Over the last 5 years we have seen outbreaks of N. meningitidis urethritis and invasive meningococcal disease (IMD) in gay and bisexual men in various centres around the world with speculation as to what has driven these outbreaks. As a result there has been a significant focus on the genomics of the isolates associated with the recent outbreaks and in particular horizontal gene transfer from N. gonorrhoeae and the impact on the virulence of N. meningitidis Vaccination against meningococcus has impacted the epidemiology of this infection broadly however the impact in MSM is less clear. There is relatively little recent data about the prevalence of asymptomatic carriage in MSM particularly in the era of PrEP. Commonly, STI management guidelines do not include sexually transmitted N. meningitidis and there are varying laboratory practices with regard to notification of isolates and public health guidance is variable as well. In this presentation the epidemiology of N. meningitidis in MSM around the world will be explored. The potential drivers of these outbreaks will be examined and in particular the genomic investigations into clonal complex 11. The public health responses to date and the implications for public health as well as STI clinicians will be examined.

Disclosure No significant relationships.