Meningococcal disease in men who have sex with men (MSM) in New York City
What is the issue?
Invasive Meningococcal Disease (IMD) continues to spread among men who have sex with men (MSM) in New York City. Four new cases of IMD in MSM have occurred in 2013. To date, 22 men have become ill in this outbreak: 1 in 2010, 4 in 2011, 13 in 2012 and 4 in 2013. Seven men have died, including three of the last five cases.
What is meningococcal disease?
Meningococcal bacteria live naturally in the back of the nose and throat of approximately 10 per cent of the population. There are many strains of meningococci and most cause no harm. Occasionally, however, a disease-causing meningococcal strain is passed to someone who has no immunity to these bacteria and this can result in a case of meningococcal disease. Illness includes meningitis (infection of the lining of the brain) and septicaemia (infection of the bloodstream). Both of these illnesses can occur rapidly and severely.
The bacteria are difficult to spread and are only passed from person to person by regular close, prolonged contact. Recent studies have shown that contact with saliva from the front of the mouth, teeth or lips will rarely pass the bacteria from person to person. The bacteria die very quickly when outside the body.
Symptoms of meningococcal disease
Although the risk of contacts developing meningococcal disease is extremely low, it is important to look out for the symptoms listed in the box. It may take up to seven days for the signs of meningococcal disease to appear.
Signs and symptoms can appear very quickly, and people with meningococcal disease can get much worse within a few hours. You know your family and best friends better than anybody else. If you or someone close to you has some of these signs, and appears to you to be much sicker than usual, seek medical attention from a doctor or nearest hospital.
Symptoms to look out for:
• General malaise
• Neck stiffness
• Discomfort when looking at bright lights (photophobia)
• Vomiting and/or diarrhoea
• Muscles aches
• Painful or swollen joints and/or difficulty walking
• Moaning, unintelligible speech
• Rash of red-purple pinprick spots or larger bruises
Who is at risk?
This outbreak in New York suggests transmission of the bacteria from MSM who are well and who do not necessarily develop illness.
Therefore those considered at risk are:
- All HIV-infected MSM
- MSM, regardless of HIV status, who regularly have close or intimate contact with other men met either through an online website, digital application (“app”), or at a bar or party
What should I do to protect myself?
If you are MSM and travelling to New York you should:
- Be vaccinated against Meningococcal C disease if you fit the risk categories listed above. Vaccines which protect against this include Neisvac-C, Meningitec, and Menjugate syringe. Take this information to your GP or specialist to assist in your travel preparation.
- Be alert to symptoms of meningococcal disease (especially if unvaccinated) while travelling and on return home.
- Seek medical assistance if you are unwell and immediate medical attention if you have symptoms of meningococcal disease.
- Ensure that you have medical insurance which covers travel to the United States.
Provided by Communicable Disease Prevention and Control Section
Department of Health, Victoria