Health officials in Los Angeles and Orange counties are racing to vaccinate gay men for meningitis, as a growing outbreak in the region appears to be hitting them particularly hard.
Orange County health workers launched evening pop-up clinics at gay bars, night clubs and LGBT centers. At the first one, at the Velvet Lounge in Santa Ana on Saturday, 31 people got a free shot at the bar — against meningitis.
"We're trying to blanket the world with that information," said Dr. Franklin Pratt, medical director of the L.A. County Department of Public Health's immunization program.
Since March, 24 people were found to have contracted meningitis in L.A. and Orange counties, 19 of whom were gay or bisexual men, according to state health officials.
"I find it extremely concerning," said Dr. Rachel Civen, a medical epidemiologist with L.A. County's Public Health Department.
Officials are unsure why the outbreak is disproportionately affecting gay men, but the cases are believed to be connected because patients were infected with the same strain of meningococcus bacteria, known as serotype C.
Meningitis, which can be transmitted by kissing and sharing drinks, can kill in just a few hours. Two people infected in the current outbreak died.
Public health officials are playing catch-up when it comes to understanding meningitis outbreaks nationwide. Over the past decade, gay communities in Chicago, New York, Berlin, Paris, Toronto and L.A. County have been disproportionately affected by the disease — and no one knows why.
Health officials speculated it might be due to HIV-positive patients who had weakened immune systems that made them more vulnerable, or that those affected had other risk factors, such as engaging in anonymous sex and using illegal drugs.
But Civen said that two-thirds of those infected in L.A.'s current outbreak didn't fall into either of those groups. So last month health officials began recommending vaccines to all gay and bisexual men.
Yet some health advocates think that's not enough. With the cause of the outbreak still uncertain, as many people as possible should consider getting vaccinated, they say.
Officials have so far been unable to find a geographic center for the outbreak or a social link between the cases. Five of the 24 people infected were not gay or bisexual men, and two were women, according to state health officials.
"This disease knows no boundaries," said Lynn Bozof, who heads the nonprofit National Meningitis Assn., an organization she founded after her 20-year-old son died of the disease.
But meningitis is still so rare, with approximately 500 cases annually, that federal health officials don't recommend universal vaccination, said Dr. Amanda Cohn, executive secretary of the U.S. Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices, which develops the CDC's vaccine recommendations.
Routine vaccinations would require a lot of resources for a relatively small public health impact, she said.
"It's really challenging with meningococcal vaccine in particular," because of how few cases there are, she said. "We don't ever want to see any cases of meningococcal disease, however we'd have to vaccinate millions and millions of people because we never know who it's going to be."
Plus, the meningitis vaccine only lasts about five years. "You would just have to vaccinate so many people to prevent each case," Cohn said.
The CDC does recommend the vaccine for certain groups considered high-risk, including teens, college students and military recruits. Meningitis tends to spread when people are living in close quarters.
Civen said that even if L.A. County officials were to decide that all residents should be vaccinated against meningitis during this outbreak, it's likely that few people would actually seek out the shot.
Every year health officials recommend that all Americans over 6 months old receive the flu shot, she said, but "how many people really do it?"
As doctors have seen with gay and bisexual men, "it's not an easy task to get adults who feel healthy and well and don't perceive that they have risk to get a vaccine," she said.
Over the past month, the L.A. County Health Department distributed 3,300 doses of the meningitis vaccine, compared with almost none in a typical month, Pratt said. That's likely a fraction of the total vaccines received by patients, since clinics can purchase them on their own, he added.
Pratt said that people who are concerned about meningitis but don't meet the current vaccination guidelines should inquire with their physician, who can assess their risk factors.
Since Dell Miller, 32, ended up in the hospital last year with meningitis, he has tried to warn people about happened to him. Both his legs were amputated because of the disease.
His closest friends and family were inoculated against meningitis when Miller got sick, but some of his friends still have not sought out the vaccine, he said.
"It's hard to understand — watching someone so close to you go through something so traumatic and still not feel that urgency to take care of it," said Miller, who works as a hairstylist and lives in West Hollywood.
Even though he knows the official recommendations are limited to gay men, he wants everyone asks to ask their doctors about the vaccine. "I tell everyone because it can get anyone," Miller said.
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