Epidemiologic Investigation and Targeted Vaccination Initiative in Response to an Outbreak of Meningococcal Disease among Illicit Drug Users in Brooklyn, New York

Abstract

Community-based outbreaks of meningococcal disease are difficult to control, and the decision to vaccinate is not straightforward. Current national guidelines for implementing a vaccination campaign are not strict criteria and cannot be expected to accommodate the myriad of factors that occur in community-based invasive meningococcal disease outbreaks, such as the inability to enumerate the population at risk.

Serogroup C invasive meningococcal disease among men who have sex with men and in gay-oriented social venues in the Paris region: July 2013 to December 2014

“…During 2012, the estimated incidence among MSM aged 18-64 years in New York was 12.6 per 100 000 persons, compared with 0.16 among non-MSM in the same age group. In addition, four cases of IMD have been reported among MSM in Los Angeles since the beginning of 2013 [22][23][24].…”

A prolonged outbreak of invasive meningococcal disease in an extended Irish Traveller family across three Health Service Executive (HSE) areas in Ireland, 2010 to 2013

“…Risk factors for IMD include close contact with a known case, crowded environments, recent upper respiratory tract infection or influenza, cigarette smoking and immunological susceptibility [1].…”

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

“…While this recommendation can be readily applied to institutional outbreaks in which the population at risk is easily defined, it is much more difficult to apply to outbreaks in which the only common link is a social network or risk behaviours. In 2005 and 2006, an outbreak of IMD MenC, ST-11, occurred among recovering and current drug users and their close contacts in NYC [14]. The outbreak extended over many months without meeting strict US CDC criteria.…”

“…The outbreak extended over many months without meeting strict US CDC criteria. The DOHMH responded by administering vaccine to 2,700 persons in affected neighbourhoods, utilising locations such as needle exchange sites, methadone clinics, and drug treatment centres [14].…”