Meningitis outbreaks among gay men

As cases of meningitis, a rare and potentially fatal disease, popped up in cities nationwide over the past several years, public health officials noticed a trend: many of those infected were gay men.

There’s no known medical reason why meningitis, which is transmitted through saliva, would spread more among gay and bisexual men. Yet New York, Chicago and now Southern California have experienced outbreaks disproportionately affecting that population.

“It is perplexing,” said Dr. Rachel Civen, a medical epidemiologist at L.A. County’s Department of Public Health.

Of the 13 cases of meningitis this year in L.A. County — excluding Long Beach, which has its own health department — seven were gay men. There were only 12 meningitis cases in the county in all of 2015, one of which was a gay or bisexual man.

In Long Beach, there have been six meningitis cases this year, half of which were gay men. Last year there were no meningitis cases in the city, according to city officials.

Civen, who has tracked the county’s meningitis cases for a decade, said it was “pretty striking” that half or more of the cases in both jurisdictions were gay men.

Meningitis cases in L.A. and Orange counties are thought to be connected because lab testing showed that many patients were infected with the same strain of meningococcus, known as serotype C.

Federal, state and local public health officials are working together to investigate the current outbreak, which is estimated to have begun in February, with most cases in the past two months. A man in Orange County died after being infected this year, alarming many in the region’s gay community.

“Certainly my patients have shown concern that something is running through the community like wildfire,” said Dr. Jay Gladstein, an internal medicine doctor in downtown L.A. who mostly treats gay and bisexual men. If patients survive the infection, it can still cause permanent brain damage or hearing loss.

The bacteria that causes meningitis is transmitted by swapping saliva, by means such as kissing and sharing drinks. It requires prolonged, close contact and is not as easily spread as the flu, experts say.

Gladstein, who is also an HIV specialist, said he thinks that the cases are likely among men who have multiple sexual partners, engage in anonymous sex and use drugs that make them more susceptible.

“It’s a particular sub-population of gay men,” Gladstein said.
Credit to LA Times