Skip to content
1887

Journal of Medical Microbiology logo Journal of Medical Microbiology

Volume 74, Issue 3

Geographical and temporal variations of serogroups and clonal types of involved in culture-confirmed invasive meningococcal disease in Canada, 2015–2023 Open Access

Abstract

Invasive meningococcal disease (IMD) is a nationally notifiable illness in Canada due to its potential severity and transmissibility. Vaccination strategies differ by province/territory and are informed by changes in the antigenic characteristics of circulating strains.

Though IMD statistics are tracked at a provincial/territorial level, there is a lack of published data characterizing trends in the epidemiology of this disease at a national level.

To examine the epidemiology of culture-confirmed IMD in Canada during the period of 2015–2023.

Meningococcal isolates sent to the National Microbiology Laboratory Branch between 2015 and 2023 as part of routine national surveillance were characterized for serogroup by bacterial agglutination and genetic methods. Clonal analysis was done by MLST. Demographic information was derived from requisition forms accompanying the samples.

The proportion of IMD caused by serogroup W meningococci (MenW) in 2015–2023 was 30.0% with more (62.9%) MenW cases detected in western provinces. Serogroup B meningococci (MenB) IMD was more common (53.4%) in Quebec and Atlantic Canada. Clonal analysis reveals 168 distinct sequence types between 2015 and 2023, with 103 belonging to MenB. The average age of MenB cases during this time was 29.1 years, significantly younger than serogroup C (MenC) (45.3 years), serogroup Y (MenY) (48.3 years) and MenW (43.0 years) patients. Additionally, 31.5% of MenB and 21.7% of MenC IMD isolates were collected from cerebrospinal fluid (CSF) or brain samples, which were significantly higher than that for MenY (12.2%) and MenW (7.3%) isolates.

Results from this and previous studies showed temporal and geographical variations in the serogroups causing IMD in Canada. MenB also showed the most genetic diversity, caused IMD in a significantly younger population and was more often isolated from CSF and brain samples than other serogroups.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): clonal analysis , serogroup , invasive meningococcal disease and temporal and geographical variations
© 2025 Crown Copyright
  • This is an open-access article distributed under the terms of the Creative Commons Attribution License. This article was made open access via a Publish and Read agreement between the Microbiology Society and the corresponding author’s institution.
Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001979
2025-03-12
2026-02-09

Metrics

Loading full text...

Full text loading...

/deliver/fulltext/jmm/74/3/jmm001979.html?itemId=/content/journal/jmm/10.1099/jmm.0.001979&mimeType=html&fmt=ahah

