Skip directly to search Skip directly to A to Z list Skip directly to site content
CDC Home

Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: Type 508 Accommodation and the title of the report in the subject line of e-mail.

Notes from the Field: Serogroup C Invasive Meningococcal Disease Among Men Who Have Sex With Men — New York City, 2010–2012

On September 27, 2012, the New York City (NYC) Department of Health and Mental Hygiene (DOHMH) alerted health-care providers and the public about 12 cases of invasive serogroup C Neisseria meningitidis disease (SCMD) occurring in NYC since August 2010 among men who have sex with men (MSM). Cases were identified through existing mandatory notifiable disease reporting and classified according to the Council of State and Territorial Epidemiologists case definitions (1). By December 31, 2012, a total of 18 cases had been identified among MSM. For 2012, the incidence rate of invasive meningococcal disease among MSM aged 18–64 years was 12.6 per 100,000 persons, compared with 0.16 among non-MSM males aged 18–64 years. MSM and non-MSM population denominators were obtained from the 2010 NYC Community Health Survey (2) a telephone-based survey of approximately 10,000 NYC residents.

All 18 patients were hospitalized, and five deaths occurred. The age range among patients was 21–59 years (median: 32 years). Nine lived in Brooklyn, four in Manhattan, two in the Bronx, and two in Queens; one was homeless. Nine were black, and four were Hispanic. Ten were infected with human immunodeficiency virus (HIV), including eight of 12 cases reported during 2012. Eleven of 12 isolates were closely related (>85%) by pulsed field gel electrophoresis (3) to a strain from a 2006 SCMD outbreak in Brooklyn (4); the last six out of seven patients' isolates were indistinguishable from each other. At least seven patients had met multiple sexual partners online.

On October 4, 2012, DOHMH recommended administration of meningococcal vaccine to HIV-infected male NYC residents who had intimate contact with any man met online, through a smartphone application, or at a bar or party since September 1, 2012. On November 29, DOHMH expanded its recommendation to HIV-uninfected men with the same high-risk behaviors who reside in areas of Brooklyn where recent cases have clustered. In addition, DOHMH publicized this outbreak among the population at risk through advertising, mass e-mail messages on MSM websites, posters distributed at MSM bars and clubs, and outreach to community leaders and physician's groups.

More information regarding invasive meningococcal disease and this outbreak is available on the CDC and DOHMH websites (5). Public health departments should be alert for cases of SCMD in MSM and should ask SCMD patients about sexual history, travel history (including travel to NYC), and HIV status to help determine if this outbreak is spreading to other juridictions.

Reported by

Don Weiss, MD, Mike Antwi, MPH, Paula Del Rosso, Marie Dorsinville, MPH, Lillian Lee, MS, Ying Lin, PhD, John Kornblum, PhD, Jay K. Varma, MD, New York City Dept of Health and Mental Hygiene. Alison Ridpath, MD, EIS Officer, CDC. Corresponding contributor: Alison Ridpath,, 347-396-2669.


  1. CDC. Meningococcal disease (Neisseria meningitidis). In: 2012 nationally notifiable diseases and conditions and current case definitions. Atlanta, GA: US Department of Health and Human Services, CDC; 2012:70. Available at Accessed December 20, 2012.
  2. New York City Dept of Health and Mental Hygiene. Community Health Survey. New York, NY: New York City Dept of Health and Mental Hygiene; 2012. Available at Accessed December 21, 2012.
  3. Popovic T, Schmink S, Rosenstein NA, et al. Evaluation of pulsed-field gel electrophoresis in epidemiological investigations of meningococcal disease outbreaks caused by Neisseria meningitidis serogroup C. J Clin Microbiol 2001;39:75–85.
  4. Weiss D, Stern E, Zimmerman C, et al. Epidemiologic investigation and targeted vaccination initiative in response to an outbreak of meningococcal disease among illicit drug users in Brooklyn, New York. Clin Infect Dis 2009;48:894–901.
  5. CDC. Meningococcal disease. Atlanta, GA: US Department of Health and Human Services, CDC; 2012. Available at Accessed December 20, 2012.

Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Health and Human Services.

References to non-CDC sites on the Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of these organizations or their programs by CDC or the U.S. Department of Health and Human Services. CDC is not responsible for the content of pages found at these sites. URL addresses listed in MMWR were current as of the date of publication.

All MMWR HTML versions of articles are electronic conversions from typeset documents. This conversion might result in character translation or format errors in the HTML version. Users are referred to the electronic PDF version ( and/or the original MMWR paper copy for printable versions of official text, figures, and tables. An original paper copy of this issue can be obtained from the Superintendent of Documents, U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. Contact GPO for current prices.

**Questions or messages regarding errors in formatting should be addressed to The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Road Atlanta, GA 30329-4027, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
A-Z Index
  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #