Table 3.
Characteristics of meningococcal outbreaks/epidemics in the Americas 1997–2020
| Region | Outbreak years | Serogroup | Age group primarily affected | No. of cases | Attack rate per 100,000 | CFR (%) | Vaccine intervention | Outcome of intervention | Ref |
|---|---|---|---|---|---|---|---|---|---|
| USA | |||||||||
| Community outbreaks | |||||||||
| Illinois | 1996 | C | 3–6 y | 4 | < 10 y: 205 | – | All children from 2 y through 8th grade | No further cases for 16 months | [65] |
| Florida | 1998 | C | 2–18 y | 12 | 15 | 17 | MenACWY-PS for 2–22 y | 1 case in a vaccinee, 4 non-vaccinated cases after the campaign | [66] |
| Florida | 2008–2009 | W | Adults | 14 | – | 29 | None | – | [124] |
| University and college outbreaks | |||||||||
| Ohio | 2008–2010 | B | 18–23 y | 13 |
13 Freshmen: 50 Greek Club members: 60 |
8 | No vaccine available | Outbreak spanned 3 years | [125] |
| Oklahoma | 2010 | C | 5–7 y | 5 | 162 | 40 |
MenACWY-CV for 4–18 y MenACWY-PS for > 55 y |
No further cases identified up to end of the month | [126] |
| New Jersey | 2013–2014 | B | 17–21 y | 9 | 134 | 11 | 4CMenB for enrolled students | No MenB cases in vaccinated persons (at least 1 dose) | [67] |
| California | 2013 | B | – | 4 | – | – | 4CMenB | Led to accelerated FDA approval of MenB vaccines | [127] |
| Rhode Island | 2015 | B | – | 2 | 44 | 0 | 3 doses of MenB-fHbp | No further college-associated cases | [128] |
| Oregon | 2015 | B | Undergraduate students | 7 | 30.5 | 14 | MenB-FHbp | No further cases | [69] |
| California | 2016 | B | Undergraduate students | 3 | – | 0 | 4CMenB for students, faculty and staff | No additional cases | [129] |
| Pennsylvania | 2017 | B | Undergraduate students | 2 | – | 0 | 4CMenB campus-wide | No additional cases | [15] |
| Canada | |||||||||
| Alberta | 1999–2001 | C | < 24 y | 61 |
0–1 y: 50 15–19 y: 35.7 |
3 | MenACWY-PS for 2–19 y and for 2–24 y in a second round | 9 cases in vaccinees and 9 in unvaccinated post-campaign. Vaccine effectiveness 84% | [17] |
| Quebec City | 2001 | C | 2 m–20 y | 58 | – | – | MenC-CV for 2–20 y |
Vaccine effectiveness 96.8% (95%CI 75.0–99.9) MenC-CV licensure fast-tracked for use |
[70] |
| British Columbia | 2001 | C | 17–27 y | 9 | – | 22 | MenC-CV for 13–29 y | – | [130] |
| Saguenay–Lac-Saint-Jean | 2006–2013 | B | ≤ 20 y | 74 | – | 0 | 4CMenB for 2 m–20 y | No further cases in the target age group | [18] |
| Nova Scotia | 2015 | B | University students | 2 | – | 50 | 4CMenB for all students, faculty, staff | Development of a rapid surveillance system for health events after mass vaccination | [72] |
| British Columbia | 2017 | W | 15–19 y | 5 | – | – | MenACWY-CV for 15-19y residents | No further cases in 2018 | [74] |
| Mexico | |||||||||
| Tijuana | 2013 | C | > 13 y | 19 | 1.07 | 37 | No vaccine intervention | – | [73, 75] |
| Brazil | |||||||||
| Santa Catarina State | 2001 | C | 15–19 y | 8 | 367.5 | 13 | Vaccination of all inhabitants > 2 y with MenAC-PS | No new cases for 12 months after vaccination | [131] |
| Heliópolis community, São Paulo State | 2007 | C | ≤ 9 y | 3 | 89.5 | 0 | House to house vaccination up to 14 y | – | [91] |
| Rio Verde, Goias State | 2008 | C | 1–19 y | 16 |
12 (residents) 77 (1–4 y) 60 (food processing plant workers) |
31 | MenAC-PS for food plant workers | 4 additional cases within 2 months of whom 3 had contact with food plant workers | [20] |
| Trancoso, Bahia State | 2009 | C | 14–25 y | 9 | – | 67 | No vaccine intervention | – | [19] |
| Salvador, Bahia State | 2009 | C | – | 194 | 1.5 | 39 | MenC-CV for 10–24 y |
MenC-CV was introduced into Bahia state routine infant programme in 2010 Vaccine effectiveness 100% (10–24 y) |
[77] |
|
São Paulo State, Oil refinery A |
2010 | C |
Oil refinery workers, family members < 4 y |
18 | 34.1 | 16.7 | MenAC-PS mass vaccination of refinery workers | 9 new cases in close contacts after reaching 91% coverage of refinery workers necessitated an expanded programme for all aged 2 m–19 y | [76] |
| Oil refinery B | 2010 | C | 12 | 12.5 | 50 | No vaccine intervention | – | ||
| West Indies | |||||||||
| Trinidad | 1998 | B | < 5 y | 14 | – | 57 |
No vaccine available |
– | [132] |
4CMenB 4-component meningococcal serogroup B vaccine, CI confidence interval, CFR case fatality rate, CV conjugate vaccine, FDA Food and Drug Administration, FHbp factor H binding protein, Men meningococcal disease vaccine, m months of age, Men(A/C/W/Y) meningococcal vaccine containing one serogroup or combinations of serogroups A, C, W and Y, PS polysaccharide vaccine, Ref source reference, y years of age