title: A cluster of invasive meningococcal disease revealed by the characterization of a novel serogroup B meningococcal clone.
abstract: The incidence of invasive infections due to Neisseria meningitidis in Israel is about 1/100 000 population annually. Three cases of meningococcal meningitis were reported in employees at a single plant; the first case appeared in March 2013 and the second and third cases appeared in December, almost 9 months later. N. meningitidis serogroup B was isolated from cerebrospinal fluid samples. Multilocus sequence typing assigned the three meningococcal isolates to ST10418, a new sequence type and a member of the ST32 clonal complex. The clonality was confirmed by performance of pulsed-field gel electrophoresis. Post-exposure antibiotic prophylaxis was administered to close contacts of the first case. Upon the diagnosis of the additional two cases, post-exposure prophylaxis was administered to all the plant employees. This report demonstrates the importance of combining public health measures and advanced laboratory studies to confirm clonality and to prevent further disease spread in a closed setting.
authors.affiliation: Government Central Laboratories,Ministry of Health,Jerusalem,Israel.
authors.forename: L
authors.initials: L
authors.lastname: Valinsky
authors.affiliation: Government Central Laboratories,Ministry of Health,Jerusalem,Israel.
authors.forename: J
authors.initials: J
authors.lastname: Jaffe
authors.affiliation: National Reference Center for Meningococci,Microbiology Laboratory,Sheba Medical Center,Ministry of Health,Israel.
authors.forename: N
authors.initials: N
authors.lastname: Keller
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases,Hadassah-Hebrew University Medical Center,Jerusalem,Israel.
authors.forename: C
authors.initials: C
authors.lastname: Block
authors.affiliation: Jerusalem District Health Office,Ministry of Health,Israel.
authors.forename: N
authors.initials: N
authors.lastname: Abramson
authors.affiliation: Jerusalem District Health Office,Ministry of Health,Israel.
authors.forename: C
authors.initials: C
authors.lastname: Stein-Zamir
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007557:Israel; D008297:Male; D008585:Meningitis, Meningococcal / Q000134:cerebrospinal fluid* / Q000188:drug therapy* / Q000382:microbiology; D008875:Middle Aged; D058885:Multilocus Sequence Typing; D038541:Neisseria meningitidis, Serogroup B / Q000235:genetics* / Q000302:isolation & purification; D056990:Post-Exposure Prophylaxis
chemical_list: D000900:Anti-Bacterial Agents
keywords: Cluster; Neisseria meningitidis; invasive meningococcal disease; molecular epidemiology