CDC Report Highlights Need for Meningococcal Vaccine Among HIV-Infected MSM

A new report published by the Centers for Disease Control and Prevention (CDC) details epidemiological findings on increased rates of meningococcal disease among men who have sex with men (MSM).

Meningococcus, or meningococcal disease, is an infection caused by Neisseria meningitidis bacteria, which can result in serious infections affecting the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia).

Infants, teens, and young adults are at increased risk of developing meningococcal disease—with community settings such as college campuses vulnerable to outbreaks. In addition, individuals with certain medical conditions such as HIV are also at risk, and the CDC recommends that anyone 2 months of age or older with HIV receive a meningococcal conjugate vaccine to prevent the illness.

A new paper published on September 28, 2018, in the CDC’s Morbidity and Mortality Weekly Report details surveillance data on meningococcal disease among MSM in the United States from 2015 to 2016. The research was conducted to identify MSM among meningococcal disease patients and improve collection of data on HIV status for all cases to help investigators understand the epidemiology and risk factors for meningococcal disease among MSM.

The paper notes that while information about MSM has not historically been collected as part of routine meningococcal disease surveillance, that has changed since 2015 when enhanced meningococcal disease surveillance activities were implemented in 45 US states as part of the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. With the agreement began the routine collection of isolates and supplementary data on meningococcal disease cases reported to the National Notifiable Diseases Surveillance System (NNDSS), including information to identify MSM and individuals with HIV infection. With epidemiological investigations into meningococcal disease cases, the CDC recommends that state and local health departments assess patients’ HIV status and to identify MSM among male patients who are aged 16 years or older.

In the new study, the investigators found that from 2015 to 2016, 271 cases of meningococcal disease were reported in men ages 18 years or older in the United States, with sufficient information to identify MSM status available for 124 men. Of the total cases in adult men, 48 (17.7%) occurred in MSM and 17 of those MSM (37.8%) had HIV infection. In addition, 39 (84.8%) cases occurring among MSM were caused by Neisseria meningitidis serogroup C, which was responsible for only 16.4% of cases among men who were not known to be MSM

“Meningococcal disease incidence has been decreasing in all age groups in the United States since 1996 although out­breaks continue to occur,” the authors write. “Identifying MSM among meningococcal disease patients and improving collection of data on HIV status will be important to better understand the epidemiology and risk factors for trans­mission and disease among MSM and to guide meningococcal vaccination policy and other prevention strategies.”