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Authors: Sidikou, Fati and Zaneidou, Maman and Alkassoum, Ibrahim and Schwartz, Stephanie and Issaka, Bassira and Obama, Ricardo and Lingani, Clement and Tate, Ashley and Ake, Flavien and Sakande, Souleymane and Ousmane, Sani and Zanguina, Jibir and Seidou, Issaka and Nzeyimana, Innocent and Mounkoro, Didier and Abodji, Oubote and Wang, Xin and Taha, Muhamed-Kheir and Moulia-Pelat, Jean Paul and Pana, Assimawe and Kadade, Goumbi and Ronveaux, Olivier and Novak, Ryan and Oukem-Boyer, Odile Ouwe Missi and Meyer, Sarah

To combat Neisseria meningitidis serogroup A epidemics in the meningitis belt of sub-Saharan Africa, a meningococcal serogroup A conjugate vaccine (MACV) has been progressively rolled out since 2010. We report the first meningitis epidemic in Niger since the nationwide introduction of MACV.We compiled and analysed nationwide case-based meningitis surveillance data in Niger. Cases were confirmed by culture or direct real-time PCR, or both, of cerebrospinal fluid specimens, and whole-genome sequencing was used to characterise isolates. Information on vaccination campaigns was collected by the Niger Ministry of Health and WHO.From Jan 1 to June 30, 2015, 9367 suspected meningitis cases and 549 deaths were reported in Niger. Among 4301 cerebrospinal fluid specimens tested, 1603 (37·3%) were positive for a bacterial pathogen, including 1147 (71·5%) that were positive for N meningitidis serogroup C (NmC). Whole-genome sequencing of 77 NmC isolates revealed the strain to be ST-10217. Although vaccination campaigns were limited in scope because of a global vaccine shortage, 1·4 million people were vaccinated from March to June, 2015.This epidemic represents the largest global NmC outbreak so far and shows the continued threat of N meningitidis in sub-Saharan Africa. The risk of further regional expansion of this novel clone highlights the need for continued strengthening of case-based surveillance. The availability of an affordable, multivalent conjugate vaccine may be important in future epidemic response.MenAfriNet consortium, a partnership between the US Centers for Disease Control and Prevention, WHO, and Agence de Médecine Preventive, through a grant from the Bill & Melinda Gates Foundation. Copyright © 2016 World Health Organization. Published by Elsevier Ltd/Inc/BV. All rights reserved. Published by Elsevier Ltd.. All rights reserved.

Journal: The Lancet. Infectious diseases
DOI: 10.1016/S1473-3099(16)30253-5
Year: 2016

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