Meningitis Outbreak Accelerates in NYC Gay and Bi Communities

Department of Health calls for 100,000 vaccinations as fatalities climb in 2013

It’s a sweaty Wednesday night at Paddles, Chelsea’s S&M dungeon of spanking chairs, steel ankle restraints and rough oak leg spreaders, and the obligatory clothing-check at the front of the house is thronged with horny men looking to release a little midweek ennui and get their freak on. And then there’s the guy with the hypodermic needles—Cure T-shirt, skinny black jeans, medical ID lanyard slung around his neck, and the eager look of the do-gooder in his eyes—asking each man in turn if he’d like a vaccination. “It’s definitely a buzzkill, I know,” says Dr. Demetre Daskalakis, 39, an assistant professor of medicine at the New York University School of Medicine who works out of Bellevue Hospital.

As Daskalakis walks a 42-year-old Wall Streeter wearing only a jock strap through the consent form attached to a clipboard (keep the top info sheet, sign the bottom one and leave it), the man asks, “Oh, so I’m the top and you’re the bottom?” drawing laughs from the conga line of naked and similarly jock-strap-clad men behind him. “Yes,” says Daskalakis. “And you get a lollipop afterward.”

Few things could dampen the mood of some 80 men having a consensual good time in these dark corners. But a sense of dread and fear has begun to grip the city’s gay and bisexual male community in recent weeks. The New York City Department of Health and Mental Hygiene has sounded an increasingly urgent alarm over a growing bacterial meningitis outbreak. This year alone, four men have contracted the potentially lethal disease, putting it on pace with last year’s record of 13 cases since the outbreak started in 2010. In that time, 22 gay and bisexual men have contracted an insidious strain of the bacteria that inflames the lining of the brain and the spinal cord. Seven have died, including three of the last five cases—practically half of the fatalities in just a matter of months.

Dr. Demetre Daskalakis administers a vaccination at Paddles.
Santiago Felipe
Dr. Demetre Daskalakis administers a vaccination at Paddles.
A vaccination form.
Santiago Felipe
A vaccination form.

It is a gruesome and painful illness. The disease can race from headache and fever to rampant rash and then to death within hours. Health officials are afraid that it could claim many more lives—both in the gay community as well as among straight people. But thus far, the disease, for reasons the health department can’t explain, has remained solely in the gay and bisexual community. “We don’t actually know why it’s only occurring in men who have sex with men,” says Dr. Jay Varma, deputy commissioner for disease control at the health department. “If you look at the subset that is this population, it is occurring at a rate 20 times higher than the overall population and 40 times higher than men who aren’t gay or bisexual. It’s frightening. We’re fearful that if we don’t stop it, it’s going to get worse.”

On March 6, the health department issued the latest in a series of dire alerts, warning the public and healthcare professionals of the danger. Doctors had not promptly reported some of the recent fatal infections to the department; some waited days until a lab had made a positive diagnosis. “That can make a difference in treatment and containment,” says Varma.

Though the health department does not believe there is a Patient X out there spreading the disease, it tracked nearly half of all its cases to Brooklyn, to areas as varied as DUMBO, Prospect Heights, Brownsville, Clinton Hill, Bed-Stuy, Crown Heights, and Williamsburg. Most of the men reported meeting for anonymous sex via gay social-media sites and phone apps like Grindr, Scruff, Adam4Adam, and Manhunt. The anonymity of such hookups (“Sometimes all a person knows is a screen name,” says Varma) has made tracking down carriers and halting the spread difficult. The department is using cell phone and computer information of known cases to locate others.

Since meningitis resides in the mucous and nasal passages of carriers—20 percent of whom never get sick—it is spread only by close contact, typically in places like schools and military barracks. It can be contracted by kissing or by any sort of shared saliva, or even just using the same drinking glass or utensils as an infected person. Health experts first identified the current strain during a 2006 outbreak, which started with a 47-year-old Bronx woman and circulated among drug users—mainly crack- and pot-smokers, because smoking irritates the lining of the throat and nasal passages, where the bacteria lives. They don’t know why it reappeared and, strangely, “We don’t know why it’s not spreading to other populations,” says Varma—like to heterosexual family members or co-workers whom they might kiss hello or share utensils with. But it could.

The health department originally thought the disease was spreading primarily among gay men with HIV—a risk factor for the disease—who had met anonymously online or through digital phone apps. But early this year it became clear the disease had invaded a much wider population. On March 6, the department expanded its vaccine recommendations to include all men who had sex with men, regardless of HIV status or where and how they met, and noting the shifting geography of recent cases, with four of the last five occurring in Manhattan. It also noted that several men in the outbreak had not self-identified as gay. The department urged medical professionals to perform complete sexual histories on their male patients to identify those at risk, and specifically urged it for men of color.

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