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

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People experiencing homelessness (PEH) face a significantly higher risk of invasive meningococcal disease (IMD). This study highlights the urgent need to explore vaccination strategies for this vulnerable population in the US.

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Neisseria meningitidisinvasive meningococcal diseasepeople experiencing homelessness

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Area of Science:

  • Epidemiology
  • Public Health
  • Infectious Diseases

Background:

  • Recent invasive meningococcal disease (IMD) outbreaks have been observed among people experiencing homelessness (PEH).
  • The overall risk of IMD among PEH has not been comprehensively described.
  • This study aimed to compare IMD incidence and characteristics between PEH and non-PEH populations in the United States.

Purpose of the Study:

  • To compare the incidence of invasive meningococcal disease (IMD) among people experiencing homelessness (PEH) and those not experiencing homelessness (non-PEH).
  • To analyze the characteristics of IMD cases within these two populations.
  • To inform public health strategies for preventing IMD in vulnerable groups.

Main Methods:

  • Analysis of 2016-2019 IMD data from the National Notifiable Diseases Surveillance System and enhanced surveillance.
  • Calculation of incidence rates using US census data and point-in-time counts of homeless populations.
  • Comparison of relative risks and serogroup distribution between PEH and non-PEH.

Main Results:

  • PEH had a substantially higher annual incidence of IMD (2.12/100,000) compared to non-PEH (0.11/100,000), a relative risk of 19.8.
  • Even excluding outbreak-associated cases, IMD incidence remained significantly elevated among PEH (RR, 12.8).
  • Serogroup C was more prevalent in IMD cases among PEH (68.2%) than non-PEH (26.4%).

Conclusions:

  • People experiencing homelessness are at a significantly increased risk for invasive meningococcal disease.
  • Further research is necessary to assess the feasibility and impact of meningococcal vaccination for PEH.
  • Targeted public health interventions may be required to mitigate IMD risk in the homeless population.