Two cases of epidemic situation of serogroup B meningitis in infants in Shandong Province in 2021 were investigated. Samples of cases and their close contacts were collected for isolation, culture and identification of Neisseria meningitides (Nm). The isolates were subjected to multi-locus sequence typing, outer membrane protein porA and fetA genotyping and drug sensitivity test. Two laboratory-confirmed outbreaks of serogroup B meningitis were reported from Yantai city and Linyi city. The indicated cases were infants aged 5 months and 2 months old respectively. They were not vaccinated with meningitis vaccine. Their epidemiological characteristics and clinical manifestations were similar and the prognosis was good. The same sequence type (ST) of serogroup B Nm strains as the indicated cases was detected in the samples of close family contacts, but without subsequent cases. Among them, Yantai strain was were identified as the type ST-8920, belonging to CC4821 clonal complex, and the genotypes of porA and fetA were p1.21-2, 23 and F3-1. Linyi strain was a new type, belonging to CC4821 clonal complex and the genotypes of porA and fetA were p1.20, 23 and F1-91. The above strains were resistant to penicillin, ciprofloxacin, levofloxacin and Chemitrim, and their sensitivity to cephalosporin decreased. Two cases of infant serogroup B epidemic were relatively rare in China, which were different from the epidemiological and pathogenic characteristics of other Nm serogroups in the past.
Epidemics ; Humans ; Infant ; Meningitis, Meningococcal/epidemiology* ; Multilocus Sequence Typing ; Neisseria meningitidis ; Serogroup

Adult ; China ; epidemiology ; Humans ; Male ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Neisseria meningitidis, Serogroup W-135 ; genetics ; isolation & purification

OBJECTIVETo characterize the meningococcal strains isolated from cases and close contacts with meningococcal disease associated with an outbreak in a jail in May 2010 by investigating the national distribution of hyperinvasive ST-4821 serogroup C clone associated with this outbreak.

METHODSThe cases were described based on the clinical symptoms and laboratory results. Pharyngeal swabs were cultured for N. meningitidis from men in the jail. Meningococcal isolates were identified by serogrouping, pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST), respectively. Four hundred and sixteen serogroup C N. meningitidis strains were collected from 27 provinces between 2003 and 2010 for a nationwide survey and analyzed by PFGE and MLST.

RESULTSThree persons in a jail system were infected with invasive N. meningitidis serogroup C. All isolates tested had matching PFGE patterns and belonged to the multilocus sequence type (ST) 4821 clonal complex. All 47 N. meningitidis strains were identified from the pharyngeal swabs of 166 peoples in the jail, and 26 of them belonged to ST-4821 serogroup C clone, and 90.14% (375/416) serogroup C strains identified in the nationwide survey belonged to the ST-4821 complex. The ST-4821 serogroup C clone was spread nationwide, distributed in 24 provinces, especially in eastern provinces between 2003 and 2010.

CONCLUSIONEndemic transmission and carriage rate of ST-4821 serogroup C clone are high in this jail system. The ST-4821 serogroup C clone is spreading in China and nationwide distributed despite the existence of some effective vaccines.

Carrier State ; China ; epidemiology ; Disease Outbreaks ; Electrophoresis, Gel, Pulsed-Field ; Humans ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Neisseria meningitidis ; genetics ; isolation & purification ; Pharynx ; microbiology ; Prisons

Adolescent ; Adult ; Antibodies, Bacterial ; blood ; Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Male ; Meningitis, Meningococcal ; epidemiology ; microbiology ; Middle Aged ; Neisseria meningitidis ; classification ; immunology ; Seroepidemiologic Studies ; Serotyping

OBJECTIVETo provide methods and alert thresholds which are scientific, sensitive, specific and practical for Early Warning System in Public Health Surveillance.

METHODSAlert data was based on historical infectious diseases reports. Control chart was used to detect outbreaks or epidemics. An epidemic was defined by consulting Specialists. After calculating sensitivity, specificity, positive predictive value and describing receiver-operating characteristic curve (ROC), the optimal model and thresholds were chosen.

RESULTSAt 80 percentile, the sensitivities and the specificities of epidemic haemorragia fever, hepatitis A, dysentery, epidemic cerebrospinal meningitis and malaria were over 90%, and there was a high efficacy of early warning. At 90 percentile, the sensitivities and the specificities of tuberculosis and measles were over 85%, and there was a high efficacy of early warning also.

