Increased Risk of Meningococcal Disease in Men Who Have Sex With Men

Meningitis, meningococcal
Meningitis, meningococcal
Men who have sex with men have an increased risk of meningococcal disease, however, this risk is under-ascertained and improved surveillance is needed.

Men who have sex with men (MSM) have an increased risk of meningococcal disease, however, this risk is under-evaluated and improved surveillance is needed, according to a study published in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

Seven outbreaks of the rare and potentially life-threatening meningococcal bacterial infection have been reported in MSM since 2003. To better describe the epidemiology of meningococcal disease in this group, and to better identify risk factors for this disease in general, researchers implemented enhanced surveillance activities in 2015 in 45 states.

From 2015 to 2016, 271 men age ­>18 years were reported to the National Notifiable Diseases Surveillance System as having cases of meningococcal disease. Of these 271 cases, 17.7% (n=48) were in patients identified as MSM and 37.8% of these patients (n=17) also had HIV.

Overall, 84.8% (n=39) of the 48 MSM cases were caused by the serogroup Neisseria meningitidis serogroup C, which is only responsible for 16.4% of infections in patients of other demographics. Meningococcal disease incidence in the general population was found to be 0.10 cases per 100,000, with 0.54 cases per 100,000 among MSM. In jurisdictions reporting an outbreak of the disease among MSM, incidence was found to be 3.27 cases per 100,000.

Study investigators concluded that “[a]lthough enhanced meningococcal disease surveillance fills an important gap in meningococcal disease surveillance, the limitations of this analysis reflect areas for strengthening surveillance. In addition, vaccination with [quadrivalent meningococcal conjugate] vaccine is recommended for the control of meningococcal disease outbreaks due to serogroups A, C, W, or Y, including during outbreaks among MSM; [further], all persons aged ≥2 months with HIV infection should receive [quadrivalent meningococcal conjugate] vaccine because of the increased risk of meningococcal disease.”

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Bozio CH, Blain A, MacNeil J, et al. Meningococcal disease surveillance in men who have sex with men — United States, 2015-2016Morb Mortal Wkly Rep. 2018; 67(38):1060-1063.