Rapid Laboratory Identification of <i>Neisseria meningitidis</i> Serogroup C as the Cause of an Outbreak — Liberia, 2017

Patel, Jaymin C.; George, Josiah; Vuong, Jeni; Cubeñas-Potts, Caelin; Bozio, Catherine H; Clark, Thomas A.; Thomas, J. H.; Schier, Joshua G.; Chang, Arthur; Waller, Jessica L.; Diaz, Maureen H.; Whaley, Melissa; Jenkins, Laurel T.; Fuller, Serena; Williams, Desmond E.; Redd, John T.; Arthur, Ray R.; Taweh, Fahn; Walker, Yatta Vera; Hardy, Patrick; Freeman, Maxwell; Katawera, Victoria; Gwesa, Gulu; Gbanya, Miatta Zenabu; Clement, Peter; Kohar, Henry; Stone, Mardia; Fallah, Mosoka; Nyenswah, Tolbert; Winchell, Jonas M.; Wang, Xin; McNamara, Lucy A.; Dokubo, E. Kainne; Fox, LeAnne M.

doi:10.15585/mmwr.mm6642a5

Cited by 18 publications

(16 citation statements)

References 10 publications

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“…Genomic analysis revealed that the strain was not genetically related to any MenC strains previously identified in Africa [33]. In April 2017, 31 IMD cases were reported, including 13 deaths, following attendance at the funeral of a religious leader in Liberia [73]. The outbreak was associated with atypical symptoms (diarrhea, vomiting, and mental confusion) and metagenomic analysis revealed the presence of a strain with 91-98% similarity to ST-10217 in six of the 10 specimens analyzed, the remaining four specimens were inconclusive [73,74].…”

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 86%

“…In April 2017, 31 IMD cases were reported, including 13 deaths, following attendance at the funeral of a religious leader in Liberia [73]. The outbreak was associated with atypical symptoms (diarrhea, vomiting, and mental confusion) and metagenomic analysis revealed the presence of a strain with 91-98% similarity to ST-10217 in six of the 10 specimens analyzed, the remaining four specimens were inconclusive [73,74]. This strain appears to be evolved and likely has the epidemic potential [75].…”

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

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The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

159

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2019) The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and highrisk populations, Expert Review of Vaccines, 18:1, 15-30, ABSTRACT Introduction: The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents. Areas covered: Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide. Expert commentary: The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention. ARTICLE HISTORY

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Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 86%

Section: Epidemiology Of Recent Meningococcal Disease Outbreaksmentioning

confidence: 99%

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

159

View full text Add to dashboard Cite

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“…Over the next two weeks, there were another 31 reported cases, with 13 deaths. All cases were linked to the funeral, with the US Center for Disease Control (CDC) using PCR to confirm 13 cases as meningococcal serogroup C. 98 In six out of 10 specimens subsequently analyzed via metagenomics, there was the presence of a strain with 91-98% similarity to ST-10,217, which previously caused meningococcal disease outbreaks in Niger and Nigeria. 99 The World Scout Jamboree (Japan, 2015) In 2015, there were six confirmed IMD cases following the 23rd World Scout Jamboree (WSJ) held in the Yamaguchi prefecture, Japan.…”

Section: Funeralsmentioning

confidence: 99%

Meningococcal disease surveillance in the Asia–Pacific region (2020): The global meningococcal initiative

Aye

Bai

Borrow

et al. 2020

Journal of Infection

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The incidence of IMD is low and similar across the represented countries (< 0.2 cases per 10 0,0 0 0 persons per year), with the predominant serogroups of Neisseria meningitidis being B, W and Y, although serogroups A and X are present in some areas. Resistance to ciprofloxacin is also of concern, with the close monitoring of antibiotic-resistant clonal complexes (e.g., cc4821) being a priority. Meningococcal vaccination is only included in a few National Immunization Programs, but is recommended for high-risk groups, including travellers (such as pilgrims) and people with complement deficiencies or human immunodeficiency virus (HIV). Both polysaccharide and conjugate vaccines form part of recommendations. However, cost and misconceptions remain limiting factors in vaccine uptake, despite conjugate vaccines preventing the acquisition of carriage.

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“…In keeping with the capacity-building goals of CHAMPS and global preparedness and response initiatives of CDC, these custom TACs have been made available on a case-by-case basis for outbreak investigations [17,18]. In 2017, CHAMPS TACs were employed to rapidly identify Neisseria meningitidis as the causative agent of an outbreak in Liberia [19]. Implementation of similar custom TAC configurations is being supported for other large-scale surveillance studies to examine infectious etiologies in children, neonates, and mother-infant pairs.…”

Section: Discussionmentioning

confidence: 99%

Development and Implementation of Multiplex TaqMan Array Cards for Specimen Testing at Child Health and Mortality Prevention Surveillance Site Laboratories

Diaz

Waller

Theodore³

et al. 2019

Clinical Infectious Diseases

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Child Health and Mortality Prevention Surveillance (CHAMPS) laboratories are employing a variety of laboratory methods to identify infectious agents contributing to deaths of children <5 years old and stillbirths in sub-Saharan Africa and South Asia. In support of this long-term objective, our team developed TaqMan Array Cards (TACs) for testing postmortem specimens (blood, cerebrospinal fluid, lung tissue, respiratory tract swabs, and rectal swabs) for >100 real-time polymerase chain reaction (PCR) targets in total (30-45 per card depending on configuration). Multipathogen panels were configured by syndrome and customized to include pathogens of significance in young children within the regions where CHAMPS is conducted, including bacteria (57 targets covering 30 genera), viruses (48 targets covering 40 viruses), parasites (8 targets covering 8 organisms), and fungi (3 targets covering 3 organisms). The development and application of multiplex real-time PCR reactions to the TAC microfluidic platform increased the number of targets in each panel while maintaining assay efficiency and replicates for heightened sensitivity. These advances represent a substantial improvement in the utility of this technology for infectious disease diagnostics and surveillance. We optimized all aspects of the CHAMPS molecular laboratory testing workflow including nucleic acid extraction, quality assurance, and data management to ensure comprehensive molecular testing of specimens and high-quality data. Here we describe the development and implementation of multiplex TACs and associated laboratory protocols for specimen processing, testing, and data management at CHAMPS site laboratories.

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Rapid Laboratory Identification of Neisseria meningitidis Serogroup C as the Cause of an Outbreak — Liberia, 2017

Cited by 18 publications

References 10 publications

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Meningococcal disease surveillance in the Asia–Pacific region (2020): The global meningococcal initiative

Development and Implementation of Multiplex TaqMan Array Cards for Specimen Testing at Child Health and Mortality Prevention Surveillance Site Laboratories

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