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Zeng X, He Q, Li Y, Zhou Y, Shao X, Hu P, Liang J, Song Y, Ma C, Zhang L, Sun L, Luo L. An Outbreak of Serogroup Y Meningococcal Meningitis in a Private Secondary Vocational School - Guangzhou City, Guangdong Province, China, 2023. China CDC Wkly 2024; 6:242-246. [PMID: 38633428 PMCID: PMC11018515 DOI: 10.46234/ccdcw2024.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 03/18/2024] [Indexed: 04/19/2024] Open
Abstract
What is already known about this topic? The inclusion of meningococcal vaccines in the National Immunization Program (NIP) over several years has significantly reduced the incidence of meningococcal meningitis in China to historic lows. Worldwide, there has been a diversification of meningococcal serogroups, leading to a shift in dominant serogroups in China from serogroup A to serogroups C and B, accompanied by a rise in reports of serogroups Y and W. What is added by this report? An outbreak of serogroup Y Neisseria meningitidis (Nm) in a secondary vocational school involved a single confirmed severe case and 24 individuals with laboratory-confirmed Nm carriage. Epidemiological investigation revealed that the outbreak was localized to the classroom of the confirmed case. Prolonged close contact within a confined space was identified as a significant risk factor for Nm transmission. The genotype sequence identified was type 1655 (ST-1655), which is categorized under clonal complex 23 (CC-23) and bears resemblance to 8 previously confirmed cases of serogroup Y meningococcal meningitis within Guangdong Province. This suggests that serogroup Y infections continue to sporadically emerge and have become prevalent strains. What are the implications for public health practice? This outbreak underscores the critical need to enhance surveillance of meningococcal serogroups and population carrier, and advocate for vaccination with MenY-containing vaccines.
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Affiliation(s)
- Xiang Zeng
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
- Zhuhai Center for Disease Control and Prevention, Zhuhai City, Guangdong Province, China
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Qing He
- Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Yilan Li
- Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
- Institute of Public Health, Guangzhou Medical University & Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Yong Zhou
- Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Xiaoping Shao
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Pei Hu
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Jian Liang
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Yudan Song
- Department of the National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Ma
- Department of the National Immunization Programme, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lijie Zhang
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Limei Sun
- Guangdong Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
| | - Lei Luo
- Guangzhou Center for Disease Control and Prevention, Guangzhou City, Guangdong Province, China
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Wang X, Xia A, Wang C, Tian H, Chang H, Zeng M, Chen M. Clinical and molecular characterization of the first culture-confirmed pediatric fulminant meningococcemia case caused by a serogroup Y clonal complex 23 strain in China. Vaccine 2021; 39:4261-4265. [PMID: 34147293 DOI: 10.1016/j.vaccine.2021.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/15/2022]
Abstract
Serogroup Y Neisseria meningitidis (NmY) is rare in China, and only serogroup A and C meningococcal polysaccharide vaccines (MPVs) are included in the national vaccination schedule. We describe a case of fulminant meningococcemia caused by NmY, which occurred in a pediatric patient (2 years old) for the first time in China, confirmed by culture. Although the boy was treated in time, the dry gangrene in his toes and fingers left him with severe sequelae. An NmY isolate was cultured from the blood of the patient, and showed decreased susceptibility to penicillin (minimum inhibitory concentration of 0.125 μg/ml), with sequence type (ST) 1655 assigned to clonal complex (cc) 23. Genomic analysis showed it was clustered with isolates from Italy, UK, Finland, and South Africa, sharing designation of Y:P1.5-1,10-1:F4-1:ST-1655(cc23). The emergence of NmY invasive meningococcal disease cases challenges local immunization strategy and warrants wider usage of MPV-ACYW if there is sustained circulation of NmY.
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Affiliation(s)
- Xiangshi Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China
| | - Aimei Xia
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China
| | - Chuning Wang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China
| | - He Tian
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China
| | - Hailing Chang
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China
| | - Mei Zeng
- Department of Infectious Diseases, Children's Hospital of Fudan University, Shanghai, PR China.
| | - Mingliang Chen
- Department of Microbiology, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, PR China; Department of Microbiology, Shanghai Institutes of Preventive Medicine, Shanghai, PR China.
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Eriksson L, Stenmark B, Deghmane AE, Thulin Hedberg S, Säll O, Fredlund H, Mölling P, Taha MK. Difference in virulence between Neisseria meningitidis serogroups W and Y in transgenic mice. BMC Microbiol 2020; 20:92. [PMID: 32295520 PMCID: PMC7160935 DOI: 10.1186/s12866-020-01760-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/23/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Neisseria meningitidis serogroups W and Y are the most common serogroups causing invasive meningococcal disease in Sweden. The majority of cases are caused by the serogroup W UK 2013 strain of clonal complex (cc) 11, and subtype 1 of the serogroup Y, YI strain of cc23. In this study, virulence factors of several lineages within cc11 and cc23 were investigated in transgenic BALB/c mice expressing human transferrin. Transgenic mice were infected intraperitoneally with serogroup W and Y isolates. Levels of bacteria and the proinflammatory cytokine CXCL1 were determined in blood collected 3 h and 24 h post-infection. Apoptosis was investigated in immune cells from peritoneal washes of infected mice. Adhesion and induction of apoptosis in human epithelial cells were also scored. RESULTS The levels of bacteraemia, CXCL1, and apoptosis were higher in serogroup W infected mice than in serogroup Y infected mice. Serogroup W isolates also induced higher levels of apoptosis and adhesion in human epithelial cells. No significant differences were observed between different lineages within cc11 and cc23. CONCLUSIONS N. meningitidis Serogroup W displayed a higher virulence in vivo in transgenic mice, compared to serogroup Y. This was reflected by higher bacteremia, proinflammatory activity, and ability to induce apoptosis in mouse immune cells and human epithelial cells.
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Affiliation(s)
- Lorraine Eriksson
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
| | - Bianca Stenmark
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | | | - Sara Thulin Hedberg
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Olof Säll
- Department of Infectious Diseases, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Hans Fredlund
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Paula Mölling
- Department of Laboratory Medicine, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Tsang RS, Law DK, Tyler SD, Stephens GS, Bigham M, Zollinger WD. Potential capsule switching from serogroup Y to B: The characterization of three such Neisseria meningitidis isolates causing invasive meningococcal disease in Canada. Can J Infect Dis Med Microbiol 2005; 16:171-4. [PMID: 18159539 DOI: 10.1155/2005/216369] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2004] [Accepted: 01/10/2005] [Indexed: 11/17/2022]
Abstract
Three group B Neisseria meningitidis isolates, recovered from meningococcal disease cases in Canada and typed as B:2c:P1.5, were characterized. Multilocus sequence typing showed that all three isolates were related because of an identical sequence type (ST) 573. Isolates typed as 2c:P1.5 are common in serogroup Y meningococci but rare in isolates from serogroups B or C. Although no serogroup Y isolates have been typed as ST-573, eight isolates showed five to six housekeeping gene alleles that were identical to that of ST-573. This suggested that the B:2c:P1.5 isolates may have originated from serogroup Y organisms, possibly by capsule switching.
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