Intercontinental Spread of an Epidemic Group a Neisseria Meningitidis Strain

Meningococcal Disease: Clinical Profile of 99 Patients

“…There is cyclic variation in prevalence with increased frequency every 8-12 years [2]. This outbreak of meningitis in Saudi Arabia was the result of introduction of the bacteria by pilgrims from South Asia who were carriers for the bacteria [1]. This epidemic subsequently gave rise to other secondary cases in the Gulf States [3], Europe [4], and North America [5].…”

“…This epidemic subsequently gave rise to other secondary cases in the Gulf States [3], Europe [4], and North America [5]. This second pandemic started in 1982 in Nepal and passed through Saudi Arabia in 1987 to Sudan [6], Chad, and Ethiopia [1,7]. The South Asians were the largest national group afflicted with meningococcal disease and Pakistanis, Indians, and Bangladeshis made up 28% of the patients.…”

“…All these patients were found to be afflicted with Neisseria meningitidis, group A. The particular strain responsible for this outbreak was later designated as "clone III-I" [1]. In this study we have analyzed the clinical profile of meningococcal disease in a heterogenous population made up of people from virtually all corners of the world.…”

Meningococcal disease: History, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial susceptibility and prevention

“…43 The carriage rate of meningococci is higher in lower socioeconomic classes, in military recruits, pilgrims, boarding-school students and prisoners. 44,45 In households where a case of meningococcal disease has occurred, the risk of invasive disease in family members is increased by a factor of 400 to 800. 46 The transmission rate of virulent clones is higher and invasive disease often occurs within the first week after acquisition, whereas some persons may carry pathogenic meningococci for many months or years without becoming ill. 33 Various bacterial factors (virulence factors) as well as host factors influence the outcome of exposure to strains of N. meningitidis.…”

“…49 Throughout life, specific antibodies are induced by the continuously repeated and intermittent carriage of different meningococci and N. lactamica. 44,45,49 Individuals who are colonized with nongroupable strains (non-encapsulated strains) develop high titers of antibody against groupable strains, probably due to shared antigenic determinants. This response does not eliminate the carriage state, but it may protect them from overt disease.…”