Meningococcal Purpura Fulminans After Rectal Sexual Intercourse in Men Having Sex With Men

Abstract

Abstract Over the past few decades, the incidence of meningococcal disease in the United States has been steadily declining and has reached historic lows. Much of this decrease in numbers of cases is attributed to the effectiveness and acceptance of immunization with conjugate meningococcal vaccines. Although the Advisory Committee on Immunization Practices has expanded its recommendation for vaccination to include all persons older than 2 years with HIV infection, uninfected men who have sex with men (MSM) without other underling conditions have never been singled out for vaccination. However, outbreaks of invasive meningococcal infection in MSM have been reported in recent years, including the largest and most recent one in Florida. The increased rate of urogenital and anorectal colonization with Neisseria meningitidis in MSM and risk of sexual transmission suggests that MSM, regardless of HIV status, should also be vaccinated against meningococcal disease.