The Establishment and Diversification of Epidemic-Associated Serogroup W Meningococcus in the African Meningitis Belt, 1994 to 2012

摘要: ABSTRACT Epidemics of invasive meningococcal disease (IMD) caused by serogroup A have been eliminated from the sub-Saharan African so-called “meningitis belt” conjugate vaccine (MACV), and yet, other serogroups continue to cause epidemics. Neisseria meningitidis W remains a major in region, with most isolates belonging clonal complex 11 (CC11). Here, genetic variation within between epidemic-associated strains was assessed sequencing genomes 92 N. collected 1994 2012 both sporadic epidemic IMD cases, 85 being selected meningitis belt countries. The sequenced belonged either CC175 (n = 9) or CC11 83). single lineage comprising four phylogenetic subclades. Separate subclades were associated 2002 Burkina Faso subclade included found Mali during 2011 2012, which descended strain very similar Hajj (Islamic pilgrimage Mecca)-related Saudi Arabian outbreak 2000. phylogeny reflected their geographic origin Faso, Malian border region closely related Mali. Evidence ongoing evolution, international transmission, replacement stresses importance maintaining surveillance Africa following MACV implementation. IMPORTANCE Meningococcal (meningitis bloodstream infections) threatens millions people across Africa. introduced 2010 protects against Africa’s then-most common disease, A. However, epidemics region—including W. rapid identification that prior outbreaks can improve assessment risk enable timely preparation public health responses, including vaccination. Phylogenetic analysis newly isolated identified two groups linked large one an We find applying whole-genome collections improves discrimination among strains, even nation-wide epidemic, be used better understand pathogen spread.