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Meningococcus serogroup C clonal complex ST-10217 outbreak in Zamfara State, Northern Nigeria

Brenda A Kwambana-Adams1, Rahab C Amaza2, Catherine Okoi1

  • 1World Health Organization, Collaborating Centre for New Vaccines Surveillance, Medical Research Council Unit The Gambia at London School of Hygiene & Tropical Medicine, Atlantic Boulevard, Fajara, PO Box 273, Banjul, The Gambia.

Scientific Reports
|September 23, 2018
PubMed

Insights

Nigeria faced a major meningococcus serogroup C (NmC) meningitis outbreak in Zamfara State, impacting children most severely. This resurgence threatens public health gains and requires urgent strategic action against meningitis.

Area of Science:

  • Epidemiology
  • Microbiology
  • Public Health

Background:

  • Nigeria experienced sequential meningitis outbreaks attributed to meningococcus serogroup C (NmC) following the MenAfriVac rollout.
  • Zamfara State was the epicenter of the largest NmC outbreak in the 21st century (2016-2017), with 7,140 cases and 553 deaths.

Purpose of the Study:

  • To analyze the epidemiology and microbiology of the recent NmC meningitis outbreak in Zamfara State, Nigeria.
  • To assess the public health implications of the NmC ST-10217 clonal complex emergence.

Main Methods:

  • Retrospective analysis of suspected meningitis cases and deaths in Zamfara State.
  • Laboratory confirmation and serotyping of Neisseria meningitidis and Streptococcus pneumoniae isolates.
  • Molecular characterization of NmC isolates, including sequencing and clonal complex identification.

Main Results:

  • The outbreak had an overall attack rate of 155 per 100,000 population, with children aged 5-14 years comprising 47% of cases.
  • The case fatality rate (CFR) was higher in children aged 5-9 years (10%) compared to adults aged ≥30 years (5%).
  • Meningococcus serogroup C (NmC) accounted for 94% of laboratory-confirmed cases, belonging to the ST-10217 clonal complex (CC).

Conclusions:

  • The emergence of NmC ST-10217 CC outbreaks poses a significant threat to public health gains achieved by MenAfriVac.
  • Urgent strategic interventions are necessary to combat the rising threat of meningitis outbreaks in Nigeria.

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