title: Characterization of invasive Neisseria meningitidis from Atlantic Canada, 2009 to 2013: With special reference to the nonpolysaccharide vaccine targets (PorA, factor H binding protein, Neisseria heparin-binding antigen and Neisseria adhesin A).
abstract: BACKGROUND
  Serogroup B Neisseria meningitidis (MenB) has always been a major cause of invasive meningococcal disease (IMD) in Canada. With the successful implementation of a meningitis C conjugate vaccine, the majority of IMD in Canada is now caused by MenB.
  
  
  OBJECTIVE
  To investigate IMD case isolates in Atlantic Canada from 2009 to 2013. Data were analyzed to determine the potential coverage of the newly licensed MenB vaccine.
  
  
  METHODS
  Serogroup, serotype and serosubtype antigens were determined from IMD case isolates. Clonal analysis was performed using multilocus sequence typing. The protein-based vaccine antigen genes were sequenced and the predicted peptides were investigated.
  
  
  RESULTS
  The majority of the IMD isolates were MenB (82.5%, 33 of 40) and, in particular, sequence type (ST)-154 B:4:P1.4 was responsible for 47.5% (19 of 40) of all IMD case isolates in Atlantic Canada. Isolates of this clone expressed the PorA antigen P1.4 and possessed the nhba genes encoding for Neisseria heparin-binding antigen peptide 2, which together matched exactly with two of the four components of the new four-component meningococcal B vaccine. Nineteen MenB isolates had two antigenic matches, another five MenB and one meningitis Y isolate had one antigenic match. This provided 75.8% (25 of 33) potential coverage for MenB, or a 62.5% (25 of 40) overall potential coverage for IMD.
  
  
  CONCLUSIONS
  From 2009 to 2013, IMD in Atlantic Canada was mainly caused by MenB and, in particular, the B:4:P1.4 ST-154 clone, which accounted for 47.5% of all IMD case isolates. The new four-component meningococcal B vaccine appeared to offer adequate coverage against MenB in Atlantic Canada.
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba;
authors.forename: Raymond Sw
authors.initials: RS
authors.lastname: Tsang
authors.affiliation: National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba;
authors.forename: Dennis Ks
authors.initials: DK
authors.lastname: Law
authors.affiliation: Communicable Disease Control Unit, Department of Health, Government of New Brunswick, Fredericton, New Brunswick;
authors.forename: Rita R
authors.initials: RR
authors.lastname: Gad
authors.affiliation: Department of Pathology and Laboratory Medicine, IWK Health Centre, Halifax, Nova Scotia;
authors.forename: Tim
authors.initials: T
authors.lastname: Mailman
authors.affiliation: Department of Health, Government of Prince Edward Island, Charlottetown, Prince Edward Island;
authors.forename: Gregory
authors.initials: G
authors.lastname: German
authors.affiliation: Public Health Laboratory and Microbiology, Eastern Health, St John's, Newfoundland and Labrador.
authors.forename: Robert
authors.initials: R
authors.lastname: Needle
keywords: Atlantic Canada; Invasive Neisseria meningitidis; MenB vaccine