25 Jun 2015

Invasive meningococcal disease: USA

Invasive meningococcal disease (meningitis) outbreak in men who have sex with men: United States (Chicago, Illinois)

During early June 2015, Chicago Department of Public Health (CDPH) and US Centers for Disease Control and Prevention identified a small outbreak of invasive meningococcal disease (meningitis serogroup C) in men who have sex with men (MSM) in Chicago City [1, 2].  As of 18 June 2015, six cases of meningitis with one death have been recorded in MSM in Illinois; five cases occurred in Chicago.  A further potential case is under investigation [3].

Risk factors associated with previous meningitis outbreaks in the MSM community include having multiple male partners met through a website, bar, party or digital application and being HIV positive [4]; public health authorities in Chicago recommend that all MSM should receive meningitis C vaccine.

Vaccine has been made available at clinics throughout the city and at several events that will take place during June, including the Annual Chicago Pride festivities (June 20-28th 2015) [3].

Advice for travellers

The bacteria that cause meningococcal disease are common and live naturally at the back of the nose and throat; at any time, one in ten people carry the bacteria but they usually cause no harm to the carrier. The bacteria are passed from person to person through inhaling or having direct contact with respiratory secretions e.g. coughing, sneezing or kissing. Rarely, these bacteria can cause serious illness including meningitis (infection of the lining of the brain), septicaemia (blood poisoning) and pneumonia. The risk of infection is greatest in crowded conditions or after prolonged close contact with a carrier or a person with the illness.

In the UK, most people born in the UK after 31 August 1978 will have received Meningococcal C conjugate vaccine (MenC), as part of the UK immunisation schedule.  MenC vaccine is currently available on the NHS for all unvaccinated individuals up to the age of 25 years and students at University in the UK [4]; from 1 August 2015, MenC vaccine will be replaced by MenACWY vaccine in this part of the National Immunisation Schedule [5].

If you are not in the eligible group for NHS provided meningococcal vaccine, and are a gay man travelling to Chicago at this time, you should discuss your individual risk with a health professional and consider the need for vaccination (preferably MenC vaccine; MenACWY may be considered as an alternative) before travel.

Advice for health professionals

Guidance on meningococcal vaccination is available in Immunisation against infectious disease Chapter 22.

In the UK, meningococcal disease is notifiable.  Any case of suspected meningococcal disease should be notified to the local Health Protection Team.

PHE have produced guidance on the clinical and public health management of meningococcal disease.


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