The media have focused on the number of gay men who have been diagnosed with bacterial meningitis, but public health officials warn that there are other groups of people who should be paying attention to the warning signs and who should talk to their healthcare provider about vaccination. Long Beach’s health department lists on its website a wide range of people who should get the vaccine: children under 5, college freshmen living in dormitories, military recruits, those living with HIV or compromised immune systems and those who are already exposed to patients suffering from meningitis.
Dr. Jonathan E. Fielding, who serves as the director of public health for Los Angeles County’s Department of Public Health, emphasized one key point at an April 17 press conference about the reach of bacterial meningitis.
“Let me very clear. This is not a gay disease at all,” Fielding said. He announced at that conference that his department has reported 13 cases of bacterial meningitis in the county since November 2012. Four of the cases were fatal. Among the 13 cases, four of the patients were men who had sex with men (MSMs). Of those four patients who identified as MSMs, two lived and two died. Fielding also stressed that this is a rare disease and that there is no geographic or behavioral connection that has so far been found between the cases of bacterial meningitis in Los Angeles County and the cases in New York City.
The County did not recommend a vaccination campaign at this time, and Fielding said that the CDC (Centers for Disease Control and Prevention) said that the numbers did not meet the criteria that defined an outbreak.
So far, the local area has not been directly affected by meningitis. The service planning area that covers a number of cities including Signal Hill and Lakewood has no confirmed cases of meningococcal disease since Nov. 1, 2012, according to a statement from the Los Angeles County Department of Public Health. Long Beach reported zero cases in the last two years, according to the city’s Health and Human Services Department. Prior to that time, two cases of bacterial meningitis were reported in 2009 and again two cases were reported in 2010 in Long Beach, according to Dr. Mitchell Kushner, who serves as a city health officer for Long Beach.
This particular strain of meningitis has been described by numerous health advisories and public health officials as an infection of the lining of the brain and spinal cord. It can prove fatal. The symptoms include a sudden onset of fever, severe headache, stiff neck, rash, low blood pressure, and generalized muscle pains. It is treatable with antibiotics if caught early. The incubation time is anywhere between two and 10 days.
The disease can be transmitted through droplets and saliva. This means that it could be spread through kissing, but health advisories note that the disease could also be contracted through other forms of close contact like sharing a glass or cigarette.
Bacterial meningitis garnered media attention after New York City’s Department of Health and Mental Hygiene reported 22 cases and recommended vaccinations for all men who often have “intimate contact” with other men that they’ve met online, through a digital application or at a bar or party.
Officials from both Long Beach’s Department of Health and Human Services and the county’s Department of Public Health have started to ask more in-depth questions from men who say that they have sex with other men to assess their risk for getting the disease. The questionnaire from the County’s Department of Public Health asks about travel to New York and details about sexual contact and partners.
Ged Kenslea, who serves as the communications director for AIDS Healthcare Foundation, acknowledged in a telephone interview that this strain of meningitis should not be considered a gay disease, but he also stressed that the number of gay men who have been affected is unusually high.
“There are still unanswered questions about what is going on in Los Angeles,” Kenslea said, “and why are gay men possibly becoming exposed or infected with bacterial meningitis at a higher rate than they represent in the general population.”
The AIDS Healthcare Foundation offered free vaccinations earlier this month. The County’s Department of Public Health also offered free vaccinations to low-income or uninsured residents. Pharmacies like Walgreens have begun to advertise the availability of meningitis vaccinations for a fee.
Kenslea compared the news of how meningitis has affected the gay community now to a time when gay patients affected by the AIDS epidemic were originally ignored by politicians and public health providers. He stressed there is already a precedent of a New York outbreak, but he also acknowledged that the health officials have so far found no geographic or behavioral similarities that link meningitis cases in Los Angeles County to New York.
The Center, an organization dedicated to LGBT issues, has also addressed the concerns in the gay community over meningitis. Ismael Morales serves as the director of health services for The Center. He says that while vaccination is not currently available at The Center, the organization’s focus is on providing information and addressing those concerns through education. They are focusing on prevention of not just meningitis, but also STDs and HIV. Morales said The Center is waiting to hear from Long Beach’s Department of Health, which will determine whether the organization can be a site to administer vaccinations.
Morales compared how meningitis is treated in the media now and how AIDS was treated in the media when the disease was new and not well understood. He said this attention on meningitis reminded him of the experiences with AIDS and HIV back when AIDS was called GRID (Gay-Related Immune Deficiency) at a time when only gay men were testing positive for HIV and AIDS in the 1980s.
He emphasized his organization’s focus on clients.
“We’d like to make sure that if our clients have a need, we kind of fill that need,” Morales said in a telephone interview on April 19. “So we definitely jumped on being more of an education center…being able to educate our community about what meningitis is and what they should look for in terms of signs and how they can access care better.”