Emergence of Localized Serogroup W Meningococcal Disease in the United States — Georgia, 2006–2016

Moore, Ashley; MacNeil, Jessica R.; Wang, Xin; Joseph, Sandeep J.; Lorentzson, Lauren; Thomas, Stepy; Tunali, Amy; Parrott, Tonia; Farley, Monica M.; Tobin-D’Angelo, Melissa

doi:10.15585/mmwr.mm6732a5

Cited by 3 publications

(3 citation statements)

References 8 publications

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“…The MenW ST-11 CC isolates in Canada are similar to the strains currently circulating globally (17). Parallel findings have been reported in Australia (18), parts of the United States (US) (19,20) and the Central African Republic (21). In Australia, 44% of IMD cases in 2016 were due to MenW, an almost three-fold increase from 2015 (18).…”

Section: Demographic Data and Specimen Sourcesupporting

confidence: 69%

“…Second, we did not collect clinical data or disease outcomes of the MenW cases, and therefore we do not know if fatality rates were as high as those reported in other countries or regions (24% in Georgia, US; 20% in England, United Kingdom; and 21% in Australia) (19,26,27). Similarly, we do not know if the Canadian cases had unusual clinical presentations such as gastrointestinal symptoms or epiglottitis (26,28).…”

Section: Limitationsmentioning

confidence: 99%

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Increase in ST-11 serogroup W Neisseria meningitidis invasive meningococcal disease in Canada, 2016–2018

Tsang¹,

Hoang²,

Tyrrell³

et al. 2019

CCDR

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Background: Many countries have experienced increases in invasive meningococcal disease (IMD) due to a serogroup W Neisseria meningitidis (MenW) strain of the multilocus sequence type (ST)-11 clonal complex (CC). MenW ST-11 was first reported in Ontario, Canada, in 2014. By 2016, this strain caused IMD in five provinces and was responsible for 18.8% of the IMD cases in Canada.Objective: To provide an update on invasive MenW disease in Canada including the strain characteristics, specimen source of isolates, age, sex and geographic distribution of cases. Methods: N. meningitidis from culture-positive IMD cases are routinely submitted to the National Microbiology Laboratory (NML) for serogroup, serotype, serosubtype and sequence type analysis. The data from January 1, 2016 to December 31, 2018 were analyzed by calculating the proportion of IMD cases caused by MenW compared with other serogroups. In addition, trends based on age, sex and geographic distribution of cases and specimen source of isolates were analyzed based on information on specimen requisition forms.Results: Over the three year period, 292 individual IMD case isolates were analyzed. The percentage of IMD case isolates typed as MenW more than doubled from 19% (n=15) to 44% (n=51) in 2018 when MenW became the most common serogroup, exceeded the number of MenB, MenC or MenY. In total, 93 MenW case isolates were identified, 91% (n=85) belonged to the ST-11 CC. The increase in MenW affected all age groups (but was most common in those older than 60) and both sexes, and occurred across the country but most prevalent in western Canada. The most common specimen source was blood. Conclusion:In 2018, MenW was the most common serogroup for isolates received by the NML from culture-positive IMD cases in Canada. Over 90% of the MenW serogroup isolates belonged to the ST-11 CC. The quadrivalent ACWY meningococcal conjugate vaccine protects against IMD caused by strains in the A, C, W or Y serogroups and therefore may protect against IMD caused by the new MenW ST-11 strain; however, more research is needed. The emergence of variant strains highlight the importance of strain characterization in IMD surveillance and research.

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Section: Demographic Data and Specimen Sourcesupporting

confidence: 69%

Section: Limitationsmentioning

confidence: 99%

Increase in ST-11 serogroup W Neisseria meningitidis invasive meningococcal disease in Canada, 2016–2018

Tsang¹,

Hoang²,

Tyrrell³

et al. 2019

CCDR

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“…Man., Sask. (19,26,27). De la même manière, nous ne savons pas si les cas canadiens présentaient un tableau clinique inhabituel, comme des symptômes gastro-intestinaux ou une épiglottite (26,28).…”

Section: Données Démographiques Et Source De Spécimenunclassified

Hausse des cas de méningococcie invasive à Neisseria meningitidis ST-11 de sérogroupe W au Canada, de 2016 à 2018

Tsang¹,

Hoang²,

Tyrrell³

et al. 2019

RMTC

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Contexte : De nombreux pays ont enregistré une hausse des cas de méningococcie invasive causée par une souche de Neisseria meningitidis de sérogroupe W (MenW) du complexe clonal (CC) de séquence type multilocus (ST)11. Le premier cas canadien de MenW a été signalé en Ontario en 2014. En 2016, cette souche avait entraîné des cas de méningococcie invasive dans cinq provinces et était responsable de 18,8 % des cas de méningococcie invasive au Canada. Objectif : Faire le bilan sur l'infection à MenW invasive au Canada, notamment les caractéristiques de cette souche, la source des isolats du spécimen, l'âge, le sexe et la répartition géographique des cas.

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First Real-world Evidence of Meningococcal Group B Vaccine, 4CMenB, Protection Against Meningococcal Group W Disease: Prospective Enhanced National Surveillance, England

Ladhani

Campbell

Andrews

et al. 2020

Clinical Infectious Diseases

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BACKGROUND 4CMenB is a protein-based meningococcal group B vaccine but the vaccine antigens may also be present on non-group B meningococci. In September 2015, the UK implemented 4CMenB into the national infant immunisation programme, alongside an emergency adolescent meningococcal ACWY (MenACWY) programme to control a national outbreak of group W (MenW) disease caused by a hypervirulent strain belonging to the ST11 clonal complex. The adolescent programme aimed to provide direct protection for adolescents and, over time, indirect (herd) protection across the population. METHODS Public Health England conducts meningococcal disease surveillance in England. MenW cases confirmed during four years before and four years after implementation of both vaccines were analysed. Poisson models were constructed to estimate direct protection against MenW disease offered by the infant 4CMenB programme on top of the indirect impact of the adolescent MenACWY programme in children eligible for 4CMenB but not MenACWY. RESULTS Model estimates showed 69% (adjusted incidence rate ratio (IRR) 0.31, 95%CI, 0.20-0.67) and 52% (aIRR 0.48, 95%CI 0.28-0.81) fewer MenW cases than predicted among age-cohorts that were fully-eligible and partly-eligible for 4CMenB, respectively. There were 138 MenW cases in &5 year-olds. 4CMenB directly prevented 98 (95%CI, 34-201) cases, while the MenACWY programme indirectly prevented an additional 114 (conservative) to 899 (extreme) cases over four years. Disease severity was similar in 4CMenB-immunised and unimmunised children. CONCLUSIONS Our results provide the first real-world evidence of the direct protection afforded by 4CMenB against MenW:cc11 disease. 4CMenB has the potential to provide some protection against all meningococcal serogroups.

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Emergence of Localized Serogroup W Meningococcal Disease in the United States — Georgia, 2006–2016

Cited by 3 publications

References 8 publications

Increase in ST-11 serogroup W Neisseria meningitidis invasive meningococcal disease in Canada, 2016–2018

Increase in ST-11 serogroup W Neisseria meningitidis invasive meningococcal disease in Canada, 2016–2018

Hausse des cas de méningococcie invasive à Neisseria meningitidis ST-11 de sérogroupe W au Canada, de 2016 à 2018

First Real-world Evidence of Meningococcal Group B Vaccine, 4CMenB, Protection Against Meningococcal Group W Disease: Prospective Enhanced National Surveillance, England

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