Volume 25, Number 3—March 2019
Synopsis
University-Based Outbreaks of Meningococcal Disease Caused by Serogroup B, United States, 2013–2018
Table 1
State of university |
Outbreak period |
No. cases (deaths) |
Approximate no. undergraduates |
Clonal complex of outbreak strain |
Sequence type of outbreak strain |
References |
New Jersey | 2013 Mar–2014 Mar | 9 (1)* | 5,000 | 41/44 | 409 | (15,16) |
California | 2013 Nov | 4† | 19,000 | 32 | 32 | (17) |
Rhode Island | 2015 Jan–Feb | 2 | 3,700 | Unassigned | 9069 | (18–21) |
Oregon | 2015 Jan–May | 7 (1)‡ | 20,000 | 32 | 32 | (22,23) |
California | 2016 Jan–Feb | 2§ | 5,000 | 32 | 11910 | (24) |
New Jersey | 2016 Mar–Apr | 2 | 35,000 | 11 | 11 | (25) |
Wisconsin | 2016 Oct | 3 | 30,000 | 32 | 11556 | (26,27) |
Oregon | 2016 Nov–2017 Nov | 5 | 25,000 | 32 | 32 | (28) |
Massachusetts¶ | 2017 Oct–2018 Feb | 3 | 26,000 | 41/44 | 41 | (29) |
Pennsylvania | 2017 Nov | 2# | 3,600 | 32** | 8758** |
*Two of the cases occurred in close contacts of undergraduate students at the outbreak-affected university: 1 in a high school student who stayed in an undergraduate dormitory and 1 in a student at a different university.
†One additional associated case that occurred in March 2013 was identified after retrospective case review. An additional case occurred 2 years later in a close contact of an undergraduate student who may have been connected to this outbreak.
‡One case occurred in a close contact of undergraduate students at the outbreak-affected university.
§One additional suspected case with inconclusive lab results occurred in February 2016 in a student previously vaccinated with 2 doses of MenB vaccine and who received antimicrobial chemoprophylaxis the day before symptom onset.
¶Cases occurred at 2 universities in a college consortium in the same geographic area. The first 2 cases occurred at University 1 and the third case occurred at University 2.
#Cases were close contacts and members of the same athletic team.
**An isolate was available for only 1 of the 2 cases, so typing results refer to the single case isolate.
References
- MacNeil JR, Blain AE, Wang X, Cohn AC. Current epidemiology and trends in meningococcal disease—United States, 1996–2015. Clin Infect Dis. 2018;66:1276–81. DOIPubMedGoogle Scholar
- Committee on Infectious Diseases, American Academy of Pediatrics, Kimberlin DW, Brady MT, Jackson MA, Long SS. Meningococcal infections. Itasca (IL): American Academy of Pediatrics; 2018 [cited 2018 Nov 13]. https://redbook.solutions.aap.org/chapter.aspx?sectionid=189640131&bookid=2205
- Centers for Disease Control and Prevention. Meningococcal disease surveillance. 2018 [cited 2018 Nov 13]. https://www.cdc.gov/meningococcal/surveillance/index.html
- Mbaeyi SA, Blain A, Whaley MJ, Wang X, Cohn AC, MacNeil JR. Epidemiology of meningococcal disease outbreaks in the United States, 2009–2013. [Epub 2018 Jun 30]. Clin Infect Dis. 2018.DOIPubMedGoogle Scholar
- Cohn AC, MacNeil JR, Clark TA, Ortega-Sanchez IR, Briere EZ, Meissner HC, et al.; Centers for Disease Control and Prevention (CDC). Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2013;62(RR-2):1–28.PubMedGoogle Scholar
- Food and Drug Administration. Bexsero US package insert. Washington (DC): The Administration; 2015 [cited 2018 Oct 9]. http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM431447.pdf
- Food and Drug Administration. Trumenba US package insert. Washington (DC): The Administration; 2014 [cited 2018 Oct 9]. http://www.fda.gov/downloads/BiologicsBloodVaccines/Vaccines/ApprovedProducts/UCM421139.pdf
