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Group A meningococcal disease in England associated with the Haj
1Regional Public Health Laboratory, Withington Hospital, Manchester, U.K.
Abstract:
An outbreak of group A meningococcal infection amongst the Muslim population in England followed the outbreak of meningococcal disease associated with the 1987 Haj to Mecca. There were 18 primary cases amongst pilgrims returning from Mecca and 15 subsequent cases among Muslims over the following 19 months. The meningococcal strains were shown to be of the same clone as strains from the Mecca outbreak by possession of an outer membrane protein PI.9. Strains of this group A clone (A III-I) had only rarely been encountered in England before this outbreak.
Insights
A group A meningococcal infection outbreak in England was linked to the 1987 Haj pilgrimage to Mecca. This outbreak involved pilgrims and subsequent cases, with strains matching those from the Mecca outbreak.
Area of Science:
- Epidemiology
- Microbiology
- Public Health
Background:
- The 1987 Haj pilgrimage to Mecca was associated with an outbreak of meningococcal disease.
- Group A meningococcal infections can cause significant public health concern, particularly in large gatherings.
Purpose of the Study:
- To investigate an outbreak of group A meningococcal infection in England.
- To determine the epidemiological link between the English outbreak and the 1987 Haj pilgrimage.
Main Methods:
- Case ascertainment of primary and secondary cases of meningococcal infection.
- Molecular typing of Neisseria meningitidis strains using outer membrane protein profiles.
- Comparison of strains from England with those from the Mecca outbreak.
Main Results:
- 18 primary cases were identified among pilgrims returning from Mecca.
- 15 subsequent cases occurred among the Muslim population in England over 19 months.
- Meningococcal strains from the English outbreak were identified as the same clone (A III-I) as those from the Mecca outbreak, characterized by outer membrane protein PI.9.
Conclusions:
- The 1987 Haj pilgrimage was the source of a group A meningococcal infection outbreak in England.
- The specific clone (A III-I) responsible for this outbreak was rarely seen in England prior.
- This highlights the risk of infectious disease transmission associated with international travel and religious gatherings.