Human infections due to the bacterial pathogen Neisseria meningitidis remain a serious health problem worldwide. We determined the incidence and epidemiologic characteristics of invasive disease due to N. meningitidis occurring in metropolitan Atlanta between 1989 and 2010. In addition, we addressed the geographical and temporal trends in the occurrence of invasive meningococcal disease and the spread of invasive clonal complexes over these two decades in the community. Cases of meningococcal disease that occurred in metropolitan Atlanta between 1989 and 2010 were identified through active prospective laboratory and population based surveillance. Genetic typing (MLST) was conducted on meningococcal isolates to identify clonal complexes and ArcMap10 was used to geocode US addresses in order to geographically study the invasive meningococcal cases. A total of 468 cases of invasive meningococcal disease were detected in the Atlanta surveillance area from 1989 to 2010. The incidence of meningococcal disease significantly declined since 2001 (X2 for linear trend, p = 0.007) and become more distributed geographically over time in the surveillance area. Genetic typing of clonal complex was available for 258 invasive meningococcal cases. Almost all of serogroups C and Y meningococcal disease were caused by the ST-11 complex and ST-23 complex, respectively, suggesting that closely related strains are circulating in the community and causing sporadic disease. In contrast, serogroup B meningococcal disease over the past twenty years were from multiple distinct genetic lineages. The temporal trends of N. meningitidis clonal complexes were reflected in the geographic distribution of meningococcal disease over time. Molecular characterization of meningococcal isolates is vital in determining the spread of specific clonal complexes in the community. In addition, it is important to conduct ongoing surveillance as the trends in the occurrence of meningococcal disease will affect future vaccine or other prevention strategies.
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About this Master's Thesis
|Committee Chair / Thesis Advisor|
|Neisseria meningitidis Epidemiology and Molecular Epidemiology in Atlanta, Georgia, 1989-2010 ()||2018-08-28||