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Meningitis outbreak caused by novel strain
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An outbreak of meningococcal disease at a university was linked to a novel serogroup B strain, with close social interaction as a significant risk factor, researchers reported in Clinical Infectious Diseases.
“All serogroups causing meningococcal disease are of concern because of the risk of death and disability, including long-term effects in those who survive the illness,” Sema Mandal, MBBS, MSc, formerly of the CDC’s Meningitis and Vaccine Preventable Diseases Branch, told Infectious Disease News. “However, with serogroup B, the lack of a vaccine limits the public health actions we can take to prevent more cases in the community. The strain seen in this outbreak was of particular interest as it had not been seen in the United States before. However, it is relatively common in Europe."
Sema Mandal
Mandal and colleagues investigated a meningitis outbreak that occurred at a university in Ohio. From January 2008 to November 2010, 13 cases of meningococcal disease were reported among 10 students of the university and three university-linked persons. Seven cases were confirmed, four were probable and two were suspected. One of the confirmed cases died.
Ten of the cases had cerebrospinal fluid samples available, and all of the specimens were serogroup B. Isolates were available for six of the confirmed cases, all of which belonged to sequence type 269, clonal complex 269. In a matched case control study that included seven of the cases and 35 student controls, the researchers found that Greek society membership, having more than one kissing partner and attending bars were significantly associated with disease.
Mandal said that there has been another recent cluster of serogroup B meningococcal disease on a college campus.
“CDC and public health partners in the United States and globally have long recognized the need for a safe and effective vaccine that protects against serogroup B,” Mandal said. “Unfortunately, the targets used in vaccines against other serogroups don’t work in a serogroup B vaccine, so new vaccine technologies are being used to develop a vaccine protective against serogroup B. The challenge is ensuring that the vaccine covers all of the strains of serogroup B that are circulating in the United States.”
Mandal said that although there is no licensed vaccine that protects against serotype B, college students can be protected against the other four serotypes — A, C, Y and W — that are responsible for the majority of meningococcal disease in the United States.
“It is important to ensure that college-aged kids receive the meningococcal conjugate vaccine before entering college so they are protected when their risk is highest,” Mandal said. “Physicians should also educate college kids on the signs and symptoms of meningococcal disease, as early diagnosis and appropriate treatment are key to recovery.”
Disclosure: Mandal reports no relevant financial disclosures.
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