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Long-term predominance of a rare meningococcal phenotype in a small geographical area

P Stefanelli1, C Fazio, A Neri

  • 1Laboratory of Bacteriology and Medical Mycology, Viale Regina Elena, 299, 00161 Rome, Italy.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|August 26, 2003
PubMed

Insights

A persistent Neisseria meningitidis clone caused increased meningococcal disease in Northern Italy. Risk factors varied by age, with younger children affected by environmental factors and older patients by influenza-like illness.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • A specific clone of Neisseria meningitidis (B:14:P1.13) was identified as a persistent cause of meningococcal disease in Northern Italy over a six-year period.
  • This clone was associated with a higher incidence of the disease in the region compared to the national average.

Purpose of the Study:

  • To investigate the genetic characteristics of the persistent Neisseria meningitidis clone.
  • To identify risk factors associated with meningococcal disease infection in different age groups.
  • To evaluate the effectiveness of implemented control measures.

Main Methods:

  • Genetic relatedness of isolates was determined using multilocus sequence typing, pulsed-field gel electrophoresis, and PorA variable region typing.
  • A case-control study involving 21 cases and 63 controls was conducted to assess risk factors.
  • Analysis included stratifying risk factors by age (children <13 years and older patients).

Main Results:

  • All examined strains belonged to the ST44 complex/lineage III.
  • For patients younger than 13 years, risk factors included rural residence, passive smoke exposure, and tourist accommodations (infinite odds ratios).
  • For older patients, previous influenza-like illness was a significant risk factor (odds ratio, 41.9).

Conclusions:

  • The study identified a persistent Neisseria meningitidis clone and its associated risk factors in Northern Italy.
  • Intervention strategies, including early treatment guidelines and public information campaigns, were successfully implemented.
  • These measures effectively reduced disease transmission and the case fatality rate in the affected region.

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