses of vaccine, eight to 12 weeks apart. Gay men and other men or transgender people who have sex with men, and who are not HIV-infected, should receive one dose.

— Matthew S. Bajko, June 24, 2016 @ 11:40 am PST
Filed under: Uncategorized

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