- MacNeil JR, Rubin L, Folaranmi T, Ortega-Sanchez IR, Patel M, Martin SW. Use of serogroup B meningococcal vaccines in adolescents and young adults: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:1171–6. DOIPubMedGoogle Scholar
- Folaranmi T, Rubin L, Martin SW, Patel M, MacNeil JR; Centers for Disease Control (CDC). Use of serogroup B meningococcal vaccines in persons aged ≥10 years at increased risk for serogroup B meningococcal disease: recommendations of the Advisory Committee on Immunization Practices, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:608–12.PubMedGoogle Scholar
- Patton ME, Stephens D, Moore K, MacNeil JR. Updated recommendations for use of MenB-FHbp serogroup B meningococcal vaccine—Advisory Committee on Immunization Practices, 2016. MMWR Morb Mortal Wkly Rep. 2017;66:509–13. DOIPubMedGoogle Scholar
- Jackson LA, Schuchat A, Reeves MW, Wenger JD. Serogroup C meningococcal outbreaks in the United States. An emerging threat. JAMA. 1995;273:383–9. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Meningococcal disease and college students. Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2000;49(RR-7):13–20.PubMedGoogle Scholar
- Walker TY, Elam-Evans LD, Yankey D, Markowitz LE, Williams CL, Mbaeyi SA, et al. National, regional, state, and selected local area vaccination coverage among adolescents aged 13–17 years—United States, 2017. MMWR Morb Mortal Wkly Rep. 2018;67:909–17. DOIPubMedGoogle Scholar
- Centers for Disease Control and Prevention. Guidance for the evaluation and public health management of suspected outbreaks of meningococcal disease. 2017 [cited 2018 Oct 9]. https://www.cdc.gov/meningococcal/downloads/meningococcal-outbreak-guidance.pdf
- McNamara LA, Shumate AM, Johnsen P, MacNeil JR, Patel M, Bhavsar T, et al. First use of a serogroup B meningococcal vaccine in the US in response to a university outbreak. Pediatrics. 2015;135:798–804. DOIPubMedGoogle Scholar
- Basta NE, Mahmoud AA, Wolfson J, Ploss A, Heller BL, Hanna S, et al. Immunogenicity of a meningococcal B vaccine during a university outbreak. N Engl J Med. 2016;375:220–8. DOIPubMedGoogle Scholar
- Breakwell L, Vogt TM, Fleming D, Ferris M, Briere E, Cohn A, et al. Understanding factors affecting university A students’ decision to receive an unlicensed serogroup B meningococcal vaccine. J Adolesc Health. 2016;59:457–64. DOIPubMedGoogle Scholar
- Soeters HM, Whaley M, Alexander-Scott N, Kanadanian KV, MacNeil JR, Martin SW, et al.; Rhode Island Meningococcal Carriage Evaluation Team. Meningococcal carriage evaluation in response to a serogroup B meningococcal disease outbreak and mass vaccination campaign at a college—Rhode Island, 2015–2016. Clin Infect Dis. 2017;64:1115–22. DOIPubMedGoogle Scholar
- Soeters HM, McNamara LA, Whaley M, Wang X, Alexander-Scott N, Kanadanian KV, et al.; Centers for Disease Control (CDC). Serogroup B meningococcal disease outbreak and carriage evaluation at a college—Rhode Island, 2015. MMWR Morb Mortal Wkly Rep. 2015;64:606–7.PubMedGoogle Scholar
- Fiorito TM, Bornschein S, Mihalakos A, Kelleher CM, Alexander-Scott N, Kanadanian KV, et al. Rapid response to a college outbreak of meningococcal serogroup B disease: Nation’s first widespread use of bivalent rLP2086 vaccine. J Am Coll Health. 2017;65:294–6. DOIPubMedGoogle Scholar
