Meningitis in gay, bisexual and men who have sex with men (MSM)

Outbreaks and clusters of meningococcal disease, which can cause meningitis, have been reported among men who have sex with men (MSM) across the U.S.

Meningococcal disease is a rare, sometimes deadly, bacterial infection. It can strike quickly and lead to devastating complications such as hearing loss, brain or kidney damage or limb amputations.

  • In New York City, the last case of an outbreak among MSM was reported in December 2014. The outbreak, which began in August 2010, included at least 22 cases and seven deaths.
  • Clusters and isolated cases among gay men and MSM have occurred in other parts of the country, such as Los Angeles and Miami.

Early symptoms can be similar to the flu or other viral infections, often leading to a misdiagnosis. But symptoms can progress very quickly, killing an otherwise healthy young adult within hours. It’s important to recognize the symptoms so that medical attention can be sought immediately.

Vaccination offers the best protection against meningococcal disease. You can get the bacteria that causes meningococcal disease from someone who has no symptoms or whose symptoms may appear mild.

Meningococcal vaccine recommendations for MSM

The Centers for Disease Control and Prevention recommends meningococcal vaccination to control outbreaks, such as those in Chicago and New York City. State and local public health departments may make additional recommendations based on local needs.

  • The Chicago Department of Health recommends meningococcal vaccination for all gay, bisexual, and MSM. The vaccine is available at no cost at many Chicago clinics and also through some Chicago Department of Health partner sites where a co-pay might apply. Click here for places to get vaccinated in Chicago.
  • The New York City Department of Health recommends meningococcal vaccination for all HIV-positive MSM and for HIV-negative MSM who have close intimate contact with men they meet through online websites, dating apps, or at bars and parties. Click here for a patient fact sheet and places to get vaccinated in NYC.

There are five major serogroups of Neisseria meningitidis, the bacteria that causes meningococcal disease:  A, B, C, W and Y. Serogroup C has been the only serogroup associated with these MSM cases.

Routine meningococcal vaccine is recommended based on age

Because of sustained increases in the risk of this disease among adolescents and young adults, CDC makes the following recommendations for the entire country:

  • Meningococcal vaccination against serogroups A, C, W and Y is recommended for everyone at age 11-12 years with a booster at age 16. Two vaccines in the U.S. are available, containing these four serogroups.
    • Adolescents with HIV, age 11 – 18 years, should receive 2 doses of the A, C, W and Y vaccine administered 2 months apart followed by a booster dose at age 16 (if the first dose was received before age 16).
  • Meningococcal vaccination against serogroup B may also be given to adolescents and young adults 16 to 23, with a preferred age of 16 to 18. While serogroup B has not been linked to the MSM cases, it is responsible for one third or more of the annual cases in the U.S., including outbreaks on college campuses in recent years.

Learn more about meningococcal symptoms, transmission and vaccination.

If you believe you are at risk for meningococcal disease, please talk to your healthcare professional even if you are not located in any of the cities or states mentioned on this page.

Last updated October 2015.