1887
Research article Open Access
Like 0

Abstract

The 23rd World Scout Jamboree in 2015 took place in Japan and included over 33,000 scouts from 162 countries. Within nine days of the meeting ending, six cases of laboratory-confirmed invasive serogroup W meningococcal disease occurred among scouts and their close contacts in Scotland and Sweden. The isolates responsible were identical to one-another by routine typing and, where known (4 isolates), belonged to the ST-11 clonal complex (cc11) which is associated with large outbreaks and high case fatality rates. Recent studies have demonstrated the need for high-resolution genomic typing schemes to assign serogroup W cc11 isolates to several distinct strains circulating globally over the past two decades. Here we used such schemes to confirm that the Jamboree-associated cases constituted a genuine outbreak and that this was due to a novel and rapidly expanding strain descended from the strain that has recently expanded in South America and the United Kingdom. We also identify the genetic differences that define the novel strain including four point mutations and three putative recombination events involving the horizontal exchange of 17, six and two genes, respectively. Noteworthy outcomes of these changes were antigenic shifts and the disruption of a transcriptional regulator.

Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2016.21.45.30395
2016-11-10
2017-12-13
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2016.21.45.30395
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/21/45/eurosurv-21-30395-3.html?itemId=/content/10.2807/1560-7917.ES.2016.21.45.30395&mimeType=html&fmt=ahah

