SFDPH Health Advisory: Outbreak of Meningococcal Disease involving Men who Have Sex With Men in Southern California; Recommendations for San Francisco June 29, 2016 SF Dept of Public Health health advisory, Meningococcal Disease, San Francisco Department of Public Health 0 Due to higher risk of invasive meningococcal disease (IMD) among HIV-infected persons, on 6/22/2016 the CDC’s Advisory Committee on Immunization Practices (ACIP) expanded its recommendation for immunization with quadrivalent meningococcal vaccine (MenACWY; Menactra ® or Menveo ® ) to include all HIV-positive persons age 2 months and above. In addition, on 6/24/2016 CDPH announced an outbreak of IMD in May-June 2016 in Los Angeles and Orange Counties. Among 9 reported cases, most were in men who have sex with men (MSM), and meningococcal serogroup C is the strain identified thus far. Therefore CDPH and SFDPH also recommend vaccination with MenACWY for MSM who are not HIV-infected but who have other risk factors for meningococcal disease: Regularly have close or intimate contact with multiple partners, or who seek partners through the use of online websites or digital phone applications Regularly visit crowded venues such as bars, parties, etc. Smoke cigarettes, marijuana, hookahs, or illegal drugs or spend time in smoky settings In 2015, a single case of IMD in a San Francisco MSM was reported, the only such case in the past 5 years. Actions Requested of SF Clinicians Routinely vaccinate all HIV-positive persons age > 2 months with MenACWY vaccine. For older children, adolescents, and adults with HIV infection the primary schedule is 2 doses given 8-12 weeks apart. (Younger children have special schedule requirements*). Previously vaccinated persons who received only one dose should receive a second dose at the earliest opportunity, regardless of the time interval since the previous dose. A booster dose should be given every 5 years. Recommend MenACWY vaccine for MSM and transgender persons who have sex with men, particularly those with the risk factors listed above. Because meningococcal vaccine-induced immunity wanes, a booster dose can be considered for those whose last dose of MenACWY vaccine was > 5 years ago. MSM not known to be HIV-infected who have not been tested for HIV within the last year should be tested for HIV along with vaccination, and should be offered screening for other sexually transmitted diseases based on reported risk. Immediately report all San Francisco residents with suspected or confirmed meningococcal disease to the 24/7 Communicable Disease Control Unit (CDCU) of SFDPH at (415) 554-2830. After hours follow instructions to page the on-call MD. Do not wait to report until the diagnosis is culture-confirmed; any delay in reporting compromises the ability to identify close contacts and ensure they receive timely antibiotic prophylaxis. SFDPH can assist with coordinating Polymerase Chain Reaction (PCR) testing. Click here to view the SFDPH Health Advisory issued on June 28, 2016. Comments are closed.
