2024年朝觐前与副朝和旅行相关的由多个血清群W ST-11亚菌株引起的脑膜炎球菌病。
Umrah- and travel-associated meningococcal disease due to multiple serogroup W ST-11 sub-strains pre-Hajj 2024.
作者信息
Lucidarme Jay, Deghmane Ala-Eddine, Sharma Shalabh, Meilleur Courtney, Eriksson Lorraine, Mölling Paula, Claus Heike, van Sorge Nina M, Bettencourt Célia, Bajanca-Lavado Paula, Tsang Raymond S W, Caugant Dominique A, Stefanelli Paola, Neri Arianna, Tzanakaki Georgina, Lekshmi Aiswarya, Campbell Helen, Clark Stephen A, Heymer Emma J, Ribeiro Sonia, Willerton Laura, Walsh Lloyd, Bai Xilian, Lâm Thiên-Trí, Wagle Basanta R, Walia Vishakh, Howie Rebecca L, Neatherlin John, Rubis Amy, Vachon Madhura, McNamara Lucy A, Ladhani Shamez N, Taha Muhamed-Kheir, Borrow Ray
机构信息
Meningococcal Reference Unit, UK Health Security Agency, Manchester Royal Infirmary, Manchester, UK.
Invasive Bacterial Infections Unit and National Reference Centre for Meningococci and Haemophilus influenzae, Institut Pasteur, Université Paris Cité, Paris, France.
出版信息
J Infect. 2025 Jul 21;91(4):106558. doi: 10.1016/j.jinf.2025.106558.
OBJECTIVES
Collectively, the Hajj and Umrah pilgrimages draw >30 million pilgrims to the Kingdom of Saudi Arabia (KSA) each year. Before Hajj 2024 (14 to 19 June), the meningococcal serogroup W ST-11 complex (W:cc11) Hajj-strain sublineage caused multiple international cases of invasive meningococcal disease (IMD) associated with travel to the Middle East and Asia. Here we identify and characterise the strains responsible.
METHODS
All Hajj strain sublineage genomes on PubMLST.org underwent core genome MLST comparisons (PubMLST.org).
RESULTS
Isolates from 30 cases, across seven countries, formed five phylogenetic clusters within two distinct strains. Travel histories included KSA, other Middle Eastern countries, India, Mauritius, Kenya via Turkey, and no known associated travel. The prevalent strain, representing four clusters, had no African, and limited Middle Eastern, representation. The geo-temporal distribution of available genomes indicated Eastern Europe as a possible source.
CONCLUSIONS
The rapid expansion of Umrah/travel-related W:cc11 IMD cases in early 2024 was due to multiple strains/sublineages. Despite the involvement of non-KSA travel-destinations, the coincidence of cases with the busy month of Ramadan, and the abrupt cessation during Hajj (when vaccine compliance is maximal), suggest that Umrah was a key driver and highlight the need to reinforce mandatory vaccination whilst maintaining global vigilance.
目的
朝觐和副朝朝圣每年吸引超过3000万朝圣者前往沙特阿拉伯王国（KSA）。在2024年朝觐（6月14日至19日）之前，脑膜炎球菌血清群W ST-11复合体（W:cc11）朝觐菌株亚系导致多起与前往中东和亚洲旅行相关的侵袭性脑膜炎球菌病（IMD）国际病例。在此，我们鉴定并描述了致病菌株。
方法
对PubMLST.org上所有朝觐菌株亚系基因组进行核心基因组多位点序列分型比较（PubMLST.org）。
结果
来自7个国家的30例病例的分离株在两个不同菌株内形成了5个系统发育簇。旅行史包括沙特阿拉伯、其他中东国家、印度、毛里求斯、经土耳其前往肯尼亚，以及无已知相关旅行史。代表4个簇的流行菌株在非洲没有代表，在中东的代表也有限。现有基因组的地理时间分布表明东欧可能是源头。
结论
2024年初与副朝/旅行相关的W:cc11 IMD病例迅速增加是由多种菌株/亚系引起的。尽管涉及非沙特阿拉伯的旅行目的地，病例与斋月繁忙月份的巧合，以及在朝觐期间（疫苗接种依从性最高时）病例突然停止，表明副朝是一个关键驱动因素，并突出了加强强制接种疫苗同时保持全球警惕的必要性。
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