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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
Authors:Cecilia Fazio  Laura Daprai  Arianna Neri  Marcello Tirani  Paola Vacca  Milena Arghittu  Luigina Ambrosio  Danilo Cereda  Maria Gramegna  Annapina Palmieri  Anna Carannante  Maria Rosa Bertoli  Lucia Crottogini  Giorgio Gennati  Eugenia Quinz  Livia Trezzi  Andrea Ciammaruconi  Silvia Fillo  Antonella Fortunato  Giovanni Rezza  Florigio Lista  Paola Stefanelli
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:Neisseria meningitidis   clonal complex 11   invasive meningocococcal disease   Italy   outbreak   serogroup C meningococcal vaccination
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