While monkeypox is more prevalent and receives the most headlines, one of Pinellas County and Florida’s leading infectious disease doctors is sounding the alarm over the worst meningococcal outbreak to hit the state in years.
Dr. Ulyee Choe is the director of the Florida Department of Health (FDOH) in Pinellas County and the statewide medical director. Choe, board-certified in internal medicine and infectious diseases, held a virtual press conference Wednesday discussing the two outbreaks.
After providing an update on the continued spread of monkeypox, Choe warned of a sharp spike in the deadlier meningococcal disease. As meningitis, the illness infects the brain and spinal cord. It can also infect a person’s bloodstream as bacteremia or septicemia.
“As an infectious disease physician, meningococcal disease, to some degree, concerns me more,” said Choe. “Given the severity of the disease.”
Health officials in Florida have confirmed 48 cases of the disease through the first six months of 2022, compared to just 27 for the entirety of 2021. Of those, 12 people have died, pushing the mortality rate to a staggering 25%.
Thus far, the FDOH has not recorded any meningococcal cases in Pinellas County.
Like monkeypox, Choe said the disease is significantly more prevalent in the LGBTQ community.
“More than half have come from the MSM (men who have sex with men) population,” said Choe. “But again, like monkeypox, anyone that has come in close contact with an infected individual is susceptible.”
Meningococcal vaccines are available for free at any local health department. The FDOH recommends vaccinations for people over 18 in the previously mentioned demographic, the immunocompromised, and those with damaged or removed spleens and sickle cell disease.
The FDOH states that meningococcal disease affects people of all ages, and those living in group settings – like college students – are at a slightly higher risk. Although it spreads through saliva, Choe explained that meningococcal bacteria are not as contagious as the common cold or the flu.
Symptoms can first appear as a flu-like illness – fever, headache, a stiff neck, nausea, light sensitivity and confusion – and rapidly worsen. Choe said that if anyone experiences those symptoms or shows any signs of meningitis, they should seek immediate medical help as effective IV antibiotics are available.
Choe said that even those exposed to a confirmed case could benefit from receiving antibiotics as a preventive measure.
“And again, this is a deadly disease,” added Choe. “The case mortality rates have averaged about 10-15% and as high as 40%, in the most severe forms.”
While not as lethal, monkeypox continues to spread throughout the area.
According to Choe, the state recorded 208 cases as of Wednesday, with 15 in the Tampa Bay area. Pinellas is responsible for nine of those – or 60% of the region’s total.
However, Choe relayed that Southeast Florida is home to 75% of the infections. Broward County leads the state with 110 monkeypox cases, followed by Miami-Dade County with 56.
Choe said health officials recorded 2,100 cases across the U.S. and over 14,200 worldwide. “In countries that do not normally report monkeypox,” added Choe.
“It’s endemic to Central and Western Africa,” explained Choe. “And since about mid-May, we have seen the outbreak both worldwide and in the U.S.”
Like meningococcal disease, Choe said most monkeypox cases stem from the MSM community, but anyone that comes in close contact with an infected individual is susceptible.
The good news, said Choe, is that monkeypox is not easily transmissible and requires intimate physical contact. The symptoms also mirror the flu but include swollen lymph nodes and a body rash or lesions. Transmission typically requires prolonged, face-to-face contact with an infected individual, direct contact with an active rash or indirect contact with contaminated items, such as clothing.
“You can’t casually get it by being in a public setting,” explained Choe. “Cases have been mild – another good point there.
“There have been no reported deaths in the U.S. with this current outbreak.”
Although not as life-threatening as meningococcal disease, Choe said that anyone who has come in contact with someone with a confirmed case of monkeypox, and those with a suspicious rash, should seek help from their healthcare provider.
Choe said the state recently received 25,000 doses of the monkeypox vaccine from the federal government, with over half going to areas with the highest number of active cases.
“Some parts of the state have zero cases,” said Choe. “So, I think, we’re trying to prioritize where we’re seeing the most transmission and disease burden.
“Really working with our community partners, I think, is the key point – especially for those that serve that high-risk group.”
The spread of monkeypox, said Choe, will likely continue to increase. He also expects the number of recorded cases to rise significantly as more commercial testing for the illness is now available.
Choe reiterated that while both outbreaks are more prominent in the MSM population, they are communicable and not confined to any particular community. Contracting monkeypox typically takes intimate physical contact, while Choe said meningococcal disease spreads through kissing or sharing a glass of water.
“I know a lot of the times we’re focusing on monkeypox,” said Choe. “But we need to cover things that are deadly – like meningococcal disease.”