Increased Risk for Meningococcal Disease Among Men Who Have Sex With Men in the United States, 2012–2015

Abstract

Background Several clusters of serogroup C meningococcal disease among men who have sex with men (MSM) have been reported in the United States in recent years. The epidemiology and risk of meningococcal disease among MSM is not well described. Methods All meningococcal disease cases among men aged 18–64 years reported to the National Notifiable Disease Surveillance System between January 2012 and June 2015 were reviewed. Characteristics of meningococcal disease cases among MSM and men not known to be MSM (non-MSM) were described. Annualized incidence rates among MSM and non-MSM were compared through calculation of the relative risk and 95% confidence intervals. Isolates from meningococcal disease cases among MSM were characterized using standard microbiological methods and whole-genome sequencing. Results Seventy-four cases of meningococcal disease were reported among MSM and 453 among non-MSM. Annualized incidence of meningococcal disease among MSM was 0.56 cases per 100 000 population, compared to 0.14 among non-MSM, for a relative risk of 4.0 (95% confidence interval [CI], 3.1–5.1). Among the 64 MSM with known status, 38 (59%) were infected with human immunodeficiency virus (HIV). HIV-infected MSM had 10.1 times (95% CI, 6.1–16.6) the risk of HIV-uninfected MSM. All isolates from cluster-associated cases were serogroup C sequence type 11. Conclusions MSM are at increased risk for meningococcal disease, although the incidence of disease remains low. HIV infection may be an important factor for this increased risk. Routine vaccination of HIV-infected persons with a quadrivalent meningococcal conjugate vaccine in accordance with Advisory Committee on Immunization Practices recommendations should be encouraged.

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

“…MSM is also considered a high-risk group [154], with a high incidence of MenC in both outbreak and non-outbreak settings. The cc11 strain was responsible for IMD outbreaks among MSM [156], and HIV infection is likely responsible for most of the increased risk among MSM. Following genomic analysis of the new clone of MenC identified in MSM, the strain was found to have acquired the capacity to spread via sexual transmission, as well as via respiratory droplets [65].…”

Detection of the United States Neisseria meningitidis urethritis clade in the United Kingdom, August and December 2019 – emergence of multiple antibiotic resistance calls for vigilance

“…The US_NmUC strain emerged around the year 2011 and forms part of a broader, predominantly serogroup C strain (PorA subtype P1.5-1,10-8: ST-11 complex) that, as well as causing invasive disease within the general community, has caused multiple outbreaks of serogroup C invasive disease among MSM in Europe and North America [8][9][10]. Phylogenetically, the isolates responsible for community cases and MSM outbreaks were broadly interspersed [11], however, discrete The US US_NmUC isolates [1] formed two sub-strains.…”

Impfen bei Immundefizienz

“…Insbesondere ist bei HIV-infizierten MSM das Risiko für invasive Meningokokken-Erkrankungen erhöht, was in Rahmen von Ausbrüchen beobachtet wurde [88][89][90]. Es gibt zusätzlich Hinweise, dass Meningokokken sexuell übertragbar sind.…”