Hajj-Related Neisseria Meningitidis Serogroup W135 in Mauritius

Abstract

Meningococcal disease is rare in Mauritius; only one case was reported from 1992 to 1999. However, since June 2000, four cases have occurred. Epidemiologic information and typing results indicate that these recent cases probably followed the introduction of Neisseria meningitidis W135 in Mauritius by pilgrims returning from the Hajj in 2000 and 2001.

Hajj‐Associated Outbreak Strain ofNeisseria meningitidisSerogroup W135: Estimates of the Attack Rate in a Defined Population and the Risk of Invasive Disease Developing in Carriers

“…This is consistent with reports from several other countries after the outbreak of W135 meningococcal disease in Saudi Arabia in the years 2000 and 2001 [8,10,[20][21][22]. We found a clear association with the Hajj pilgrimage, on the basis of the temporal relationship and the relatedness of the isolated strains of W135.…”

Extrameningeal Complications of Neisseria meningitidis Serogroup W135 Infection

“…This program worked quite well until 2000 and 2001, when an epidemic caused by N. meningitidis serogroup W135 occurred in pilgrims and their contacts. Because of the immigration of Muslim populations over the past fifty years to western Europe and the United States, cases caused by W135 were reported with a worldwide distribution involving Saudi Arabia, western Europe, Africa, the United States, Asia, and the Middle East after the Hajj [3][4][5]. The W135 strain causing these outbreaks belonged to the electrophoretic type 37 (ET-37) clonal complex.…”

“…The W135 strain causing these outbreaks belonged to the electrophoretic type 37 (ET-37) clonal complex. This clonal complex is known to cause hyperendemic disease [3][4][5]. After the 2001 outbreak, the Saudi Arabian government changed the vaccination recommendation to mandate vaccination with the tetravalent (A, C, Y, and W135) vaccine.…”

Meningococcal Meningitis Outbreak in Trinidad, 1998

“…Neisseria meningitidis is the etiological agent in more than 40% of these cases (1). The African meningitis belt, which stretches from Senegal to Ethiopia, has the highest incidence of the disease, but N. meningitidis is also responsible for recent outbreaks in Asia and the Americas (2,3). Serogroup A has caused the majority of the African epidemics (4) while Serogroup C has caused outbreaks in North America as well as in Africa.…”

“…The island is roughly rectangular in shape, with large promontories on the northwest and southwest and an area of circa 4662 km 2 . The island's greatest length is 90km, from north to south, and its greatest breadth is 57.6 km, from east to west.…”