Outbreak of Neisseria meningitidis C in a Brazilian oil refinery involving an adjacent community

Background An outbreak of serogroup C meningococcal disease (MD) that involved employees from an oil refinery occurred in Paulínia, from March to June 2010, and spread to the community of Cosmópolis, both situated in São Paulo State, Brazil. The aim of this study was to describe the epidemiological and laboratory aspects, and the control measures that were implemented. Methods Descriptive and molecular epidemiological analysis was used to define the extent of the outbreak and the common risk factors among outbreak related cases. Vaccination initiative targeted the employees from the oil refinery and the community-based individuals. Results A total of six outbreak-related cases of MD in the oil refinery and 12 cases in the city of Cosmópolis, São Paulo State occurred in a three-month period. All 18 MD cases were confirmed as serogroup C either by culture, real time polymerase chain reaction (RT-PCR), or counterimmunoelectrophoresis (CIE). The meningococcal isolates (n=15) had the phenotype C:23:P1.14-6 and showed close genetic relationship by pulsed field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) characterization showed that the clones were ST 3780, ST-103 complex. The isolates were susceptible to the antibiotics tested. Vaccination was administered to 15,848 persons at the oil refinery and 18,571 persons of the community (AU)

Introducción De marzo a junio de 2010 se produjo un brote de enfermedad meningocócica (EM) del serogrupo C en una refinería de petróleo en la ciudad de Paulina, afectando a los empleados y a la comunidad de Cosmópolis, ambas ciudades situadas en el estado de Sao Paulo (Brasil). Los objetivos del estudio fueron describir los aspectos epidemiológicos y de laboratorio así como las medidas de control que se implementaron. Métodos Se realizo un análisis epidemiológico descriptivo y molecular para definir la extensión de la epidemia y los factores de riesgo comunes entre los casos relacionados con el brote. Se utilizo vacuna para los empleados de la refinería de petróleo y sus contactos en la comunidad. Resultados Un total de seis casos fueron relacionados con el brote de EM en la refinería de petróleo y 12 casos en la ciudad de Cosmópolis, durante un período de tres meses. Dieciocho casos de EM fueron confirmados como del serogrupo C mediante cultivo, reacción en cadena de la polimerasa en tiempo real (RT-PCR) o contrainmunoelectroforesis (CIE). Las cepas de meningococo aisladas (n=15) presentaban el fenotipo C: 23: P1.14-6 y mostraron estrecha relación genética por PFGE. La caracterización de MLST demostró que las cepas eran ST 3780, complejo ST-103 y eran susceptibles a los antibióticos probados. La vacunación se administró a 15.848 personas en la refinería y a 18.571 personas de la comunidad. Conclusiones La caracterización molecular de las cepas de N. meningitidis, la investigación eficaz y rápida y las medidas implementadas fueron esenciales para controlar la enfermedad en la región (AU)

Outbreak of Neisseria meningitidis C in a Brazilian oil refinery involving an adjacent community.

BACKGROUND: An outbreak of serogroup C meningococcal disease (MD) that involved employees from an oil refinery occurred in Paulínia, from March to June 2010, and spread to the community of Cosmópolis, both situated in São Paulo State, Brazil. The aim of this study was to describe the epidemiological and laboratory aspects, and the control measures that were implemented. METHODS: Descriptive and molecular epidemiological analysis was used to define the extent of the outbreak and the common risk factors among outbreak related cases. Vaccination initiative targeted the employees from the oil refinery and the community-based individuals. RESULTS: A total of six outbreak-related cases of MD in the oil refinery and 12 cases in the city of Cosmópolis, São Paulo State occurred in a three-month period. All 18 MD cases were confirmed as serogroup C either by culture, real time polymerase chain reaction (RT-PCR), or counterimmunoelectrophoresis (CIE). The meningococcal isolates (n=15) had the phenotype C:23:P1.14-6 and showed close genetic relationship by pulsed field gel electrophoresis (PFGE). Multilocus sequence typing (MLST) characterization showed that the clones were ST 3780, ST-103 complex. The isolates were susceptible to the antibiotics tested. Vaccination was administered to 15,848 persons at the oil refinery and 18,571 persons of the community. CONCLUSIONS: The molecular characterization of the Neisseria meningitidis (N. meningitidis) strains, and the efficient investigation and the prompt measures implemented were essential for controlling the disease in the region.