A Review of Global Epidemiology and Response to Meningococcal Disease Outbreaks among Men Who Have Sex with Men, 2001–2018

Abstract

Men who have sex with men (MSM) have been previously shown to be at increased risk for meningococcal disease compared to other men. We summarized the global epidemiology and public health response to meningococcal disease outbreaks among MSM. At least ten outbreaks of serogroup C meningococcal disease among MSM have been reported since 2001. Investigation of and response to outbreaks among MSM have often been hampered by an inability to identify epidemiologic links among cases, and the target population recommended for vaccination has been expanded over time in many outbreaks. Unique communication methods, including the use of apps and social media, have been used during some outbreaks to identify close contacts and to communicate health messages. Although HIV-infected MSM have a higher risk of sporadic meningococcal disease in the USA, other factors are likely contributing to outbreaks among MSM. An increase in urethritis due to Neisseria meningitidis has recently been reported in US men, though its role in meningococcal disease transmission among MSM remains unclear. Meningococcal disease outbreaks among MSM raise questions regarding possible unique risk factors in this population. The role of HIV infection and mode of N. meningitidis transmission are being investigated to provide further insights into meningococcal disease and outbreaks in this population. Vaccination remains the primary prevention and control strategy during meningococcal disease outbreaks among MSM.