By Ryan Gierach, West Hollywood, California
The Los Angeles County Department of Public Health (Public Health) today confirmed reports of a total of eight invasive meningococcal disease (IMD) cases in Los Angeles County in 2014.
Of these eight, four cases were reported among men who have sex with men (MSM), including three men who were HIV-positive. Of those cases, three died. Public health refused to provide any more information, so it remains unclear if any of the deaths were of gay men.
A vital difference between these cases and investigations of IMD in 2012 and 2013 is that distinct epidemiological commonalities were found among the 2014 MSM cases.
Of the four IMD cases among MSM, three reported either residence in, or socializing around, the West Hollywood and North Hollywood areas, and three were between 27-28 years of age (the fourth case was 50 years of age).
The nexus being West Hollywood and the illness extending to the HIV community raise the level of caution issued by the Public Health Department. Based on consultations with the Centers for Disease Control, Public Health recommends that all HIV positive men and men who have sex with men (MSM) get vaccinated for meningitis immediately.
“All HIV-positive MSM and all MSM, regardless of HIV status, who regularly have close or intimate contact with multiple partners, or who seek partners through the use of digital applications, particularly those who share cigarettes, marijuana or use illegal drugs, should visit their health provider to be vaccinated against invasive meningococcal disease,” said Jonathan E. Fielding, MD, MPH, Director of Public Health and Health Officer.
“At-risk MSM who don’t have health insurance can obtain a free vaccination through the Department of Public Health.
”IMD is a sporadic and uncommon bacterial infection of the blood or the lining of the brain and spinal cord that can affect the entire body.
“The infection can cause brain damage, hearing loss, and even death. The bacteria can be spread by very close exposure to sneezing and coughing or direct contact with saliva or nose mucus.”
Disease symptoms may include: high fever, stiff neck, altered mental status, skin rash, severe headache, low blood pressure, aversion to bright lights, and generalized muscle pains. Symptoms usually occur within 5 days of the exposure, but may present as many as 10 days after exposure. IMD progresses rapidly, so immediate diagnosis and treatment is imperative
Last year West Hollywood took a scare when popular lawyer named Brett Shaad died hours after falling ill from the disease. Days later it was revealed that a second gay man, Los Angelino Rjay Spoon, had succumbed to the disease. Still, despite the concerns expressed at the time about the potential for widespread contagion, neither Mr. Shaad nor Mr. Spoon had an acquaintance or crossed paths, and no more gay men came down with the infection in the weeks following.
Public health was slower to get off the dime than city and HIV/AIDS leaders council member John Duran and AHF founder/president Michael Weinstein, however, so AHF dug into its own pockets to offer free meningitis vaccinations to the HIV and gay community to phenomenal response. Within three days of offering the vaccine, AHF’s outreach campaign had provided 2,896 free vaccinations to the community.
It also came to light that Public Health until November 2012 did not, the department do any sexual orientation screening, but that a retroactive look for indicators had been done and found that gay men in West Hollywood/Los Angeles were not spreading the illness in larger than usual numbers.
“Most of the meningitis we see,” Jonathan E. Fielding, the county director of public health said last year, “is in family groups. Children, especially, spread the illness.” Explaining last year that he understood the “level of concern” in the gay community, the illness he said that meningitis should not be considered a “gay disease,” and while meningitis is infectious, it is not as contagious as flu or the common cold, he said. Still, the community stakeholders and Public Health remain wary of large gatherings of people likely to share water bottles, cutlery or engage in deep kissing, such as nightclubs.
Public Health is losing no time this year raising concerns, especially given the WeHo/NoHo nexus of gay infections, which are roughly the same number as last year. They recommended vaccines immediately upon confirming the reports and are offering them free of charge to people without insurance.
AIDS Healthcare Foundation, which led the way to vaccinations last year, will also be offering them at their Men’s Wellness Center located at 1300 North Vermont Avenue, Suite 407, Los Angeles. For more information, please call (866) 339-2525 or visit www.aidshealth.org.
The L.A. Gay & Lesbian Center offers meningococcal vaccine at its McDonald/Wright Building, located at 1625 North Schrader Boulevard, Los Angeles.
It also offers free meningococcal vaccine at The Spot, located at 745 North San Vicente Boulevard, West Hollywood. For more information, please call (323) 860-5855 (McDonald/Wright) or (323) 993-7440 (The Spot) or visit www.lagaycenter.org.
The Saban Community Clinic offers free meningococcal vaccine at its Hollywood-Wilshire Health Center, located at 5205 Melrose Avenue, Los Angeles. For more information, please call (323) 769-7800 or visit www.sabancommunityclinic.org.
In West Hollywood, the MinuteClinic at CVS/pharmacy, located at 8491 Santa Monica Boulevard, offers meningococcal vaccine for a fee, though the MinuteClinic will accept health insurance coverage. For more information, please call (866) 389-2727 or visit http://www.minuteclinic.com/CA/Los-Angeles/West-Hollywood.aspx