A cluster of four cases of meningococcal disease in a single nuclear family

Abstract

A cluster of four confirmed cases of meningococcal disease was seen in the same nuclear family across a 15-week period. The cases were three siblings and a parent and all recovered well. The first case was confirmed by meningococcal PCR only but the subsequent three cases were due to indistinguishable strains of serogroup B (B:NT:P1.19-1,15-11). Contact tracing was initially undertaken and reviewed in detail after each subsequent case. Antibiotic prophylaxis was administered to close family contacts on three separate occasions, including switching of antibiotic agents, with good compliance. Subsequent investigation of the family has not revealed any obvious immunological problem and no further significant infections have been recognised. A cluster of meningococcal disease of this nature and timescale is highly unusual. Details of the cluster, investigation and implications for health protection practice are discussed.

Meningococcal disease in adolescents and young adults: a review of the rationale for prevention through vaccination

“…34 MenB disease has also been the cause of recent outbreaks at college campuses in the United States, 47 outbreaks in nursery and high schools, [48][49][50] cluster of disease in Europe. 51 An increase in MenW disease owing to endemic expansion of a single type cc11 has been observed across all age groups in England, Wales, and the Netherlands. 12,52,53 In England and Wales, among those aged 5 to 19 years, cases of MenW cc11 increased from 3 in 2008/ 2009 to 15 in 2013/2014 compared with 21 in 2008/2009 and 98 in 2013/2014 across all ages.…”

A prolonged outbreak of invasive meningococcal disease in an extended Irish Traveller family across three Health Service Executive (HSE) areas in Ireland, 2010 to 2013

“…Family clusters have also been described in the literature but their time duration is considerably shorter than our outbreak [24].…”

Four-month outbreak of invasive meningococcal disease caused by a rare serogroup B strain, identified through the use of molecular PorA subtyping, England, 2013

“…Others have reported a cluster of cases over a long timescale, e.g. Acheson et al [12], but this was within a single nuclear family, a setting where there is a higher risk of secondary cases. The authors concluded that it was likely that the strain was reintroduced by a regular non-household contact or unidentified close contact [12].…”

“…Acheson et al [12], but this was within a single nuclear family, a setting where there is a higher risk of secondary cases. The authors concluded that it was likely that the strain was reintroduced by a regular non-household contact or unidentified close contact [12]. In addition, Mandal et al reported an outbreak of 13 cases between January 2008 and November 2010 [13].…”