Meningococcal Disease Caused by Neisseria meningitidis Serogroup B Serotype 4 in São Paulo, Brazil, 1990 to 1996

Abstract

A large epidemic of serogroup B meningococcal disease (MD), has been occurring in greater São Paulo, Brazil, since 1988. A Cuban-produced vaccine, based on outer-membrane-protein (OMP) from serogroup B: serotype 4: serosubtype P1.15 (B:4:P1.15) Neisseria meningitidis, was given to about 2.4 million children aged from 3 months to 6 years during 1989 and 1990. The administration of vaccine had little or no measurable effects on this outbreak. In order to detect clonal changes that could explain the continued increase in the incidence of disease after the vaccination, we serotyped isolates recovered between 1990 and 1996 from 834 patients with systemic disease. Strains B:4:P1.15, which was detected in the area as early as 1977, has been the most prevalent phenotype since 1988. These strains are still prevalent in the area and were responsible for about 68% of 834 serogroup B cases in the last 7 years. We analyzed 438 (52%) of these strains by restriction fragment length polymorphism (RFLPs) of rRNA genes (ribotyping). The most frequent pattern obtained was referred to as Rb1 (68%). We concluded that the same clone of B:4:P1.15-Rb1 strains was the most prevalent strain and responsible for the continued increase of incidence of serogroup B MD cases in greater São Paulo during the last 7 years in spite of the vaccination trial.

Phenotypic and molecular characterization of invasive serogroup W135 Neisseria meningitidis strains from 1990 to 2005 in Brazil

“…3–5,30,31 We have characterized the hyperinvasive lineages ST-32 complex/ET-5 complex, ST-11 complex/ET-37 complex, ST-8 complex/Cluster A4, and ST-103 complex in both N. meningitidis serogroup B and N. meningitidis serogroup C isolates. Our rates of N. meningitidis serogroup W135 MD cases remain low, but we have observed a slight increase of this serogroup over 25 years of laboratory-based surveil-lance.…”

Letalidade na epidemiologia da doença meningocócica: estudo na região de Campinas, SP, 1993 a 1998

“…O comportamento da doença seguiu padrão da Grande São Paulo, onde desde 1988 observou-se maior prevalência da cepa B:4:P1.15, responsável pela continuidade da epidemia de DM naquela localidade. 11 Os maiores coeficientes de incidência foram registrados entre menores de 4 anos, particularmente no primeiro ano de vida, decrescendo com a idade, enquanto a letalidade apresenta-se mais elevada nas faixas etárias extremas, conforme observado por outros autores. O coeficiente de letalidade é um indicador valioso no acompanhamento da DM, podendo ser utilizado com maior freqüência nos sistemas de vigilância epidemiológica, municipais e regionais.…”

Clonal Distribution of Invasive Neisseria meningitidis Serogroup C Strains Circulating from 1976 to 2005 in Greater São Paulo, Brazil

“…MAbs for SerTs 8 (2725H6) and 15 (1951C8) OMVs, SDS-PAGE, and immunoblotting. Outer membrane vesicles (OMVs) were prepared and purified from a serogroup C NT:NST isolate (strain N.753/ 00), the isolate chosen for MAb production, as previously described (10,27,28,40). This serogroup C spinal fluid isolate was recovered in 2000 from a 17-yearold female in GSP with a fatal case of MD.…”

“…A sample of meningococcal isolates from GSP has been previously characterized phenotypically and genotypically (25,26,28). These studies have shown that until 1982, nonserotypeable (NT) and nonserosubtypeable (NST) serogroup B strains accounted for most of the serogroup B isolates.…”