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Cluster of meningococcal disease in rugby match spectators
H Orr1, E Kaczmarski, J Sarangi
1Communicable Disease Surveillance Centre (South West), Public Health Laboratory, Gloucester. horr@phls.nhs.uk
Abstract:
Four adults among three unconnected groups of spectators at a rugby match developed invasive meningococcal disease four to five days after the match. Two died. All four cases were caused by serogroup C serotype 2a strains, genotype P1.5, P1.2. Although the route of transmission remains uncertain, the most likely explanation is that an asymptomatic carrier disseminated meningococci to at least four others in the course of an afternoon. Clusters among spectators at an event without other links between cases are very unusual.
Insights
An unusual cluster of invasive meningococcal disease (IMD) occurred in spectators at a rugby match. The outbreak, caused by specific meningococci strains, suggests transmission from an asymptomatic carrier.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Invasive meningococcal disease (IMD) is a serious bacterial infection.
- Clusters of IMD are typically linked by close contact.
- Public gatherings can pose unique transmission risks.
Purpose of the Study:
- To investigate an unusual cluster of IMD cases.
- To identify the causative agent and potential transmission routes.
- To understand the epidemiology of meningococcal disease in a large event setting.
Main Methods:
- Case ascertainment among rugby match spectators.
- Microbiological analysis of isolates for serogroup and genotype.
- Epidemiological investigation to determine links between cases.
Main Results:
- Four adults from three separate groups developed IMD within days of a rugby match.
- Two fatalities were reported.
- All cases were linked to serogroup C, serotype 2a, genotype P1.5, P1.2 meningococci.
- An asymptomatic carrier disseminating the bacteria is the most probable transmission source.
Conclusions:
- This event highlights the potential for rapid dissemination of meningococci in large crowds.
- Asymptomatic carriers may play a significant role in outbreaks at public events.
- Such clusters among unconnected groups at a single event are rare and warrant further investigation.