Control of recent community-based outbreaks of invasive meningococcal disease in men who have sex with men in Europe and the United States

Abstract

Invasive meningococcal disease (IMD) is an infrequent yet deadly infection that constitutes a public health emergency. Control requires rapid identification and diagnosis of suspect cases, prompt administration of antibiotic prophylaxis to close contacts, and recognition of epidemiological links among cases. In 2011, the incidence rate of IMD was 0.73 per 100,000 in European Union (EU) countries, as reported by Marcus et al. in their report on a recent cluster of serogroup C Neisseria meningitidis (MenC) in MSM in this edition of Eurosurveillance [1], in the United States (US), it was 0.25 per 100,000 (an all-time low). While outbreaks of IMD in the US and EU are rare, they can be difficult to control, particularly when the primary risk factor is membership in a social network rather than an organisation or institution [2]. In September 2012, a slowly evolving outbreak of IMD was recognised among men who have sex with men (MSM) in New York City (NYC). The NYC Department of Health and Mental Hygiene (DOHMH), in collaboration with community providers, implemented a meningococcal vaccine campaign to prevent further illness and death [3]. IMD cases in MSM have recently also been recognised in Germany, France, and Belgium. In response to these clusters the European Centre for Disease Prevention and Control, with input from leading experts, composed and distributed a rapid risk assessment to help guide medical and public health authorities [4]. The report by Marcus et al. in this issue summarises the German cluster and highlights important issues regarding local and international IMD control [1].