1427. Meningococcal Disease Among Men Who Have Sex with Men – United States, 2012-2015
Session: Poster Abstract Session: Public Health
Friday, October 28, 2016
Room: Poster Hall
Background: Meningococcal disease is a rare but serious bacterial infection. Three clusters among men who have sex with men (MSM) have been reported in the US since 2012. We characterized the risk of disease among MSM to informthe Advisory Committee on Immunization Practices' discussions regarding use of meningococcal vaccines in this population.  

Methods: All cases among males aged 18-64 years reported to the National Notifiable Disease Surveillance System between January 2012 and June 2015 were reviewed. MSM status and potential risk factors for disease were collected from state health departments. We compared annualized incidence rates among MSM and men not known to be MSM (non-MSM). Denominators were estimated using 2012 census data and published estimates of the proportion of MSM in the US. Isolates were characterized using standard microbiological methods and PCR; genetic similarity of these isolates was assessed using pulsed-field gel electrophoresis (PFGE) and whole genome sequencing (WGS).

Results: Seventy-four cases, including 35 cluster-associated cases, were reported among MSM and 453 among non-MSM. The majority of MSM-associated cases (n=46, 62%) were aged 26-45 years, compared to 160 (36%) among non-MSM. Among the 63 MSM-associated cases with known HIV status, 37 (59%) were HIV-infected. The risk of meningococcal disease among MSM was 4.0 times (95% CI: 3.55-4.50) the risk in non-MSM. HIV-infected MSM had 10.1 times (95% CI: 6.1-16.6) the risk of HIV-uninfected MSM. Among MSM with known information, 48.1% (N=52) reported recreational drug use, 31.7% (N=63) tobacco use, and 45.2% (N=31) multiple or anonymous sexual partners. Sixty-two cases (83.8%) among MSM were due to serogroup C N. meningitidis (NmC), compared to 98 (21.6%) among non-MSM. Among 25 isolates analyzed from MSM-associated clusters, all were due to NmC ST-11. PFGE and WGS revealed distinct phylogenetic groups associated with the MSM clusters.

Conclusion: MSM, particularly HIV-infected MSM, are at higher risk for meningococcal disease than non-MSM in the US. While vaccination of MSM may reduce their risk, policymakers should consider other factors, including suboptimal vaccine immune response in HIV-infected persons, low absolute risk of disease, and likely need for booster doses in all MSM when making recommendations.

Temi Folaranmi, MD1, Melissa Whaley, MS, MPH2, Hajime Kamiya, MD, MPH, PhD3, Jessica Macneil, MPH2, Cecilia Kretz, PhD1, Amy Blain, MPH2, Stephanie Ngai, MPH4, Kathleen Winter, MPH, PhD5, Massimo Pacilli, MS MPH6, Xin Wang, PhD2, Virginia Bowen, PhD1, Manisha Patel, MD, MS2, Stacey W. Martin, MS2, Lara K. Misegades, PhD, MS7 and Sarah Meyer, MD, MPH7, (1)Centers for Disease Control and Prevention, Atlanta, GA, (2)National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, (3)Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan, (4)Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Long Island City, NY, (5)Immunization Branch, California Department of Public Health, Richmond, CA, (6)Chicago Department of Public Health, Chicago, IL, (7)Meningitis and Vaccine Preventable Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

T. Folaranmi, None

M. Whaley, None

H. Kamiya, None

J. Macneil, None

C. Kretz, None

A. Blain, None

S. Ngai, None

K. Winter, None

M. Pacilli, None

X. Wang, None

V. Bowen, None

M. Patel, None

S. W. Martin, None

L. K. Misegades, None

S. Meyer, None

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