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Journal of Clinical Microbiology, January 2000, p. 198-200, Vol. 38, No. 1
0095-1137/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

The 1998 Senegal Epidemic of Meningitis Was Due to the Clonal Expansion of A:4:P1.9, Clone III-1, Sequence Type 5 Neisseria meningitidis Strains

Pierre Nicolas,1,* Georges Raphenon,2 Martine Guibourdenche,3 Laurent Decousset,1 Richard Stor,1 and Abou Beckr Gaye4

Unité du Méningocoque, Institut de Médecine Tropicale du Service de Santé des Armées, WHO Collaborating Center, BP 46, 13998 Marseille Armées,1 and Unité des Neisseria, Centre National de Référence, Institut Pasteur, 75 724 Paris Cedex 15,3 France, and Institut Pasteur, BP 220 Dakar,2 and Médecin-Chef du Service National des Grandes Endémies, Ministère de la Santé Publique et de l'Action Sociale, Dakar,4 Sénégal

Received 19 July 1999/Returned for modification 10 September 1999/Accepted 22 September 1999

Between January and April 1998, a meningitis outbreak due to serogroup A meningococcus took place in Senegal. The outbreak began in Gandiaye, 165 km to the east of Dakar, and progressed towards the towns of Gossas, Niakkhar, Guinguineo, Fatik, Foundiougne, Dioffior, Sokone, Kaolack, and Nioro. At the same time, the outbreak reached regions of Kaffrine, Koungheul, and Tambacounda in the east of Senegal. A total of 1,350 cases and 200 deaths were reported. The WHO Collaborating Center in Marseilles received 24 strains for analysis. All were serogroup A Neisseria meningitidis, type 4 and subtype P1.9. Multilocus enzyme electrophoresis, performed by Institut Pasteur Paris, showed that the strains belonged to clone III-1. DNA restriction fragments generated by endonuclease BglII and analyzed by pulsed-field gel electrophoresis showed 24 indistinguishable fingerprint patterns similar to those of meningococcus strains isolated from African outbreaks since 1988. Three strains were studied by multilocus sequence typing (MLST) with seven loci. The comparison between sequences and existing alleles on the MLST website (http://mlst.zoo.ox.ac.uk) allowed us to assign these strains to sequence type 5 (ST5), as their sequences were identical to the consensus at seven loci. All 24 strains were susceptible to penicillin, amoxicillin, chloramphenicol, and rifampin. Subgroup III is finishing its spread towards west of the meningitis belt of Africa. To our knowledge, this is the first time subgroup III, and more precisely ST5, strains are reported as being responsible for a meningitis outbreak in Senegal.

* Corresponding author. Mailing address: Unité du méningocoque, IMTSSA, centre collaborateur OMS, BP 46, le Pharo, 13998 Marseille Armées, France. Phone: 33 4 91 15 01 15. Fax: 33 4 91 59 44 77. E-mail: imtssa{at}gulliver.fr.

Journal of Clinical Microbiology, January 2000, p. 198-200, Vol. 38, No. 1
0095-1137/0/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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