Q Health

Bacterial meningitis cases in MSM

Since 2010, New York City has seen a significant increase in cases of bacterial meningitis among men who have sex with men (MSM). More recently, Los Angeles identified a cluster of cases in MSM, including an openly gay attorney from West Hollywood who died from his infection. Earlier this month, a gay man in Salt Lake County was diagnosed with bacterial meningitis.

Getting the facts out to the gay community about these recent outbreaks is not intended to cause panic. What is important right now is that we educate the very community that seems to be susceptible regarding prevention, and that we find ways to provide everyone with accurate information.

Bacterial meningitis is a condition that is caused by an infection in the meninges in the brain.  It is unique in the sense that the bacteria manage to go from a localized infection to an invasive infection. This means that the bacteria have penetrated the protective fluid that surrounds the brain and spinal cord causing a meningitis or that the bacteria have gotten into the blood causing a blood infection referred to as sepsis. The organisms that most commonly cause bacterial meningitis or sepsis seem to be streptococcus pneumonia and neisseria meningitidis.  The recent cases in the gay community have been caused by neisseria meningitidis.

In general, cases of bacterial meningitis are rare and very few cases are linked together.  The issue with this type of “invasive” illness is that it can result in permanent brain damage, loss of limbs or death. The CDC estimates that between 2003-2007, only 4,100 cases of bacterial meningitis occurred each year in the United States, however 500 of those cases each year were fatal.

Bacterial meningitis is not an STD. It is spread via throat or oral secretions.  The most common mode of transmission includes such activities as kissing, sharing utensils, sharing cigarettes and sharing non-injection drugs. Anyone with chronic conditions such as HIV, diabetes or other autoimmune diseases has a higher risk of becoming infected.

Illness often advances very suddenly making early diagnosis and intervention with antibiotics important. Common symptoms include headache, fever, sensitivity to light, nausea and/or vomiting and rash. The good news is that there is a vaccine available for adults and children 11 years of age and older. Given this recent increase in cases in the MSM community, the Salt Lake County Health Department is recommending vaccine for gay and bisexual men. The vaccine is often referred to as Menactra or Meningococcal vaccine.

Once again, the message here is not to panic or that bacterial meningitis is now a gay disease. We have yet to fully understand why the recent increases have been seen in MSM; we can only look at connections and raise awareness. The public health message is simply to be aware. If you are experiencing an unusual illness that includes the symptoms listed above, seek medical attention. Public health also encourages the MSM community to get vaccinated.

Most health insurance carriers offer the vaccine. If you are interested in getting vaccinated, ask your doctor. If you are uninsured, the Salt Lake County Health Department offers the vaccine or more information, call 385-468-4222.

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  1. Let the health department not forget that (perhaps especially in Utah) that men who have sex with men are not always identified as gay or bisexual!

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