CHICAGO (CBS) — The Chicago Department of Health announced Tuesday that two new cases of meningococcal meningitis have been confirmed in Chicago men. There are now nine confirmed cases from the Chicago area linked to last summer’s outbreak, all in men who have sex with men including one related death last June.

“While meningitis can affect anyone, African American men who have sex with men, and men who are living with HIV have been disproportionately affected,” said Chicago Department of Public Health Commissioner Julie Morita.

“We’re urging all men who have sex with men to get vaccinated, it’s that simple. It’s preventable,” said Dr. Allison Arwady.

Since May of 2015, CDPH has distributed nearly 18,000 vaccinations of which 14,653 have been administered.

The disease spreads through the sharing of saliva and spit, such as in kissing or sexual contact; or by sharing drinks, cigarettes, marijuana or other smoking devices.

Meningococcal disease also can lead to an infection of the bloodstream, resulting in fatigue, vomiting, chills, cold hands and feet, severe aches, rapid breathing, diarrhea and sometimes a dark purple rash, according to the CDC.

Left untreated, meningitis can lead to death within a few hours, according to the CDC.