References

  1. Halperin SA, Bettinger JA, Greenwood B, Harrison LH, Jelfs J, Ladhani SN, et al. The changing and dynamic epidemiology of meningococcal disease. Vaccine. 2012;30(Suppl 2):B26-36.  https://doi.org/10.1016/j.vaccine.2011.12.032  PMID: 22178525 
  2. Taha MK, Achtman M, Alonso JM, Greenwood B, Ramsay M, Fox A, et al. Serogroup W135 meningococcal disease in Hajj pilgrims. Lancet. 2000;356(9248):2159.  https://doi.org/10.1016/S0140-6736(00)03502-9  PMID: 11191548 
  3. Smith-Palmer A, Oats K, Webster D, Taylor S, Scott K, Smith G, et al. Outbreak of Neisseria meningitidis capsular group W among Scouts returning from the World Scout Jamboree, Japan, 2015. Euro Surveill. 2016;21(45):22636.
  4. Health Protection Agency (HPA). Guidance for public health management of meningococcal disease in the UK. London: HPA. 2012. Available from: https://www.gov.uk/government/publications/meningococcal-disease-guidance-on-public-health-management
  5. Campbell H, Parikh SR, Borrow R, Kaczmarski E, Ramsay ME, Ladhani SN. Presentation with gastrointestinal symptoms and high case fatality associated with group W meningococcal disease (MenW) in teenagers, England, July 2015 to January 2016. Euro Surveill. 2016;21(12):30175.  https://doi.org/10.2807/1560-7917.ES.2016.21.12.30175  PMID: 27035055 
  6. Brundage JF, Zollinger WD. Evolution of meningococcal disease epidemiology in the US army. In: Vedros NA, editor. Evolution of meningococcal disease. Boca Raton: CRC Press; 1987.
  7. Clusters of meningococcal disease in university students. Commun Dis Rep CDR. Wkly. 1997 Oct 31;7(44):393, 396.
  8. Kupferschmidt K. Infectious diseases. Bacterial meningitis finds new niche in gay communities. Science. 2013;341(6144):328.  https://doi.org/10.1126/science.341.6144.328  PMID: 23888010 
  9. Mustapha MM, Marsh JW, Harrison LH. Global epidemiology of capsular group W meningococcal disease (1970-2015): Multifocal emergence and persistence of hypervirulent sequence type (ST)-11 clonal complex. Vaccine. 2016;34(13):1515-23.  https://doi.org/10.1016/j.vaccine.2016.02.014  PMID: 26876439 
  10. von Gottberg A, du Plessis M, Cohen C, Prentice E, Schrag S, de Gouveia L, et al. Group for Enteric, Respiratory and Meningeal Disease Surveillance in South Africa. Emergence of endemic serogroup W135 meningococcal disease associated with a high mortality rate in South Africa. Clin Infect Dis. 2008;46(3):377-86.  https://doi.org/10.1086/525260  PMID: 18181736 
  11. Abad R, López EL, Debbag R, Vázquez JA. Serogroup W meningococcal disease: global spread and current affect on the Southern Cone in Latin America. Epidemiol Infect. 2014;142(12):2461-70.  https://doi.org/10.1017/S0950268814001149  PMID: 24831052 
  12. Ladhani SN, Beebeejaun K, Lucidarme J, Campbell H, Gray S, Kaczmarski E, et al. Increase in endemic Neisseria meningitidis capsular group W sequence type 11 complex associated with severe invasive disease in England and Wales. Clin Infect Dis. 2015;60(4):578-85.  https://doi.org/10.1093/cid/ciu881  PMID: 25389259 
  13. Lucidarme J, Hill DM, Bratcher HB, Gray SJ, du Plessis M, Tsang RS, et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage. J Infect. 2015;71(5):544-52.  https://doi.org/10.1016/j.jinf.2015.07.007  PMID: 26226598 
  14. Mayer LW, Reeves MW, Al-Hamdan N, Sacchi CT, Taha MK, Ajello GW, et al. Outbreak of W135 meningococcal disease in 2000: not emergence of a new W135 strain but clonal expansion within the electophoretic type-37 complex. J Infect Dis. 2002;185(11):1596-605.  https://doi.org/10.1086/340414  PMID: 12023765 
  15. PubMLST Neisseria Sequence Typing Home Page. Oxford: PubMLST. [Accessed 21 January 2016]. Available from: http://pubmlst.org/neisseria
  16. Bratcher HB, Corton C, Jolley KA, Parkhill J, Maiden MC. A gene-by-gene population genomics platform: de novo assembly, annotation and genealogical analysis of 108 representative Neisseria meningitidis genomes. BMC Genomics. 2014;15(1):1138.  https://doi.org/10.1186/1471-2164-15-1138  PMID: 25523208 
  17. Huson DH. SplitsTree: analyzing and visualizing evolutionary data. Bioinformatics. 1998;14(1):68-73.  https://doi.org/10.1093/bioinformatics/14.1.68  PMID: 9520503 
  18. Health Protection Scotland (HPS). Respiratory bacteria quarterly report. Quarter four: 1 October to 31 December 2015. HPS Weekly Report. 2016 Mar 22;50(2016/12):87-90. Available from: http://www.hps.scot.nhs.uk/documents/ewr/pdf2016/1612.pdf
  19. Puleston R, Beck C, Tahir M, Bardhan M, Charlemagne P, Alves C, et al. An unusual transmission event of Neisseria meningitidis serogroup W135 type 2a in a healthcare setting, England, 2012. Euro Surveill. 2012;17(44):20308. PMID: 23137486 
