Resurgence of Meningococcal Disease Among MSM Causes Alarm

By: Ranier Simons, ADAP Blog Guest Contributor

Amidst the myriad of present-day public health concerns, including Covid-19 and monkeypox, there is another to add to the list. The U.S. Centers for Disease Control & Prevention (CDC) has raised the alarm regarding a surge in meningococcal disease. There has been an unusual surge of meningococcal disease in Florida.[1] The outbreak has been deadly, with 26 reported cases and 7 deaths. The CDC describes this outbreak as one of the worst meningococcal disease outbreaks among gay and bisexual men in U.S. history.[2] Twenty-four of the 26 documented cases and 6 of the 7 deaths thus far have been MSM (men who have sex with men). Anyone can become infected with meningococcal disease. It just happens that this present outbreak has initially affected mainly MSM. Presently, the outbreak primarily affects people living in Florida but has affected people who have traveled to Florida.

There are two types of meningococcal disease: meningitis and bloodstream sepsis. The Neisseria meningitidis bacteria cause them.[3] Meningitis is an infection of the tissues surrounding the brain and spinal cord. Bloodstream sepsis is a bloodstream infection resulting from the body attempting to fight infection. The body releases chemicals into the bloodstream to fight the meningococcal bacteria. As a result, those chemicals cause inflammation throughout the body. That inflammation can negatively affect the body in many ways, including organ failure and death.[4]

Photo Source: CDC

The disease is respiratory with bacteria found in the back of the throat or nose. Spread generally requires close contact and can also be caused by coughing or kissing. This is why the CDC is very alarmed, given the many summer music events, Pride festivals, and other gatherings where people are in crowded areas for extended periods. Signs of meningitis are sudden high fever, neck stiffness, headache, nausea, sensitivity to light, and mental confusion.[5] Symptoms of meningococcal sepsis are fever, chills, unusual fatigue, and in some cases, a purplish rash on the hands and feet.[5]

Without treatment, both meningococcal diseases can kill within days.[3] There are multiple species or subgroups of meningococcal bacteria. Subgroups B and C have been detected in the Florida outbreaks. Strain C is affecting large numbers of gay, bisexual, and other MSM in the counties of Orange, Polk, Seminole, Miami-Dade, and Broward. A much smaller outbreak has been detected in Leon County of Florida, affecting primarily college students, caused by strain B.

Fortunately, vaccines against meningococcal disease have been around for a long time and are widely available. The most common one is the MenACWY vaccination which protects against subgroups  A, C, W, and Y. The MenB vaccine is for subgroup B. The CDC urges all those living with HIV to get vaccinated in addition to MSM. Even before this outbreak, doctors recommended vaccination for people living with HIV. In the U.S., healthcare providers have recommended the 2-does series of the MenACWY vaccine since 2016.[6] However, widespread adoption of vaccine adherence has historically not been accomplished. The effort to educate on the importance of vaccination needs to increase as there isn’t high vaccination uptake among those newly diagnosed with HIV. 

Photo Source: TNS; The Atlanta-Journal Constitution

Since anyone can become infected, everyone must be mindful of the danger of meningococcal disease. Those in high-risk groups, including college students and MSM, should vaccinate and maintain vaccination over time. People can survive if providers administer antibiotics early. However, there can be long-term issues after contracting the bacteria, such as hearing or vision loss, amputation of affected limbs, and even memory and concentration issues.

Diseases spread quickly. Thus, it is important for people all over the country to take meningococcal vaccination seriously, not just people living in Florida. People travel to and from Florida regularly, especially as travel contiuously  increases in the direction of pre-Covid pandemic numbers.

[1] Thomas, D. (2022, June 30). Georgia health officials report no cases here, but issue cautions for men who have sex with men and travel to Florida. Retrieved from https://www.ajc.com/news/coronavirus/unusual-surge-of-meningococcal-disease-cases-in-florida-alarms-the-cdc/KHCYT7D46VFLLJIWVYS67WIPJA/
[2] Freeman, L. (2022, June 30). Meningococcal outbreak in Florida; Lee County has second highest case count with four cases. Retrieved from https://news.yahoo.com/meningococcal-outbreak-florida-lee-county-151840797.html?soc_src=social-sh&soc_trk=tw&tsrc=twtr&guccounter=1/
[3] Thomson, J. (2022, June 24). Florida Meningococcal Disease Outbreak: CDC Urges Gay Men To Get Vaccine. Retrieved from https://www.newsweek.com/gay-men-florida-outbreak-meningococcal-disease-meningitis-sepsis-vaccine-1718797
[4] CDC. (2021, August). What is sepsis? Retrieved from https://cdc.gov/sepsis/what-is-sepsis.html
[5] Padgett, D. (2022, July 7). CDC Encourages Meningococcal Vaccine For At-Risk Florida Visitors. Retrieved from https://news.yahoo.com/cdc-encourages-meningococcal-vaccine-risk-193000372.html?soc_src=social-sh&soc_trk=tw&tsrc=twtr
[6] Shaw, M. (2022, June 23). Meningococcal vaccine uptake lagging among people living with HIV. Retrieved from https://www.ajmc.com/view/meningococcal-vaccine-uptake-lagging-among-people-living-with-hiv

Disclaimer: Guest blogs do not necessarily reflect the views of the ADAP Advocacy Association, but rather they provide a neutral platform whereby the author serves to promote open, honest discussion about public health-related issues and updates.