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Meningococcal C Disease Outbreak Caused by Multidrug-Resistant Neisseria meningitidis, Fiji
Abstract:
We describe an outbreak of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup C in Fiji. We created surveillance case definitions and collected data by using standard investigation forms. Bacterial identification, antimicrobial susceptibility testing, and PCR were performed in Fiji. Molecular testing was conducted at the Microbiological Diagnostic Unit in Melbourne, Victoria, Australia. During January 2016-December 2018, a total of 96 confirmed or probable IMD cases were reported. Of case-patients, 61.5% (59/96) were male and 38.5% (37) female, 84.4% (81) were indigenous people of Fiji, and 70.8% (68) were children <15 years of age. Annual incidence increased from 1.8/100,000 population in 2016 to 5.2/100,000 population in 2018. Serogroup C multilocus serotype 4821 that is resistant to ciprofloxacin was prevalent (62.1%, 41/66). Public health measures, which included targeted mass vaccination with monovalent meningitis C vaccine, were effective in controlling the outbreak. We observed a rapid decline in meningitis C cases in subsequent years.
Insights
An invasive meningococcal disease (IMD) outbreak in Fiji caused by serogroup C Neisseria meningitidis was controlled by targeted mass vaccination. This public health intervention led to a significant reduction in meningitis C cases.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- An outbreak of invasive meningococcal disease (IMD) occurred in Fiji between January 2016 and December 2018.
- The causative agent was identified as Neisseria meningitidis serogroup C.
- The outbreak disproportionately affected indigenous Fijian children under 15 years of age.
Purpose of the Study:
- To describe the epidemiology of the invasive meningococcal disease (IMD) outbreak in Fiji.
- To identify the characteristics of the Neisseria meningitidis serogroup C strains involved.
- To evaluate the effectiveness of public health interventions, including vaccination.
Main Methods:
- Established surveillance case definitions and utilized standard investigation forms for data collection.
- Conducted bacterial identification, antimicrobial susceptibility testing, and PCR in Fiji.
- Performed molecular testing at the Microbiological Diagnostic Unit in Melbourne, Australia.
Main Results:
- A total of 96 confirmed or probable IMD cases were reported during the study period.
- Annual incidence of IMD increased from 1.8 to 5.2 per 100,000 population between 2016 and 2018.
- A prevalent strain, serogroup C multilocus serotype 4821, exhibited resistance to ciprofloxacin (62.1%).
Conclusions:
- Targeted mass vaccination with a monovalent meningitis C vaccine was effective in controlling the outbreak.
- A rapid decline in meningitis C cases was observed following the implementation of public health measures.
- The study highlights the importance of surveillance and vaccination in managing meningococcal disease outbreaks.
