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.
“It’s a particular sub-population of gay men,” Gladstein said.
Earlier this year, the U.S. Centers for Disease Control and Prevention and the New York City Department of Public Health launched a project to investigate the connection between gay men and meningitis.
The research may also consider whether meningitis can be transmitted in other ways, such as sexual routes that might be making gay men more susceptible, Civen said. The bacteria Neisseria meningitidis that leads to meningitis is known to colonize the throat and mouth, but researchers will investigate whether it can also colonize other parts of the body, such as the genitals or anus.
Three years ago, there was a similar increase in meningitis cases among gay men in L.A. County, during which three people died of the disease. That followed a bigger outbreak in New York City that began in 2010.
L.A. County and Long Beach health departments are giving out free vaccines to all gay men.
Meningitis is still a very rare disease, with fewer than 1 case per 100,000 people per year. Symptoms begin quickly and include nausea, vomiting and confusion. If not treated, the infection can kill within hours. (L.Atimes)
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