Epidemic Spread of Subgroup III ofNeisseria meningitidisSerogroup A to South Africa in 1996

Abstract

A total of 111 strains of Neisseria meningitidis isolated during a meningitis outbreak in Johannesburg, South Africa, in 1996 were analyzed by serogrouping, arbitrarily primed polymerase chain reaction analysis, ribotyping, and multilocus enzyme electrophoresis. Nineteen different clusters were identified, and typing patterns for the three techniques were comparable. Of the 111 strains analyzed, 55 (49.5%) belonged to the serogroup A clone complex designated internationally as subgroup I-1. The second largest cluster included 15 isolates (13.5%) that were identified as belonging to the pandemic clone III-1. A number of unrelated strains were also encountered. Our study provides the first documented evidence of the presence of clone III-1 in South Africa and indicates the continued spread of this clone well outside the African meningitis belt.

Meningococcal Disease in South Africa, 1999–2002

“…In South Africa, subgroup I strains were first identified in 1968 (1 isolate) ( 11 , 32 ) and from 1976 through 1983 (41 isolates) ( 32 ). In 1996, 49.5% (55/111) of isolates analyzed from an outbreak in South Africa were identified as serogroup A belonging to subgroup I; 13.5% (15/111) belonged to subgroup III ( 34 ). MLST analysis of 1 of these subgroup III isolates showed it was ST-5 (data not shown).…”

Update on Meningococcal Disease with Emphasis on Pathogenesis and Clinical Management

“…From here the organism was transported with the Hajis (318), causing epidemics in 1988 in The Sudan and Chad and in the following years in Ethiopia, Kenya, and Uganda (315). In the 1990s, the epidemic moved to countries south of the traditional meningitis belt, reaching Nigeria and South Africa in 1996 (305). In that year, more than 150,000 cases and at least 16,000 deaths were reported in Africa (2,80,189).…”

Emergence of Endemic Serogroup W135 Meningococcal Disease Associated with a High Mortality Rate in South Africa

“…Two provinces have historically been responsible for highest rates of disease, and disease has typically been due to specific serogroups: serogroup B in Western Cape Province [20,21] and serogroup A in Gauteng Province [22][23][24]. Western Cape Province has a Mediterranean climate, with wet winters and hot, dry summers; Gauteng Province lies on a plateau and has a temperate climate with summer rainfall [25].…”