Emergence of epidemic Neisseria meningitidis serogroup C in Niger, 2015: an analysis of national surveillance data. Issue 11 (November 2016)

• Record Type: Journal Article
• Authors: Sidikou, Fati; Zaneidou, Maman; Alkassoum, Ibrahim; Schwartz, Stephanie; Issaka, Bassira; Obama, Ricardo; Lingani, Clement; Tate, Ashley; Ake, Flavien; Sakande, Souleymane; Ousmane, Sani; Zanguina, Jibir; Seidou, Issaka; Nzeyimana, Innocent; Mounkoro, Didier; Abodji, Oubote; Wang, Xin; Taha, Muhamed-Kheir; Moulia-Pelat, Jean Paul; Pana, Assimawe; Kadade, Goumbi; Ronveaux, Olivier; Novak, Ryan; Oukem-Boyer, Odile Ouwe Missi; Meyer, Sarah
• Is Part Of: Lancet infectious diseases. Volume 16:Issue 11(2016:Nov.)
• Page Start: 1288
• Page End: 1294
• Publication Date: 2016-11
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable Diseases -- Periodicals; Infection -- Periodicals; Maladies infectieuses -- Périodiques; Infection -- Périodiques; Communicable diseases; Infection; Periodicals; 616.905
• DOI: 10.1016/S1473-3099(16)30253-5
• Languages: English
• ISSNs: 1473-3099

Abstract

Summary: Background: To combat Neisseria meningitidis serogroup A epidemics in the meningitis belt of sub-Saharan Africa, a meningococcal serogroup A conjugate vaccine (MACV) has been progressively rolled out since 2010. We report the first meningitis epidemic in Niger since the nationwide introduction of MACV. Methods: We compiled and analysed nationwide case-based meningitis surveillance data in Niger. Cases were confirmed by culture or direct real-time PCR, or both, of cerebrospinal fluid specimens, and whole-genome sequencing was used to characterise isolates. Information on vaccination campaigns was collected by the Niger Ministry of Health and WHO. Findings: From Jan 1 to June 30, 2015, 9367 suspected meningitis cases and 549 deaths were reported in Niger. Among 4301 cerebrospinal fluid specimens tested, 1603 (37·3%) were positive for a bacterial pathogen, including 1147 (71·5%) that were positive for N meningitidis serogroup C (NmC). Whole-genome sequencing of 77 NmC isolates revealed the strain to be ST-10217. Although vaccination campaigns were limited in scope because of a global vaccine shortage, 1·4 million people were vaccinated from March to June, 2015. Interpretation: This epidemic represents the largest global NmC outbreak so far and shows the continued threat of N meningitidis in sub-Saharan Africa. The risk of further regional expansion of this novel clone highlights the need for continued strengthening of case-based surveillance. The availability of an affordable, multivalent conjugate vaccine may be important in future epidemic response. Funding: MenAfriNet consortium, a partnership between the US Centers for Disease Control and Prevention, WHO, and Agence de Médecine Preventive, through a grant from the Bill & Melinda Gates Foundation.