CONCLUSIONControl chart based on five years was chose as a essential method in early warning system. The alert threshold for epidemic haemorragia fever, hepatitis A, dysentery, epidemic cerebrospinal meningitis and malaria was 80 percentile. The alert threshold for tuberculosis and measles was 90 percentile.

China ; epidemiology ; Communicable Diseases ; epidemiology ; Databases, Factual ; Disease Notification ; Dysentery, Bacillary ; epidemiology ; Environmental Monitoring ; methods ; Epidemiological Monitoring ; Female ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Hepatitis A ; epidemiology ; Humans ; Male ; Meningitis, Meningococcal ; epidemiology ; Population Surveillance

OBJECTIVEWe developed a multiplex polymerase chain reaction (PCR) method for detection, identification and sero-grouping strains of N. meningitidis.

METHODSThe gene of crgA was selected for detection and identification of N. meningitidis and the 230 bp of crgA fragments were amplified. The genes of siaD and orf-2 were used for sero-grouping. With this technology, N. meningitidis of serogroup A,B,C,Y and W135 can be differentiated from the specific fragment 400 bp,450 bp,250 bp, 120 bp,120 bp.

RESULTSThis multiple PCR method seemed to be more sensitive than latex agglutination. We used this method to detect 61 isolates of N. meningitidis and the 230 bp of crgA fragments were amplified. No positive results were obtained from on 4 strains of non-N. meningitidis. It seemed that the PCR method which was based on crag, was specific in detecting N. meningitidis. The 55 strains of N. meningitidis could be grouped into A,B,C,Y and W135 by this multiplex PCR. No gene fragment was synthesized for the other serogroups of N. meningitidis. No cross-reaction was observed for other bacterial species. 4 samples of meningococcal meningitis patients were detected by the multiplex PCR and two of them were positive with 400 bp band,representing serogroup A of N. meningitidis but all were negative to culture and latex agglutination. 18 samples of Japanese (B) encephalitis patients were also detected by multiplex PCR and no positive result was obtained which was consistent to the finding from culture and latex agglutination.

CONCLUSIONThis multiplex PCR method showed its potential in clinical diagnosis and epidemiological investigation.

Bacterial Proteins ; genetics ; China ; Humans ; Meningitis, Meningococcal ; diagnosis ; epidemiology ; Neisseria meningitidis ; classification ; genetics ; Polymerase Chain Reaction ; methods ; Serotyping ; Transcription Factors ; genetics

OBJECTIVEDuring 2003-2005, an outbreak of meningitis due to Neisseria meningitidis serogroup C occurred in China. With the aim to find strain clues result in the final epidemics, the ancestral strain 053442, a clinical isolate, and a carrier strain 053426 with different gene type were analyzed.

METHODSClinical strain 053442 and carrier strain 053426 were cultured on GC agar plates under the same condition. Two-dimensional electrophoresis was performed using the pH 3-10 nonlinear IPG strips of 24 cm length, and all the protein spots were identified by matrix-assisted laser desorption/ionization time of flight spectrometry.

RESULTS502 and 380 protein spots were identified in 053426 and 053442 respectively, relating to 266 and 202 different genes covering a wide range of cellular functions. The express volume and number of proteins involved in energy metabolism, protein synthesis and amino acid biosynthesis in 053426 were higher than in 053442. Virulence factor Opa, Opc and a series of proteins involved in pilus assembly and retraction were identified in 053442, which appear to be of primary importance in colonization and invasion of human cells. Compared to 053442, virulence protein species were less in 053426, with lower express volumes too. No Opa and Opc were detected in 053426.

CONCLUSIONSThe different protein expression profiles of the clinical strain 053442 and carrier strain 053426 in the present study provide some clues of the different pathogenicity of the two strains, which may account for result in the final epidemics.

Bacterial Proteins ; analysis ; Bacterial Typing Techniques ; China ; epidemiology ; Disease Outbreaks ; Electrophoresis, Gel, Two-Dimensional ; Humans ; Meningitis, Meningococcal ; cerebrospinal fluid ; epidemiology ; microbiology ; Neisseria meningitidis, Serogroup C ; classification ; isolation & purification ; Proteome ; analysis ; Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization