January 11, 2013
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18 meningitis cases identified among high-risk MSM in New York

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There have been 18 cases of invasive serogroup C Neisseria meningitidis disease identified among men who have sex with men in New York City as of Dec. 31, according to a report in Morbidity and Mortality Weekly Report.

In 2012, the incidence rate of invasive meningococcal disease among MSM aged 18 to 64 years was 12.6 per 100,000 persons. Among non-MSM, the rate was 0.16 per 100,000 persons. All patients were hospitalized and five died.

Among the 18 patients, nine were from Brooklyn, four were from Manhattan, two were from the Bronx, two were from Queens and one was homeless. Nine of the men were black and four were Hispanic. Ten were also infected with HIV and seven patients reported having multiple sex partners they met online.

The New York City Department of Health and Mental Hygiene alerted the public about the outbreak in September. In October, they recommended that MSM with HIV, who had intimate contact with a man met online, through a smartphone application or at a bar or party since September, be given meningococcal vaccine. The recommendation was expanded in November to include men without HIV who have the same high-risk behaviors and who lived in Brooklyn, where there was a cluster of cases.

Twelve isolates underwent pulsed-field gel electrophoresis. Eleven of the isolates were closely related to a strain from a similar outbreak in 2006 in Brooklyn. Of the last seven isolates collected, six were indistinguishable.

“Public health departments should be alert for cases of invasive serogroup C Neisseria meningitidis disease in MSM and should ask patients with this disease about sexual history, travel history (including travel to New York City) and HIV status to help determine if this outbreak is spreading to other jurisdictions,” the CDC wrote.