Outbreak of Neisseria meningitidis serogroup C outside the meningitis belt-Liberia, 2017: an epidemiological and laboratory investigation

被引：20

作者：

Bozio, Catherine H. ^{[1
]}

Vuong, Jeni ^{[1
]}

Dokubo, E. Kainne ^{[3
]}

Fallah, Mosoka P. ^{[4
]}

McNamara, Lucy A. ^{[1
]}

Potts, Caelin C. ^{[1
]}

Doedeh, John ^{[5
]}

Gbanya, Miatta ^{[5
]}

Retchless, Adam C. ^{[1
]}

Patel, Jaymin C. ^{[1
]}

Clark, Thomas A. ^{[2
]}

Kohar, Henry ^{[4
]}

Nagbe, Thomas ^{[4
]}

Clement, Peter ^{[6
]}

Katawera, Victoria ^{[6
]}

Mahmoud, Nuha ^{[6
]}

Djingarey, Harouna M. ^{[7
]}

Perrocheau, Anne ^{[8
]}

Naidoo, Dhamari ^{[8
]}

Stone, Mardia ^{[6
]}

George, Roseline N. ^{[4
]}

Williams, Desmond ^{[3
]}

Gasasira, Alex ^{[6
]}

Nyenswah, Tolbert ^{[4
]}

Wang, Xin ^{[1
]}

Fox, LeAnne M. ^{[1
]}

机构：

[1] US Ctr Dis Control & Prevent, Div Bacterial Dis, Natl Ctr Immunizat & Resp Dis, Atlanta, GA USA

[2] US Ctr Dis Control & Prevent, Div Reprod Hlth, Natl Ctr Chron Dis Prevent & Hlth Promot, Atlanta, GA USA

[3] US Ctr Dis Control & Prevent, Div Global Hlth Protect, Ctr Global Hlth, Monrovia, Liberia

[4] Natl Publ Hlth Inst Liberia, Monrovia, Liberia

[5] Liberia Minist Hlth, Monrovia, Liberia

[6] World Hlth Org Liberia, Monrovia, Liberia

[7] WHO, AFRO, Brazzaville, Rep Congo

[8] WHO, Geneva, Switzerland

来源：

LANCET INFECTIOUS DISEASES | 2018年 / 18卷 / 12期

关键词：

MENINGOCOCCAL DISEASE; UNITED-STATES; URINE; NIGER;

D O I：

10.1016/S1473-3099(18)30476-6

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Background On April 25, 2017, a cluster of unexplained illnesses and deaths associated with a funeral was reported in Sinoe County, Liberia. Molecular testing identified Neisseria meningitidis serogroup C (NmC) in specimens from patients. We describe the epidemiological investigation of this cluster and metagenomic characterisation of the outbreak strain. Methods We collected epidemiological data from the field investigation and medical records review. Confirmed, probable, and suspected cases were defined on the basis of molecular testing and signs or symptoms of meningococcal disease. Metagenomic sequences from patient specimens were compared with 141 meningococcal isolate genomes to determine strain lineage. Findings 28 meningococcal disease cases were identified, with dates of symptom onset from April 21 to April 30, 2017: 13 confirmed, three probable, and 12 suspected. 13 patients died. Six (21%) patients reported fever and 23 (82%) reported gastrointestinal symptoms. The attack rate for confirmed and probable cases among funeral attendees was 10%. Metagenomic sequences from six patient specimens were similar to a sequence type (ST) 10217 (clonal complex [CC] 10217) isolate genome from Niger, 2015. Multilocus sequencing identified five of seven alleles from one specimen that matched ST-9367, which is represented in the PubMLST database by one carriage isolate from Burkina Faso, in 2011, and belongs to CC10217. Interpretation This outbreak featured high attack and case fatality rates. Clinical presentation was broadly consistent with previous meningococcal disease outbreaks, but predominance of gastrointestinal symptoms was unusual compared with previous African meningitis epidemics. The outbreak strain was genetically similar to NmC CC10217, which caused meningococcal disease outbreaks in Niger and Nigeria. CC10217 had previously been identified only in the African meningitis belt. Copyright (c) 2018 World Health Organization. Published by Elsevier Ltd. All rights reserved.

引用

页码：1360 / 1367

页数：8

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