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. 2022 Oct 7;226(Suppl 3):S322-S326.
doi: 10.1093/infdis/jiac230.

Invasive Meningococcal Disease Among People Experiencing Homelessness-United States, 2016-2019

Keegan C Rudmann  1 , Nicole E Brown  1   2 , Amy B Rubis  1 , Meagan Burns  3 , April Ramsey  4 , Denise De Las Nueces  4 , Tasha Martin  5 , Meghan Barnes  6 , Emily Spence Davizon  6 , Adam C Retchless  1 , Caelin Potts  1 , Xin Wang  1 , Susan Hariri  1 , Lucy A McNamara  1
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Invasive Meningococcal Disease Among People Experiencing Homelessness-United States, 2016-2019

Keegan C Rudmann et al. J Infect Dis. .

Abstract

Background: Recently, several invasive meningococcal disease (IMD) outbreaks caused by Neisseria meningitidis have occurred among people experiencing homelessness (PEH). However, overall IMD risk among PEH is not well described. We compared incidence and characteristics of IMD among PEH and persons not known to be experiencing homelessness (non-PEH) in the United States.

Methods: We analyzed 2016-2019 IMD data from the National Notifiable Diseases Surveillance System and enhanced meningococcal disease surveillance. Incidence was calculated using US census data and point-in-time counts from the US Department of Housing and Urban Development.

Results: Of cases from states participating in enhanced surveillance during 2016-2019 (n = 1409), 45 cases (3.2%) occurred among PEH. Annual incidence was higher among PEH (2.12 cases/100 000) than non-PEH (0.11 cases/100 000; relative risk, 19.8; 95% confidence interval [CI], 14.8-26.7). Excluding outbreak-associated cases (PEH n = 18, 40%; non-PEH n = 98, 7.2%), incidence among PEH remained elevated compared to incidence in non-PEH (relative risk, 12.8; 95% CI, 8.8-18.8). Serogroup C was identified in 68.2% of PEH cases compared to 26.4% in non-PEH (P < .0001).

Conclusions: PEH are at increased risk for IMD. Further assessment is needed to determine the feasibility and potential impact of meningococcal vaccination for PEH in the United States.

Keywords: Neisseria meningitidis; invasive meningococcal disease; people experiencing homelessness.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed.

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