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ALERT! Meningitis in MSM: Recommendations for Travel

April 19, 2013

Invasive Meningococcal C Outbreak among Men Who Have Sex with Men (MSM) in New York City: Recommendations for Travel

An ongoing outbreak of invasive meningococcal disease serogroup C has been occurring among men who have sex with men in New York City. Since 2010, there have been 22 cases reported: one in 2010, four in 2011, 13 in 2012 and four in 2013. Seven men have died, including three of the last five cases. The age range of cases is 21 to 59 years, and 50% have been Black, 27% White, and 18% Hispanic (any race). Twelve cases were HIV-infected, of which five have died. Cases of meningitis have also been reported in MSM in California.

The New York City Department of Health is recommending meningococcal vaccine to the following New York City residents:
• All HIV-infected MSM
• MSM, regardless of HIV status, who regularly have close or intimate contact with other men met either through an online website, digital application (“app”), or at a bar or party
The Public Health Agency of Canada (PHAC) is not aware of any cases among Canadians related to this outbreak. Toronto Public Health has also not seen any cases related to this outbreak. Please call Toronto Public Health if you think you have a suspect or confirmed case of meningococcal disease to TPH's surveillance unit at 416-392-7411 during work hours (8:30am to 4:30pm, Monday to Friday) or at 3-1-1 after hours.
The National Advisory Committee on Immunization (NACI) recommends use of the quadrivalent meningococcal conjugate vaccine (Men ACYW-135 – Menactra or Menveo) to travelers where the risk of meningococcal transmission is high. NACI also says vaccination should be considered for individuals with HIV.

Toronto Public Health recommends physicians offer meningococcal conjugate ACYW-135 vaccine to MSM who are planning to travel to New York City and who are either HIV-infected or who may have close or intimate contact with other men met either through an online website, digital application (“app”), or at a bar or party in New York City. Note that this vaccine is not publicly funded for this group.

More information:
Toronto Public Health Immunization Information Centre:
416-392-1250 or email immunization@toronto.ca
New York City Department of Health alerts:
https://a816-health29ssl.nyc.gov/sites/NYCHAN/WebPages/home.aspx.
Canadian Immunization Guide on meningococcal vaccines:
http://www.phac-aspc.gc.ca/publicat/cig-gci/p04-meni-eng.php.