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. 2022 Jun;27(24):2100919.
doi: 10.2807/1560-7917.ES.2022.27.24.2100919.

Reactive vaccination as control strategy for an outbreak of invasive meningococcal disease caused by Neisseria meningitidis C:P1.5-1,10-8:F3-6:ST-11(cc11), Bergamo province, Italy, December 2019 to January 2020

Cecilia Fazio  1 , Laura Daprai  2 , Arianna Neri  1 , Marcello Tirani  3   4 , Paola Vacca  1 , Milena Arghittu  5   6 , Luigina Ambrosio  1 , Danilo Cereda  3 , Maria Gramegna  3 , Annapina Palmieri  7 , Anna Carannante  1 , Maria Rosa Bertoli  8 , Lucia Crottogini  3 , Giorgio Gennati  8 , Eugenia Quinz  8 , Livia Trezzi  8 , Andrea Ciammaruconi  9 , Silvia Fillo  9 , Antonella Fortunato  9 , Giovanni Rezza  10 , Florigio Lista  9 , Paola Stefanelli  1
Affiliations

Reactive vaccination as control strategy for an outbreak of invasive meningococcal disease caused by Neisseria meningitidis C:P1.5-1,10-8:F3-6:ST-11(cc11), Bergamo province, Italy, December 2019 to January 2020

Cecilia Fazio et al. Euro Surveill. 2022 Jun.

Abstract

In Italy, serogroup C meningococci of the clonal complex cc11 (MenC/cc11) have caused several outbreaks of invasive meningococcal disease (IMD) during the past 20 years. Between December 2019 and January 2020, an outbreak of six cases of IMD infected with MenC/cc11 was identified in a limited area in the northern part of Italy. All cases presented a severe clinical picture, and two of them were fatal. This report is focused on the microbiological and molecular analysis of meningococcal isolates with the aim to reconstruct the chain of transmission. It further presents the vaccination strategy adopted to control the outbreak. The phylogenetic evaluation demonstrated the close genetic proximity between the strain involved in this outbreak and a strain responsible for a larger epidemic that had occurred in 2015 and 2016 in the Tuscany Region. The rapid identification and characterisation of IMD cases and an extensive vaccination campaign contributed to the successful control of this outbreak caused by a hyperinvasive meningococcal strain.

Keywords: Italy; Neisseria meningitidis; clonal complex 11; invasive meningocococcal disease; outbreak; serogroup C meningococcal vaccination.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

Figure 1
Figure 1
Geolocalisation of invasive meningococcal disease cases involved in the outbreak, Bergamo province, Italy, December 2019–January 2020 (n = 6)
Figure 2
Figure 2
NeighbourNet phylogenetic network based on a comparison of 1,597 core genome loci (cgMLST) of meningococcal genomes C:P1.5–1,10–8:F3–6:ST-11(cc11) (n = 33) and B:P1.5–1,10–8:F3–6:ST-11(cc11) (n = 5) obtained from invasive meningococcal disease cases, Italy, 2012–2020
See this image and copyright information in PMC

References

    1. Peterson ME, Li Y, Bita A, Moureau A, Nair H, Kyaw MH, et al. Meningococcal serogroups and surveillance: a systematic review and survey. J Glob Health. 2019;9(1):010409. 10.7189/jogh.09.010409 - DOI - PMC - PubMed
    1. 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. 10.1016/j.jinf.2015.07.007 - DOI - PMC - PubMed
    1. Waśko I, Hryniewicz W, Skoczyńska A. Significance of meningococcal hyperinvasive clonal complexes and their influence on vaccines development. Pol J Microbiol. 2015;64(4):313-21. 10.5604/17331331.1185912 - DOI - PubMed
    1. Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM. Meningococcal disease. N Engl J Med. 2001;344(18):1378-88. 10.1056/NEJM200105033441807 - DOI - PubMed
    1. Ezeoke I, Galac MR, Lin Y, Liem AT, Roth PA, Kilianski A, et al. Tracking a serial killer: Integrating phylogenetic relationships, epidemiology, and geography for two invasive meningococcal disease outbreaks. PLoS One. 2018;13(11):e0202615. 10.1371/journal.pone.0202615 - DOI - PMC - PubMed

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