- Fiorito TM, Baird GL, Alexander-Scott N, Bornschein S, Kelleher C, Du N, et al. Adverse events following vaccination with bivalent rLP2086 (Trumenba®): an observational, longitudinal study during a college outbreak and a systematic review. Pediatr Infect Dis J. 2018;37:e13–9.PubMedGoogle Scholar
- Fisher EA, Poissant T, Luedtke P, Leman R, Young C, Cieslak P. Evaluation of mass vaccination clinics in response to a serogroup B meningococcal disease outbreak at a large, public university—Oregon, 2015. J Adolesc Health. 2018;63:151–6. DOIPubMedGoogle Scholar
- McNamara LA, Thomas JD, MacNeil J, Chang HY, Day M, Fisher E, et al.; Oregon Meningococcal Carriage Team. Meningococcal carriage following a vaccination campaign with MenB-4C and MenB-FHbp in response to a university serogroup B meningococcal disease outbreak—Oregon, 2015–2016. J Infect Dis. 2017;216:1130–40. DOIPubMedGoogle Scholar
- Biswas HH, Han GS, Wendorf K, Winter K, Zipprich J, Perti T, et al. Notes from the field: outbreak of serogroup B meningococcal disease at a University—California, 2016. MMWR Morb Mortal Wkly Rep. 2016;65:520–1. DOIPubMedGoogle Scholar
- Soeters HM, Dinitz-Sklar J, Kulkarni PA, MacNeil JR, McNamara LA, Zaremski E, et al. Serogroup B meningococcal disease vaccine recommendations at a university, New Jersey, USA, 2016. Emerg Infect Dis. 2017;23:867–9. DOIPubMedGoogle Scholar
- Ritscher AM, Ranum N, Malak JD, Ahrabi-Fard S, Baird J, Berti AD, et al. Meningococcal serogroup B outbreak response University of Wisconsin-Madison. J Am Coll Health. 2018;1–6. DOIPubMedGoogle Scholar
- Schauer S. A serogroup B meningococcal disease outbreak on a Wisconsin university campus and the mass vaccine campaign response—communication. Presented at: 48th National Immunization Conference; 2018 May 15–17; Atlanta, GA, USA.
- Haubenreiser J, Dunn A. Managing meningococcal disease outbreaks in the university setting: Oregon State University and the State of Oregon Partnership and Response. Presented at: 48th National Immunization Conference; 2018 May 15–17; Atlanta, GA, USA.
- Becker A. Meningitis on campus: reaching students during a meningitis-B outbreak. Presented at: 23rd Annual Massachusetts Adult Immunization Conference; 2018 Apr 10; Marlborough, MA, USA.
- Mbaeyi SA, Joseph SJ, Blain A, Wang X, Hariri S, MacNeil JR. Meningococcal disease among college-aged young adults: 2014–2016. Pediatrics. 2019;143:e20182130. DOIPubMedGoogle Scholar
- Jolley KA, Maiden MC. BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics. 2010;11:595. DOIPubMedGoogle Scholar
- MacDougall DM, Langley JM, Li L, Ye L, MacKinnon-Cameron D, Top KA, et al.; Canadian Immunization Research Network. Knowledge, attitudes, beliefs, and behaviors of university students, faculty, and staff during a meningococcal serogroup B outbreak vaccination program. Vaccine. 2017;35:2520–30. DOIPubMedGoogle Scholar
- Vyse A, Ellsbury G, Madhava H. Protecting UK adolescents and adults against meningococcal serogroup B disease. Expert Rev Vaccines. 2018;17:229–37. DOIPubMedGoogle Scholar
- Oliver S. Meningococcal vaccine policies among colleges and universities—United States, 2017. Presented at: 48th National Immunization Conference; 2018 May 15–17; Atlanta, GA, USA.
- Mandal S, Wu HM, MacNeil JR, Machesky K, Garcia J, Plikaytis BD, et al. Prolonged university outbreak of meningococcal disease associated with a serogroup B strain rarely seen in the United States. Clin Infect Dis. 2013;57:344–8. DOIPubMedGoogle Scholar
1Members of the group are listed at the end of this article.