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Intercontinental spread of an epidemic group A Neisseria meningitidis strain

P S Moore1, M W Reeves, B Schwartz

  • 1Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Georgia 30333.

PubMed

Insights

A specific strain of Neisseria meningitidis (group A clonal complex III-1) caused recent epidemics across multiple continents. This virulent clone spread globally through religious pilgrimages, highlighting the role of clonal expansion in meningococcal disease outbreaks.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • Neisseria meningitidis is a significant cause of bacterial meningitis and sepsis.
  • Epidemics of meningococcal disease are often linked to specific bacterial clones.
  • Understanding the geographic spread and origins of virulent strains is crucial for disease control.

Purpose of the Study:

  • To identify the specific clonal complex of Neisseria meningitidis responsible for recent epidemics in Nepal, Saudi Arabia, and Chad.
  • To trace the origin and dissemination pathways of this epidemic clone.
  • To investigate the factors contributing to meningococcal disease epidemics.

Main Methods:

  • Electrophoretic enzyme typing was used to characterize Neisseria meningitidis isolates.
  • Epidemiological investigations were conducted to determine disease spread and potential sources.
  • Analysis of strain profiles and travel patterns of affected populations.

Main Results:

  • A single clonal complex, designated III-1, of group A Neisseria meningitidis was identified as the cause of recent epidemics in Nepal, Saudi Arabia, and Chad.
  • Evidence suggests this clone was introduced to the Middle East via the Hajj pilgrimage in 1987.
  • The clone was subsequently introduced into sub-Saharan Africa by returning pilgrims, potentially initiating current epidemics.

Conclusions:

  • Clonal virulence is a key factor in the emergence of Neisseria meningitidis epidemics.
  • The global dissemination of specific clones can be facilitated by human travel, such as religious pilgrimages.
  • While clonal factors are important, other elements are likely necessary for the full development of meningococcal disease epidemics.

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