Pictured above: Brett Shaad (left), who died from his meningitis infection, and West Hollywood councilman John Duran.
Recent cases of meningitis among men who have sex with men in Los Angeles and New York have people pretty worried. Here, in brief, is what you need to know about the meningitis flair up that's reportedly infected 22 men who have sex with men and claimed 7 lives since 2010.
***UPDATE: JOHN DURAN just contacted us to say there has been another alleged death caused by meningitis and there will be a press conference at 3 p.m. PST today at AIDS Healthcare Foundation.
1. WHAT IS MENINGITIS: Meningitis comes in many forms: viral, fungal, parasitic and bacterial. The type one everyone's talking about right now is a bacterial infection that swells membranes around the brain and spinal cord, leading to coma, memory loss, brain damage and sometimes death. Note the use of "type" and not strain here: medical investigators are unsure whether the strains found in New York and Los Angeles are one and the same.
2. WHAT ARE THE SYMPTOMS: Stiff neck, headache, nausea, vomiting, confusion or disorientation, sensitivity to light or noise and a rash. Symptoms can begin anywhere from 1-22 days from exposure, but they usually arise around day 5. If you have any of these symptoms, stop, drop what you're doing and head to the hospital. Otherwise, remain calm.
3. HOW MENINGITIS IS SPREAD: Though it is an airborne respiratory infection, meningitis is most commonly transmitted by passing saliva or other membranous material between mouths and/or noses. And we're talking serious fluid exchange here, like tongue kissing or face sneezing. But, yes, also just speaking to someone closely, particularly someone who spits when they talk, can lead transmit meningitis.
"It's spread by respiratory droplets, which means you can be sitting and having a prolonged conversation with somebody and spread the disease without having sex. It can also be transmitted through saliva and intimate activities," explained Dr. Parveen Kaur from the AIDS Healthcare Foundation. That said, let's be clear: meningitis is not an STD.
"The recommendation by DOH has been expanded to include MSM residing outside NYC who have traveled to the City and engaged in the risk behaviors described below since September 1, 2012," said the NY Department of Health. Dr. Jay Varma, the group's deputy commissioner on disease control, said, "We have identified two groups that are at highest risk of contracting meningitis: HIV-infected men who have sex with men, and any men, regardless of HIV status, who regularly have intimate contact with other men met through a website, digital application (App), or at a bar or party. Vaccination is the best defense against this dangerous infection. We urge men who meet these criteria to get vaccinated now and protect themselves from this disease before it is too late."
GMHC reiterated that claim and health officials in Los Angeles, particularly the gay neighborhood of West Hollywood, have issued and continue to issue similar calls. But truth be told, any vaccine advice can be given two ways: everyone should get it because everyone can catch meningitis; or, HIV-infected MSM and anyone else with immunodeficiencies. Again, in case this wasn't clear enough, there is no cause for alarm.
5. ONCE AND FUTURE PANIC: So, what's all the fuss about? Well, the memory of HIV's first wave remains vivid for many, and the urgency we're hearing is an effort to stop any similar type of public health catastrophe from happening. But, as with many of the elements at play here, this is a double-edged sword, because these gay-specific warnings make people think this is some kind of gay out break. It is not, nor is it a gay disease, and endorsing such an idea can lead to the same misinformation that allowed AIDS to be seen called "gay cancer."
6. WHO IS BRETT SHAAD? In case you're just tuning into this developing story, Brett Shaad (pictured at the top of the page and again here) has become the face and name of the recent meningitis outbreak. He was a 33-year old, healthy gay lawyer living in West Hollywood who fell ill with meningitis last Wednesday. He was in a coma by the end of Thursday, declared brain dead Friday and taken off life support Saturday.
Aside form some drama over when he actually died — some say a Los Angeles politician [see below] mistakenly declared him dead before his family pulled the plug — Shaad's face, young and vibrant, provides visual proof of how fast and devastating meningitis can be while his sexuality, something that truly should not be part of the conversation, helps fuel that aforementioned panic, shading this flash as somehow a "gay matter."
Again, this story cuts both ways. On the one hand it gets gay men to pay attention to a very real threat, but on the other it further alienates gay communities and allows those who want to keep us down a very convenient and all-too-familiar argument: gays are dirty disease-spreaders.
7. WHO IS JOHN DURAN?: A West Hollywood Councilman who's one of the only openly HIV positive and gay politicians in the country, John Duran rose to national prominence last week when he told the Los Angeles Times, "We don't want to panic people, But we learned 30 years ago the consequences of delay in the response to AIDS."
"We are sounding the alarm that sexually active gay men need to be aware that we have a strain of meningitis that is deadly on our hands," he said, thus sparking the panic he claimed not to want. He also claimed that Shaad had attended the White Party, an annual gay dance event closely associated with drugs and sex and whose mere mention had critics lambasting Shaad for perpetuating the stereotype of an irresponsible gay man bringing a deadly disease home.
Duran's fiercest critics have been Shaad's family, who were furious after Duran misspoke about Shaad's time of death. They also insist Shaad did not attend the White Party. Duran, they say, is simply trying to build political capital off of Shaad's death. "There has been huge amount of misinformation about the time, circumstances and details of my brother’s death driven by a politically-motivated council member and inaccurate media reporting,’ said Brian Shaad, Brett's brother.
8. SHOULD WE ALL PANIC?. Ug! No. Stop with the panicking. You probably aren't going to get meningitis and die. This disease infects about
3,000 people in the United States each year (UPDATE: The CDC say fewer than 1,000 people are infected with meningitis annually), and maybe about 150-300 of infected people die, but probably less. And there's often no common thread between communities or outbreaks. Ten airmen at Travis Air Force Base in California came down with meningitis in 2010; nine of those people had children at the same school. In another case, in Los Angeles, there was a small outbreak among homeless people. A 21-year old college student at the University of Wisconsin-Madison died last week, sadly, but there's no indication his death is connected to any of the others. The most recent big spurt was last year, when at least 119 people were infected with a non-contagious form of meningitis via a tainted steroidal injection. At least 12 patients died, including six in Florida, where Gov. Rick Scott accidentally told concerned citizens to call a phone sex line instead of the health department, a brief moment of levity during what ended up being an equally brief outbreak.
So, relax. Get a vaccination if you're really worried. Los Angeles information can be found here, but also know that the AIDS Healthcare Foundation is distributing vaccinations around the city of angels. New York information is here. Other cities should contact their health departments, doctors or local clinics, especially the LGBT clinics; they'll know what's up.But, again, you're probably alright on the meningitis front.
If you absolutely must worry about a disease, think about the black death and that final line in Camus' 1947 work The Plague, "the plague bacillus never dies or disappears for good… it can lie dormant for years… it bides its time." That very plague kills an average of seven people in the States each year, according to the CDC. This meningitis "outbreak" has taken seven lives in two years. #perspective.