Orange County Facing Outbreak of Meningitis Among Gay Men

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Public health officials are sounding alarms on an outbreak in cases of meningitis – a rare but potentially fatal bacterial infection – among gay men in Orange County and throughout Southern California.

Six infections from the meningococcus bacteria have been diagnosed in Orange County since June, with three of those six occurring just last week, according to Jessica Good, a spokeswoman for the Orange County Health Care Agency.

So far, two people have died due to the outbreak.

Orange County normally averages five cases of meningococcus infections a year, said Good. The majority of the newly infected individuals are men who had intimate or sexual contact with another man.

Outbreaks of meningitis, an infection of the lining around the brain and spinal cord, are particularly dangerous because the disease progresses quickly and can become fatal if untreated within 24 to 48 hours. The bacteria can also cause a dangerous blood infection, or sepsis, which has an even higher mortality rate.

The recent infections are part of a regional outbreak of one strain of the bacteria, called serotype C, which began in March. In Los Angeles County, 15 infections have been documented, with eight of those occurring in gay or bisexual men.

Dr. Helene Calvet, an epidemiologist with the Health Care Agency, said the cause of the outbreak, and why gay men appear to be more susceptible, is unclear.

“That’s a puzzle – we don’t have a good, real answer for that,” Calvet said. “As far as we can tell, none of these [patients] have known each other or had direct contact with each other. Some have been to crowded venues, others haven’t.”

Meningococcus bacteria are spread by exchanging saliva and spit in close and prolonged contact, such as through coughing or kissing, according to the Centers for Disease Control and Prevention.  Outbreaks often occur in college dorms and military barracks, and many schools require proof of vaccination prior to enrollment.

Although it’s unclear why gay or bisexual men are particularly vulnerable to infection, public health officials have speculated that the use of online dating applications to find new sexual partners have contributed to its spread. Anonymous sex, having multiple sexual partners, sharing drinks and cigarettes are all potential risk factors, Calvet said.

Symptoms of an infection can be similar to the flu, such as a sudden onset of fever, headache and stiff neck. But the condition can quickly progress to include nausea, vomiting, increased sensitivity to light, confusion and a distinctive rash of red dots that don’t fade when pressure is applied to the skin.

Meningitis can be effectively prevented with a vaccine or through antibiotics, but time is of the essence, said Calvet.

“Once it starts, the symptoms progress quickly, so the sooner you get antibiotics, the better chance you have of recovering,” said Calvert. “Long term, [meningitis] can cause hearing loss and brain damage. With the blood infection, you can get gangrene of the limbs and organ damage.”

Although most healthy people can encounter or carry the bacteria without becoming sick, individuals with a weakened immune system, such as those who are HIV positive or have another underlying health condition, are more susceptible to infection.

Just this June, the American College of Immunization Practices began recommending all HIV-positive individuals receive the vaccination, based on studies that found those with HIV are five to 24 times more likely to be at risk of infection.

Responding to a rash of new cases in recent years, New York City’s public health department used dating apps to spread the word about an outbreak and their free vaccination program.

Calvet recommends all gay and bisexual men, as well as those who are HIV positive, contact their doctor for the vaccination or go to a county clinic for a low-cost or free vaccination.

“It’s really the close contact [that causes outbreaks],” said Calvet. “The bacteria lives in the back of the throat, so it’s transmitted through close, face-to-face contact.”

The vaccination is available at a low cost or for free at the county Immunization Clinic at 1725 W. Seventeenth Street in Santa Ana. The vaccine and testing for sexually-transmitted diseases is also available at the Testing, Treatment and Care Clinic, which is located at the same address.

View an informational flier in English, Spanish and Vietnamese.

This story was updated on 8/3/16 to reflect new information about the number of people infected. 

Contact Thy Vo at tvo@voiceofoc.org or follow her on Twiter @thyanhvo or Facebook.com/reporterthy.