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New York Times
On Alert for Meningitis in Los Angeles

<p>Ian Lovett</p>


April 13, 2013

WEST HOLLYWOOD, Calif. - A potentially deadly strain of meningitis, which has left one resident brain dead, has sent a shiver through the large gay community here, as public health officials have urged residents to be on the lookout for any symptoms of the disease.

Although only one case has been confirmed in the area, officials said, the onset follows an outbreak of deadly meningitis among gay men in New York City. At least 22 men have contracted meningitis in New York since 2010, 13 of them this year, and 7 have died.

Health officials have not yet determined if there is any connection between the cases in New York and the one here. But the similarities have ignited fears that this case could be an early sign of a bicoastal outbreak.

“The lesson we learned 30 years ago in the early days of H.I.V. and AIDS is that people were not alerted to what was going on and a lot of infections occurred that didn’t need to occur,” said John Duran, a West Hollywood city councilman and one of the few openly H.I.V.-positive elected officials in the country. “So even with an isolated case here, we need to sound the alarms, especially given the cases in New York.”

In New York, the city health department issued a warning last month, urging all men who regularly have intimate contact with other men to be vaccinated for meningitis. Officials here have thus far been reluctant to do the same.

At a news conference on Friday, Dr. Maxine E. Liggins, with the Los Angeles County Department of Public Health, warned residents to watch for early signs of meningococcal meningitis, including a severe headache and stiff neck. The disease, a bacterial infection of the membrane surrounding the brain and the spinal cord, can be effectively treated with antibiotics if detected early, although it can intensify quickly.

Ms. Liggins said the county was still investigating the case, looking for people who might have recently had close contact with Brett Shaad, the 33-year-old West Hollywood lawyer who was declared brain dead on Friday, just days after friends described him as fit and healthy. He remained on life support Saturday, pending arrangements for organ donations.

Officials had not yet determined if he was infected with the same strain as the patients in New York, and they were not recommending the vaccine for gay men.

“Currently, we do not have an outbreak going on,” Ms. Liggins said, noting that Los Angeles County had 13 cases of meningococcal meningitis last year.

The health department’s response has frustrated gay leaders here, who argued that at the very least the county should make the vaccine available to gay and bisexual men who want it.

The Los Angeles Gay and Lesbian Center has publicly urged the health department to make the vaccine more widely available, and ordered an initial supply of the vaccine, about 100 doses, which will be offered to people without insurance or who otherwise cannot afford to pay for it at the private clinics where it is available.

“People are scared, and we want those who are concerned to be able to get the vaccine,” said Jim Key, a spokesman for the Gay and Lesbian Center. “We don’t want to wait.”

Mr. Duran said he would push for the City of West Hollywood to cover the cost of about 100 additional doses of the vaccine. He called the health department’s response “government neglect” reminiscent of the delayed response to the outbreak of AIDS in the 1980s.

It was unclear whether the supply of the vaccine could keep up with demand. As word of Mr. Shaad’s condition spread through West Hollywood, the epicenter of gay culture and nightlife in Southern California, many frightened residents went in search of places where they could be vaccinated.

Pharmacies and doctor’s offices around West Hollywood, few of which offered the vaccine, fielded almost nonstop calls about it on Friday afternoon. By Saturday morning, multiple clinics that had been offering the vaccine in the Los Angeles metro area had already run out, and staff members did not know when they would be getting more.

“I don’t see any reason why everyone shouldn’t get vaccinated in our community,” said Michael Valeo, a 41-year-old gay resident of West Hollywood, who was vaccinated on Friday. “With the cases in New York and now here, that’s a lot of people in our community who have gotten sick. We have a mechanism to take care of it, so let’s take care of it.”



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