Prevalence of serogroups and sulfonamide resistance of meningococci from the civilian population in the United States, 1964-1970

The changing epidemiology of meningococcal disease in North America 1945-2010

The epidemiology of Invasive Meningococcal Disease (IMD) is distinct in the United States and Canada compared with other countries. This review describes the incidence, mortality and vaccination strategies relevant to IMD in these countries over the past 65 y. The incidence of IMD has remained consistently low in both countries during this period. Serogroup B and serogroup C have been the most prominent disease-causing serogroups. Notably, serogroup Y has recently become an important cause of IMD in the USA, but has not been as prominent in Canada. Periodic rises in incidence have been characterized by local outbreaks that have raised public concern, especially those caused by serogroup C in Canada, and serogroup B in the USA. Case fatality rates have remained consistent at around 10-20%, but vary by age and serogroup. Recent outbreaks have led to the introduction of vaccination programs for both outbreak control and routine immunization.

Meningococcal disease in The Netherlands, 1959-1981: the occurrence of serogroups and serotypes 2a and 2b of Neisseria meningitidis

By means of a filter radioimmunoassay and the use of monoclonal anti-2a and anti-2b antibodies, we have serotyped 3164 of 3688 strains of Neisseria meningitidis isolated from patients in The Netherlands between 1959 and 1981. Serotypes 2a and 2b were distributed differently among the major serogroups A, B, C, and W-135. Neither of the types was found among group A strains. Type 2b strains of serogroup B emerged in 1965, causing a country-wide epidemic which reached a peak incidence in March and April of 1966 and continued to predominate within group B until 1979. Type 2a strains of serogroup C were responsible for a substantial number of sporadic cases over a long period without any association with outbreaks or with a shift in the pattern of the serogroup. After the appearance of group W-135 in 1971, W-135 strains caused a small non-focal epidemic wave. The upsurge of disease due to virulent sub-populations of strains B:2b and C:2a appeared to be closely related to a basic pattern of regular cyclical waves with peak intervals which differed for serogroups A, B, and C. In recent years both serotype 2a and 2b strains within the different serogroups fell to insignificant numbers. Our results show that retrospective large-scale serotyping of collected strains provides insight into the epidemiological patterns of endemic meningococcal disease.

Escherichia coli K51 and K93 capsular polysaccharides are crossreactive with the group A capsular polysaccharide of Neisseria meningitidis. Immunochemical, biological, and epidemiological studies

Eleven Escherichia coli strains, crossreactive with the capsular polysaccharide (CPS) of Neisseria meningitidis group A (GrA), were detected among 645 stool isolates from healthy families in Cairo, Egypt. 10 of these strains were of the O107:K93:H27 or O107:K93:SP serotypes and may be considered descendents of a single bacterium or as a clone. The remaining crossreactive strain was of the O7:K51:H18 serotype. None of the 11 strains produced enterotoxins and none were enteroinvasive. The purified CPS of these E. coli strains, as well as a polysaccharide (PS) from B. pumilis, strain Sh17, precipitated with equine GrA (H49) antiserum. A partial identity between the E. coli K93, K51 and Sh17 PS on the one hand and the GrA CPS on the other was observed by double immunodiffusion when reacted against the H49 antiserum. Four K93 strains and one K51 strain were found among 320 E. coli strains from patients at the Clinical Center, National Institutes of Health, and three K93 strains were found in 105 stool samples from children in Copenhagen. The data from these three surveys suggest that these crossreactive E. coli are common organisms and could serve as a stimulus for "natural" GrA CPS antibodies. Quantitative precipitation analysis showed that K51, K93, and Sh17 PS precipitated 25, 46.8, and 50% of H49 antibodies, respectively. Absorption of H49 antiserum with the GrA CPS removed its precipitating activity with the E. coli K93, K51, and Sh17 PS. Absorption of H49 antiserum with either K51 CPS or Sh17 PS removed the homologous crossreactivity only, whereas K93 CPS absorbed both K93 and K51 reactivities. Antibodies, raised by intravenous injection of formalinized E. coli K93 or K51 cells into rabbits, precipitated with GrA CPS and were bactericidal against GrA meningococci. The crossreaction between the E. coli K93 and the GrA CPS was unexpected since these two CPS are compositionally so dissimilar.

Homogeneity of protein serotype antigens in Neisseria meningitidis group A

Serotype antigens (STA), which have been shown to be constituents of outer-membrane protein, were extracted from group A meningococci with 0.2 M LiCl and pelleted by centrifugation at 150,000 X g. The STAs from 100 group A strains, which had been isolated from cases and carriers in various geographical locations, were compared by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE). Every STA produced three major protein bands with molecular weights of approximately 35,000, 39,000, and 45,000, respectively. This SDS-PAGE pattern is clearly distinct from that produced by the serotype of group B and C meningococci most commonly isolated from cases (group B type 2 and group C type 2). The group A STAs were also indistinguishable by immunodiffusion. However, differences in bactericidal reactions were demonstrated, suggesting that there are other antigens that play a role in antibody response.