Three Outbreak-causing Neisseria meningitidis Serogroup C Clones, Brazil¹

David E. Barroso

, Terezinha M.P.P. Castiñeiras, Fernanda S. Freitas, Jane W. Marsh, Mary G. Krauland, Mary M. Tulenko, Érica L. Fonseca, Ana C.P. Vicente, Maria C. Rebelo, Elaine O. Cerqueira, Adriano C. Xavier, Ana P.C.M. Cardozo, Simone E.M. da Silva, and Lee H. Harrison

Author affiliations: Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil (D.E. Barroso, F.S. Freitas, É.L. da Fonseca, A.C.P. Vicente); Federal University School of Medicine, Rio de Janeiro (T.M.P.P. Castiñeiras); University of Pittsburgh, Pittsburgh, Pennsylvania, USA (J.W. Marsh, M.G. Krauland, M.M. Tulenko, L.H. Harrison); State Department of Health, Rio de Janeiro (M.C. Rebelo, E.O. Cerqueira); Cientificalab Laboratory Products and Systems, Rio de Janeiro (A.C. Xavier, A.P.C.M. Cardozo, S.E.M. da Silva).

Abstract

During 2003–2012, 8 clusters of meningococcal disease were identified in Rio de Janeiro State, Brazil, all caused by serogroup C Neisseria meningitidis. The isolates were assigned to 3 clonal complexes (cc): cc11, cc32, and cc103. These hyperinvasive disease lineages were associated with endemic disease, outbreaks, and high case-fatality rates.

The last epidemic of Neisseria meningitidis serogroup C meningococcal disease in Rio de Janeiro State, Brazil, occurred in 1994. It was caused by C:2b:P1.10 isolates that belonged to cluster A4 (1). Although the number of cases of serogroup C disease subsequently declined after a vaccination campaign, rates of serogroup C disease again began to increase in 2000. During 2003–2012, public health surveillance identified 8 clusters of serogroup C meningococcal disease in Rio de Janeiro State. We report the investigation of these meningococcal disease clusters and typing information of the causative agent.

The Study

Public health surveillance of meningococcal disease in Rio de Janeiro State is conducted by the Meningitis Advisory Committee of the State Department of Health, which uses data obtained from 2 surveillance sources: mandatory reports of meningococcal disease cases and reports of laboratory-confirmed N. meningitidis isolates collected by the Central Laboratory Noel Nutels and the Infectious Diseases State Institute São Sebastião, which are state reference laboratories, and 1 outsourced laboratory for bacterial meningitis (Cientificalab Laboratory Products and Systems, Rio de Janeiro, Brazil). Chemoprophylaxis with rifampin is currently recommended for close contacts of persons with confirmed or suspected cases of meningococcal disease.