Another meningitis scare emerges, targeting NYC's gay men

(HealthDay)—As a nationwide outbreak of steroid-linked meningitis grabs headlines, health officials in New York City say a separate, unrelated outbreak is hitting gay and bisexual men.

The city's Department of Health and Mental Hygiene (DOHMH) say 12 new cases of bacterial meningitis have arisen among gay and bisexual men since August of 2010, with the biggest spike in cases coming over the past five weeks. One of those infected has died, while another patient remains in critical care. Eight of the 12 cases occurred among men infected with HIV.

As a result, last week the DOHMH issued an advisory recommending that all HIV-positive male residents who've recently engaged in casual "intimate contact" with other men get vaccinated against the disease immediately.

The new recommendations specifically address all HIV-infected men "who have had intimate contact with another man met through a website, digital application ('app'), or at a bar or party since Sept. 1, 2012."

City officials note that people who are HIV-positive generally face a greater risk for acquiring invasive meningococcal disease, a potentially deadly illness that is estimated to take the life of approximately one in five infected patients.

They stressed that while everyone is potentially at risk for meningitis infection, the risk is much lower among non-HIV-positive individuals, so the general population "does not require vaccination" due to this outbreak.

Officials also stressed that the outbreak among New York City's gay males is entirely separate from the national fungus-linked meningitis outbreak linked to tainted steroid injections that has infected 137 people and killed 12 across 10 different states this past month.

That outbreak is linked to tainted medicine while the NYC outbreak is tied to person-to-person transmission, the health department said.

Bacterial meningitis is not an airborne disease, and cannot be spread through inhalation. However, it can be transmitted via prolonged intimacy, such as kissing and sex, and/or through the sharing of objects, such as eating and drinking utensils or cigarettes.

A number of vaccines are effective (although not foolproof) at offering protection against the illness within a week to 10 days following inoculation. And for the next couple of months, the city is making vaccines available through a number of citywide health facilities, where normal insurance co-pay requirements will be waived.

City officials cautioned, however, that HIV-positive men should first seek the advice of their health care provider before going in for an inoculation, in order to make sure that the vaccine is appropriate for them.

They further added that the vaccine does not cure or treat the disease, and urge anyone who has already developed telltale symptoms of infection to seek medical attention immediately.

Dr. Amanda Cohn, a medical epidemiologist with the U.S. Centers for Disease Control and Prevention, in Atlanta, said that the outbreak seems so far isolated to New York City.

No similar outbreaks have been reported this year from other cities, and "the number of cases of meningitis caused by this bacteria is at an all-time low in the United States," Cohn said. "There are usually two to three outbreaks or clusters of meningococcal meningitis in the United States in a year, but most of the cases are sporadic and not related to other cases."

"(So) we consider what's happening in NYC of concern," Cohn added, "but not unduly alarming."

According to Cohn, "meningitis is a serious infection that causes inflammation of the lining of the brain and spinal cord. In some cases this inflammation can cause death, or serious complications such as long-term neurologic problems. Persons who are experiencing sudden onset of symptoms such as high fever, headache and neck stiffness need to be seen by a medical provider urgently."

The DOHMH notes that such symptoms typically manifest two to 10 days following exposure to the bacterium.

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