Alert for HIV Positive Men in LA

The Los Angeles County Department of Public Health (DPH) has issued a special meningitis vaccination alert to all HIV positive men who have sex with men (MSM).

This alert includes people who have been previously vaccinated against meningitis.

This LAC DPH alert focuses on the outbreak of invasive meningococcal disease (IMD) in Southern California.

Dr. Benjamin Schwartz, Interim Director, Acute Communicable Disease Program, hopes the message will help save the lives of people with HIV and stop an outbreak of IMD first identified in March of 2016.

The LAC DPH has issued new guidelines to health care providers and is stressing a more rigorous treatment protocol for men who have sex with men, and all HIV positive individuals.

They are now reporting that it appears a single inoculation is insufficient to protect HIV positive people from contracting IMD.

For an HIV positive person, even one who has a healthy immune system, contracting meningitis can be deadly.

A clearly alarmed DPH is now recommending “two doses of the conjugate meningococcal (MenACWY) vaccine at least 8 weeks apart and a booster 5 years later and every 5 years thereafter throughout life.”

“Meningococcal disease is a rare, but serious disease that can lead to swelling in the brain and spinal cord, loss of a limb, deafness, brain damage or even death,” DPH  warned.

According to the Centers For Disease Control and Prevention, meningococcal disease can refer to any illness caused by the type of bacteria called Neisseria meningitidis, also known as meningococcus [muh-ning-goh-KOK-us]. These illnesses are often severe and can be deadly. They include infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (bacteremia or septicemia).

These bacteria spread through the exchange of respiratory and throat secretions like spit (e.g., by living in close quarters, kissing). Doctors treat meningococcal disease with antibiotics, but quick medical attention is extremely important.

Keeping up to date with recommended vaccines is the best defense against meningococcal disease.

The DPH bulletin, which was distributed directly to the community also instructs medical professionals to implement “completion of the 2-dose vaccination schedule for all HIV-infected persons.”

The DPH issued a list of recommended actions to doctors and medical providers.

• Vaccinate all HIV-uninfected MSM patients with a single dose of the MenACWY vaccine (Menveo or Menactra) or provide a booster if it has been ≥5 years since the last vaccine dose.
• Vaccinate all HIV-infected patients with 2 doses of MenACWY vaccine at least 8 weeks apart and a booster 5 years later* and every 5 years thereafter throughout life.
• Vaccinate MSM ≥56 years or older with the MenACWY vaccine instead of the meningococcal polysaccharide vaccine (Menomune®).
• Use evidence-based practices (e.g., reminder-recall, co-scheduling) to ensure completion of the 2-dose schedule for all HIV-infected individuals.
• Refer MSM for free MenACWY vaccine if vaccination is not feasible at their primary care provider (see below).
• Report all suspect cases of IMD immediately to LAC DPH.

The cost of the MenACWY vaccine is covered by the AIDS Drug Assistance Program (ADAP) and is provided free of charge at DPH public health clinics and various other medical facilities within LA County.