The Relationship Between Sexually Transmitted Diseases and Invasive Meningococcal Disease (IMD) in NYC, 2000-2012

Kotzen, Mollie

Tuesday, June 10, 2014

Exhibit Hall

Mollie Kotzen, MPH Candidate¹, Julia Schillinger, MD, MSc², Sharon Greene, PhD, MPH¹, Blayne Cutler, MD, PhD³, Sarah Braunstein, PhD, MPH⁴, Preeti Pathela, DrPH, MPH⁵, Robin Hennessy, MPH⁶, Beth Isaac, MPH Candidate¹, Susan Blank, MD, MPH⁵ and Don Weiss, MD, MPH¹, 1Bureau of Communicable Disease, New York City Department of Health and Mental Hygiene, Long Island City, NY, 2Bureau of Sexually Transmitted Disease Control, NYC Department of Health & Mental Hygiene, Division of Sexually Transmitted Disease Prevention, Centers for Disease Control and Prevention, Queens, NY, 3Bureau of HIV/AIDS Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, 4HIV Epidemiology and Field Services, New York City Department of Health and Mental Hygiene, Long Island City, NY, 5Bureau of STD Control and Prevention, New York City Department of Health and Mental Hygiene, Long Island City, NY, 6Bureau of STD Control and Prevention, New York City Department of Health and Mental Hygiene, Queens, NY

Background: Invasive Meningococcal Disease (IMD) is acquired through respiratory droplets. From 2012-2013, an IMD outbreak occurred in men-who-have-sex-with-men (MSM) in NYC. We measured the association between diagnosis of sexually transmitted diseases (STDs), a marker for risky sexual behavior, and IMD.

Methods: IMD cases ages 15 to 64 reported during 2000-2012 were matched to the STD registry. The relative risk (RR) of IMD for persons with an STD was defined as the ratio of: the number of persons with both IMD and STD divided by total persons in the STD registry, to the number of persons with IMD but without STD divided by the city population without STD. Relative risks were examined by age group, sex, type of STD, and year. RRs were calculated for two non-sexually transmitted diseases, Haemophilus influenzae (Hi)and Rocky Mountain Spotted Fever (RMSF).

Results: Among 285 IMD cases, 26 (9%) were in the STD registry. The RR of having IMD given an STD was 13.3 (95% confidence interval [CI] 8.9-20.0). RRs were highest for persons ages 45-64 (52.8 [95% CI 21.3-130.0]), men (22.4 [95% CI 13.3-37.6]), and men with syphilis (79.5 [95% CI 40.5-156.2]). The RR before the outbreak (2000-2011) was 7.6 (95% CI 4.6-12.4); during the peak outbreak year (2012), it was 67.9 (95% CI 28.1-163.8). RRs for Hiand RMSF were 7.9 (95% CI 5.4-11.7) and 5.0 (95% CI 2.4-10.6), respectively. The RR of IMD for persons in the STD registry was 2.7 times the RR for persons with RMSF (RR Ratio: 2.7, 95% CI 1.13-6.3).

Conclusions: Presence in the STD registry was positively associated with IMD. The association was especially strong for men and during the outbreak year, suggesting the relationship between STD and IMD may be driven by MSM. Further research is needed to understand the interaction of STDs, HIV, and social network with the risk of IMD.

TP 126 The Relationship Between Sexually Transmitted Diseases and Invasive Meningococcal Disease (IMD) in NYC, 2000-2012