  20. Harrison LH, Jolley KA, Shutt KA, Marsh JW, O’Leary M, Sanza LT, et al. Maryland Emerging Infections Program. Antigenic shift and increased incidence of meningococcal disease. J Infect Dis. 2006;193(9):1266-74.  https://doi.org/10.1086/501371  PMID: 16586364 
  21. Tsang RS, Law DK, Henderson AM, Blake ML, Stoltz J. Increase in serogroup C meningococcal disease in Canada is associated with antigenic changes in the protein antigens of the ET-15 clone of Neisseria meningitidis. J Infect Dis. 2006;194(12):1791-2, author reply 1792-3.  https://doi.org/10.1086/509515  PMID: 17109354 
  22. Mustapha MM, Marsh JW, Krauland MG, Fernandez JO, de Lemos AP, Dunning Hotopp JC, et al. Genomic Epidemiology of Hypervirulent Serogroup W, ST-11 Neisseria meningitidis. EBioMedicine. 2015;2(10):1447-55.  https://doi.org/10.1016/j.ebiom.2015.09.007  PMID: 26629539 
  23. Tauseef I, Harrison OB, Wooldridge KG, Feavers IM, Neal KR, Gray SJ, et al. Influence of the combination and phase variation status of the haemoglobin receptors HmbR and HpuAB on meningococcal virulence. Microbiology. 2011;157(Pt 5):1446-56.  https://doi.org/10.1099/mic.0.046946-0  PMID: 21310784 
  24. Berry JL, Pelicic V. Exceptionally widespread nanomachines composed of type IV pilins: the prokaryotic Swiss Army knives. FEMS Microbiol Rev. 2015;39(1):134-54.  https://doi.org/10.1093/femsre/fuu001  PMID: 25793961 
  25. Folster JP, Johnson PJ, Jackson L, Dhulipali V, Dyer DW, Shafer WM. MtrR modulates rpoH expression and levels of antimicrobial resistance in Neisseria gonorrhoeae. J Bacteriol. 2009;191(1):287-97.  https://doi.org/10.1128/JB.01165-08  PMID: 18978065 
  26. Cloward JM, Shafer WM. MtrR control of a transcriptional regulatory pathway in Neisseria meningitidis that influences expression of a gene (nadA) encoding a vaccine candidate. PLoS One. 2013;8(2):e56097.  https://doi.org/10.1371/journal.pone.0056097  PMID: 23409129 
  27. Nägele V, Heesemann J, Schielke S, Jiménez-Soto LF, Kurzai O, Ackermann N. Neisseria meningitidis adhesin NadA targets beta1 integrins: functional similarity to Yersinia invasin. J Biol Chem. 2011;286(23):20536-46.  https://doi.org/10.1074/jbc.M110.188326  PMID: 21471204 
  28. Ladhani SN, Giuliani MM, Biolchi A, Pizza M, Beebeejaun K, Lucidarme J, et al. Effectiveness of Meningococcal B Vaccine against Endemic Hypervirulent Neisseria meningitidis W Strain, England. Emerg Infect Dis. 2016;22(2):309-11.  https://doi.org/10.3201/eid2202.150369  PMID: 26811872 
  29. Brouwer MC, Spanjaard L, Prins JM, van der Ley P, van de Beek D, van der Ende A. Association of chronic meningococcemia with infection by meningococci with underacylated lipopolysaccharide. J Infect. 2011;62(6):479-83.  https://doi.org/10.1016/j.jinf.2011.03.010  PMID: 21459106 
  30. Gray SJ, Trotter CL, Ramsay ME, Guiver M, Fox AJ, Borrow R, et al. Meningococcal Reference Unit. Epidemiology of meningococcal disease in England and Wales 1993/94 to 2003/04: contribution and experiences of the Meningococcal Reference Unit. J Med Microbiol. 2006;55(Pt 7):887-96.  https://doi.org/10.1099/jmm.0.46288-0  PMID: 16772416 
  31. Wörmann ME, Horien CL, Bennett JS, Jolley KA, Maiden MC, Tang CM, et al. Sequence, distribution and chromosomal context of class I and class II pilin genes of Neisseria meningitidis identified in whole genome sequences. BMC Genomics. 2014;15(1):253.  https://doi.org/10.1186/1471-2164-15-253  PMID: 24690385 
  32. Read RC, Baxter D, Chadwick DR, Faust SN, Finn A, Gordon SB, et al. Effect of a quadrivalent meningococcal ACWY glycoconjugate or a serogroup B meningococcal vaccine on meningococcal carriage: an observer-blind, phase 3 randomised clinical trial. Lancet. 2014;384(9960):2123-31.  https://doi.org/10.1016/S0140-6736(14)60842-4  PMID: 25145775 
  33. MacLennan J, Maiden MCUK. _Meningococcocal_carriage_Group. UKMENCAR4: A meningococcal carriage study in 21,000 teenagers to understand changing meningococcal epidemiology and evaluate national vaccination policy. 13th EMGM. Amsterdam, The Netherlands; 2015.
  34. Campbell H, Saliba V, Borrow R, Ramsay M, Ladhani SN. Targeted vaccination of teenagers following continued rapid endemic expansion of a single meningococcal group W clone (sequence type 11 clonal complex), United Kingdom 2015. Euro Surveill. 2015;20(28):21188.  https://doi.org/10.2807/1560-7917.ES2015.20.28.21188  PMID: 26212140 
/content/10.2807/1560-7917.ES.2016.21.45.30395
Loading

Data & Media loading...

Comment has been disabled for this content
Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error