The Facts About Bacterial Meningitis for Gay Men in San Francisco

Magnet Medical Director Chris Hall, MD, gives us the facts about bacterial meningitis and what guys in our community need to know. Check back here for more updates as we learn them.

What is bacterial meningitis?
Meningitis is an inflammation of the delicate membranes that cover the brain and spinal cord. One form of bacterial meningitis, caused by Neisseria meningitidis (or meningococcus), is uncommon but potentially fatal and should always be viewed as a medical emergency. As many as 10-15% of cases lead to death, sometimes within 24 hours, and a significant number of those with who contract the infection have serious complications.

How is it transmitted?
It is transmitted from person-to-person through droplets of respiratory or throat secretions. Close contact—such as kissing, sneezing or coughing on someone, or living in close quarters with an infected person—facilitates the spread of the disease. Droplet spread (versus airborne spread) generally takes place at a range of three feet or less, and prolonged contact generally is required for infection to occur.

What are the symptoms?
The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, severe headache, and vomiting. Rash may also occur. The symptoms usually develop within three to seven days of infection. Antibiotic treatment is effective, but it must be given without delay once meningococcal disease is suspected.

What if I start to feel symptoms?
If you suspect that you or someone you know has meningitis, seek medical care right away. Early, aggressive treatment of bacterial meningitis can prevent serious complications and death. Preventive oral antibiotic therapy for close contacts of confirmed cases is available and highly effective.

Is there a vaccine?
Yes. If you are concerned about potential future exposure, you should get vaccinated. You can see your primary care physician, the Adult Immunization and Travel Clinic in San Francisco, or a local Walgreens pharmacy. The vaccine typically costs between $130 and $160 without insurance, and two doses separated by two months are required for people who are HIV-positive.

Is there an elevated risk of bacterial meningitis for gay men, based on recent cases discussed in the media?
The overwhelming majority of meningococcal meningitis cases in the United States are sporadic and isolated—only a small percentage of cases are linked to an outbreak. However, an outbreak of bacterial meningitis in gay men and other men who have sex with men (MSM) in New York has been tracked since 2010, with 22 cases identified through April 2013, leading to seven deaths. These individuals were affected at 60 times the incidence rate, compared to that expected in the overall population. Fifty-five (55) percent of the cases were among HIV-positive individuals, and African Americans were disproportionately affected. The individuals shared risk factors that included meeting sex partners through social media. For this reason, the New York City Department of Health has issued advisories recommending that all sexually active gay and other MSM be vaccinated. Since that time, other health departments, including San Francisco's, have advised vaccinations for those gay men traveling to New York City who might be sexually active while there. On April 13, 2013, a West Hollywood man died of meningococcal meningitis, raising concern that a similar pattern of illness might be observed in the Los Angeles area. 

Have we seen any concerning cases of bacterial meningitis among gay men in San Francisco or the Bay Area?
Public health officials in San Francisco and Alameda Counties are closely monitoring the situation here in the Bay Area. To date, there are no concerning cases or signs of local clusters or cases specifically linked to those in either New York City or Los Angeles. Therefore, a community-wide vaccination program has not been initiated.

Gay men are encouraged to discuss risk and advisability of vaccination with a health care provider. Should concerning cases arise in the Bay Area, recommendations will be updated to reflect what is known. San Francisco AIDS Foundation continues to work closely with local public health officials to promote the health and safety of gay and other MSM in San Francisco who might be affected by this potential health threat.

Additional Resources

San Francisco Department of Public Health
Adult Immunization and Travel Clinic

Phone (415) 554-2625
Address: 101 Grove Street, Room 102, San Francisco

San Francisco Department of Public Health
Updated recommendations for certain San Francisco men traveling to New York City

California Department of Public Health
Meningitis advisory

New York City Department of Public Health
Recent meningitis outbreak in men who have sex with men

Centers for Disease Control and Prevention
General information

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