Abstract
In 2015, a suspected cluster of two invasive meningococcal disease (IMD) cases of serogroup W Neisseria meningitidis (MenW) occurred in elderly care home residents in England over 7 months; case investigations followed United Kingdom guidance. An incident control team reviewed epidemiological information. Phenotyping of case specimens informed public health action, including vaccination and throat swabs to assess carriage. Whole genome sequencing (WGS) was conducted on case and carrier isolates. Conventional phenotyping did not exclude a microbiological link between cases (case 1 W:2a:P1.5,2 and case 2 W:2a:NT). After the second case, 33/40 residents and 13/32 staff were vaccinated and 19/40 residents and 13/32 staff submitted throat swabs. Two MenW carriers and two MenC carriers were detected. WGS showed that MenW case and carrier isolates were closely related and possibly constituted a locally circulating strain. Meningococcal carriage, transmission dynamics and influence of care settings on IMD in older adults are poorly understood. WGS analyses performed following public health action helped to confirm the close relatedness of the case and circulating isolates despite phenotypic differences and supported actions taken. WGS was not sufficiently timely to guide public health practice.
| Original language | English |
|---|---|
| Article number | 1900070 |
| Journal | Eurosurveillance |
| Volume | 24 |
| Issue number | 23 |
| DOIs | |
| Publication status | Published - 2019 |
Bibliographical note
Funding Information:This publication made use of the Neisseria Multi Locus Sequence Typing website (https://pubmlst.org/neisseria/) sited at the University of Oxford. The development of this site has been funded by the Wellcome Trust and the European Union. It also made use of the Meningitis Research Foundation Meningococcus Genome Library (http://www. meningitis.org/research/genome) developed by Public Health England, the Wellcome Trust Sanger Institute and the University of Oxford as a collaboration. The project is funded by Meningitis Research Foundation.
Funding Information:
Ray Borrow reports grants for contract research on behalf of Public Health England (formerly the Health Protection Agency) for GlaxoSmithKline, Novartis Vaccines, Pfizer, and Sanofi Pasteur MSD, outside the submitted work. Jay Lucidarme has performed contract research on behalf of Public Health England for GlaxoSmithKline, Pfizer, and Sanofi Pasteur, outside the submitted work.
Publisher Copyright:
© 2019, European Centre for Disease Prevention and Control (ECDC). All right reserved.
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
