New York City Lawmakers Hail Meningitis Bill

Openly gay New York City legislators have passed legislation to expand access to meningitis vaccinations, in the midst of an alarming and deadly outbreak of the disease among men who have sex with men.

"Allowing pharmacists to administer the meningitis vaccine will help us stop a wider outbreak of this deadly disease which is evolving into a serious public health concern for the NYC LGBT community," said Senator Brad Hoylman, who introduced the legislation, known as S.4881A/A.7324A. "The best way to prevent illness and death from meningitis is to be vaccinated. As we've seen with the flu vaccine, when pharmacists have the authority to administer a vaccine, immunization rates increase."

Meningitis is a bacterial infection that can be spread through close contact with someone who is infected, especially through coughing, sneezing, and intimate contact like kissing. Symptoms usually develop over seven to ten days and may include fever, severe headaches and a stiff neck as well as nausea, vomiting, increased sensitivity to light, confusion or decreased level of consciousness.

People with a compromised immune system, including those who are HIV-positive, may be at greater risk of infection. Those who experience symptoms and believe they may have been infected should call 911 or go to the emergency room immediately.

According to the New York City Department of Health and Mental Hygiene (DOHMH), 22 cases of meningitis among MSM have been reported since 2010, including 17 cases since 2012 -- seven of which were fatal. The legislation, which is carried in the Assembly by Assembly Member Daniel O'Donnell, authorizes licensed pharmacists who have received additional certification, as well as certified nurse practitioners, to administer meningococcal vaccinations to adults 18 years of age and older.

Dr. Thomas Farley, Commissioner of NYC DOHMH, said, "Allowing pharmacists to offer vaccination against meningitis will save lives and pave the way for even greater access to vaccinations to fight childhood flu and other communicable diseases. I want to thank Senator Hoylman, Senator LaValle, Assembly Member O'Donnell and Assembly Member Glick for passing this important piece of legislation."

Experts say that this strain of meningitis is so insidious that it could suddenly mushroom into a major outbreak, said Hoylman. An article published in late June in the Annals of Internal Medicine noted that health professionals urged gay men visiting New York for Pride Month get vaccinated. In the city, there are numerous anecdotal reports of at-risk men encountering obstacles to getting vaccinated at places like health clinics, hospitals and private doctors' offices. This legislation will address this deficiency in the health care delivery system.

"Passage of this legislation is a tremendous step in our effort to contain the spread this potentially fatal disease," said New York City Council Speaker Christine C. Quinn. "Early on in the outbreak, advocates identified access to the meningitis vaccine as a significant obstacle. I applaud Senator Hoylman for introducing this legislation to increase access by allowing pharmacists to administer the immunizing agents, and am grateful to both him and Assembly Member O'Donnell for securing its passage."

Hoylman thanked Quinn, his colleagues in the State Senate, the bill's lead sponsor in Assembly, O'Donnell, and Deborah Glick, who passed the bill in their house, and said he was optimistic that Governor Andrew Cuomo would sign it into law.

This legislation is one of the many efforts Hoylman is pursuing to help combat the meningitis outbreak, including spearheading a successful effort to recruit Adam4Adam.com, one of the largest online hookup sites, to send a warning to its NYC-area users regarding the meningitis outbreak.

The NYC Health Department has officially tied the meningitis outbreak to the use of smartphone apps, warning all New York users to get vaccinated. They have used the same technology to spread the word about free meningitis vaccinations, advising that all users of such apps get vaccinated, possibly through the city's free program. (Users with HIV are at especially high risk: Twelve of the 24 victims have been HIV-positive.)

"In New York City, if you were to grab 100 gay men and say, 'let me see your phone,' the chances are they all have [a hookup app]," says Dr. Demetre Daskalakis, the incoming medical director of the Mount Sinai AIDS Program and EDGE's resident HIV expert. "It may or may not be a direct driver of this infection. But it is a marker for people who are socializing in a network where the disease can be transmitted."

Meningitis Also Connected to Deaths in West Hollywood

On April 12, L.A. County health officials reported a single case of bacterial meningitis in a gay man, 33-year-old Brad Shaad of West Hollywood, who died from it. It's not known whether the strain that infected the West Hollywood resident is the same as the New York strain.

"It's important to note that this is just one case, but the Center has called on the L.A. County Department of Public Health (DPH) to conduct a rapid and thorough investigation," said Center Director of Medical Services Dr. Bob Bolan, "and we've been told they have already begun tracking those who may have been exposed by the person who died today."

Adding to the fear of a potential outbreak is the fact that Shaad went to the White Party in Palm Springs, a dance party attended by thousands of gay men from March 29 to April 1.

Later, the AIDS Healthcare Foundation, which is offering free meningitis vaccines, also announced two previous deaths in 2012: Rjay Spoon, 30, of downtown Los Angeles died on Dec. 16; and an unidentified 30-year-old San Diego State University student who lived in Chula Vista died on Dec. 10.

Spoon's partner Casey Hayden said he woke up one night to find Spoon vomiting. Spoon's symptoms puzzled doctors until it was too late, he said.

"We went to the hospital and the first thing they said it was was a drug overdose," Hayden told reporters. "Then they said it was extremely advanced HIV, which was not the case. He was negative."

Meningococcal meningitis causes the brain and spinal cord to become inflamed. As many as one in five people who develop this meningitis have serious complications, including brain damage, hearing loss, learning disabilities and death. If caught early, it can be effectively treated with antibiotics.

??"Meningococcal meningitis can be prevented by a vaccine that is available at some local pharmacies and clinics. It is covered by some insurance plans or available for purchase at a cost of approximately $125," said Bolan. "We've asked DPH to give supplies of the vaccine to community clinics like the Center's so we can vaccinate those who want it and who are uninsured and can't afford it. We want to prevent a public health concern from potentially becoming a public health crisis."