References

  1. Deeks S, Tam T, Wilson S. On behalf of the pubic health agency of canada Guidelines for the prevention and control of meningococcal disease. CCDR 2005; 31:1–26
     [Google Scholar]
  2. Saboui M, Tsang RSW, Mac Tavish R, Agarwal A, Li YA et al. Epidemiology of invasive meningococcal disease in canada, 2012–2019. CCDR 2022; 48:228–236
     [Google Scholar]
  3. Voss SS, Nielsen J, Valentiner-Branth P. Risk of sequelae after invasive meningococcal disease. BMC Infect Dis 2022; 22:148 [View Article] [PubMed]
     [Google Scholar]
  4. Harrison LH, Trotter CL, Ramsay ME. Global epidemiology of meningococcal disease. Vaccine 2009; 27 Suppl 2:B51–63 [View Article] [PubMed]
     [Google Scholar]
  5. Li YA, Tsang R, Desai S, Deehan H. Enhanced surveillance of invasive meningococcal disease in Canada, 2006-2011. Can Commun Dis Rep 2014; 40:160–169 [View Article] [PubMed]
     [Google Scholar]
  6. Tsang RSW, Law DKS, Saul D, Hoang L. Ciprofloxacin-resistant Neisseria meningitidis in Canada: likely imported strains. Can J Microbiol 2017; 63:265–268 [View Article] [PubMed]
     [Google Scholar]
  7. Tsang RSW, Hoang L, Tyrrell GJ, Horsman G, Van Caeseele P et al. Increase in Neisseria meningitidis serogroup W invasive disease in Canada: 2009–2016. Can Commun Dis Rep 2017; 43:144–149 [View Article]
     [Google Scholar]
  8. Tsang RSW, Ahmad T, Tyler S, Lefebvre B, Deeks SL et al. Whole genome typing of the recently emerged canadian serogroup W Neisseria meningitidis sequence type 11 clonal complex isolates associated with invasive meningococcal disease. Int J Infect Dis 2018; 69:55–62 [View Article] [PubMed]
     [Google Scholar]
  9. Tsang RSW, Ahmad T, Jamieson FB, Tyrrell GJ. WGS analysis of a penicillin-resistant neisseria meningitidis strain containing a chromosomal ROB-1 β-lactamase gene. J Antimicrob Chemother 2019; 74:22–28 [View Article] [PubMed]
     [Google Scholar]
  10. Tsang RSW, Law KS, Zhou K, Haldane D, Garceau R et al. Characterization of invasive meningococcal disease case isolates in Atlantic Canada, 2014 to 2020: spatial-temporal variations of clones and predicted meningococcal B vaccine coverage. J Med Microbiol 2022; 71:001615 [View Article] [PubMed]
     [Google Scholar]
  11. Tsang RSW, Deceuninck G, Meilleur C, Zhou J, Lefebvre B et al. Temporal variations in the serogroup distribution of invasive meningococcal disease in Quebec, Canada, due to emerging unique clade of serogroup Y strain belonging to the Sequence Type-23 clonal complex. J Infect 2024; 88:106163 [View Article] [PubMed]
     [Google Scholar]
  12. Zhou J, Lefebvre B, Deng S, Gilca R, Deceuninck G et al. Invasive serogroup B Neisseria meningitidis in Québec, Canada, 2003 to 2010: persistence of the st-269 clone since it first emerged in 2003. J Clin Microbiol 2012; 50:1545–1551 [View Article]
     [Google Scholar]
  13. Ibarz-Pavón AB, Maclennan J, Andrews NJ, Gray SJ, Urwin R et al. Changes in serogroup and genotype prevalence among carried meningococci in the United Kingdom during vaccine implementation. J Infect Dis 2011; 204:1046–1053 [View Article] [PubMed]
     [Google Scholar]
  14. Sanogo YO, Guindo I, Diarra S, Retchless AC, Abdou M et al. A New Sequence Type of neisseria meningitidis serogroup C associated with a 2016 meningitis outbreak in mali. J Infect Dis 2019; 220:S190–S197 [View Article]
     [Google Scholar]
  15. Ashton FE, Ryan A, Borczyk A, Caugant DA, Mancino L et al. Emergence of a virulent clone of Neisseria meningitidis serotype 2a that is associated with meningococcal group C disease in Canada. J Clin Microbiol 1991; 29:2489–2493 [View Article] [PubMed]
     [Google Scholar]
  16. Law DKS, Lorange M, Ringuette L, Dion R, Giguère M et al. Invasive meningococcal disease in Quebec, Canada, due to an emerging clone of ST-269 serogroup B meningococci with serotype antigen 17 and serosubtype antigen P1.19 (B:17:P1.19). J Clin Microbiol 2006; 44:2743–2749 [View Article] [PubMed]
     [Google Scholar]
  17. Jolley K, Brehony C, Maiden MC. Molecular typing of meningococci: recommendations for target choice and nomenclature. FEMS microbiology reviews 2007 [View Article]
     [Google Scholar]
  18. Caugant DA, Maiden MCJ. Meningococcal carriage and disease--population biology and evolution. Vaccine 2009; 27 Suppl 2:B64–70 [View Article] [PubMed]
     [Google Scholar]
  19. Rivacoba MC, Villena R, Hormazabal JC, Benadof D, Payá E et al. Hypervirulent strains of neisseria meningitidis and clinical manifestations in children with invasive meningococcal disease. Pediatr Infect Dis J 2023; 42:660–666 [View Article] [PubMed]
     [Google Scholar]
  20. Maiden MC, Bygraves JA, Feil E, Morelli G, Russell JE et al. Multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. Proc Natl Acad Sci U S A 1998; 95:3140–3145 [View Article] [PubMed]
     [Google Scholar]
  21. Desai S, Baclic O, Crowcroft N, Henry B, Rotondo J et al. An advisory committee Statement (ACS) national advisory Committee on immunization’s update on quadrivalent meningococcal vaccines available in Canada. Ottawa, Canada: The Public Health Agency of Canada; 2015 http://www.healthycanadians.gc.ca/publications/healthy-living-vie-saine/meningococcal-vaccines-quadrivalent-vaccins-meningocoque-2015/alt/meningococcal-vaccines-quadrivalent-vaccins-meningocoque-2015-eng.pdf
  22. Finne J, Bitter-Suermann D, Goridis C, Finne U. An IgG monoclonal antibody to group B meningococci cross-reacts with developmentally regulated polysialic acid units of glycoproteins in neural and extraneural tissues. J Immunol 1987; 138:4402–4407 [PubMed]
     [Google Scholar]
  23. Serruto D, Bottomley MJ, Ram S, Giuliani MM, Rappuoli R. The new multicomponent vaccine against meningococcal serogroup B, 4cmenb: immunological, functional and structural characterization of the antigens. Vaccine 2012; 2:B87–B97
     [Google Scholar]
  24. Gandhi A, Balmer P, York LJ. Characteristics of a new meningococcal serogroup B vaccine, bivalent rLP2086 (MenB-FHbp; Trumenba®). Postgrad Med 2016; 128:548–556 [View Article] [PubMed]
     [Google Scholar]
  25. De Wals P. Epidemiology and control of Meningococcal disease in Canada: a long, complex, and unfinished Story. Canadian Journal of Infectious Diseases and Medical Microbiology 2019; 2019:1–11 [View Article]
     [Google Scholar]
  26. National Advisory Committee on Immunization Statement on the recommended use of meningococcal vaccines. CCDR 2001; 27:2–36
     [Google Scholar]
  27. Government of Canada Provincial and territorial routine and catch-up vaccination schedule for infants and children in Canada; 2023 https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information/provincial-territorial-routine-vaccination-programs-infants-children.html accessed 16 May 2024
  28. Public Health Agency of Canada Provincial and territorial routine and catch-up vaccination schedule for infants and children in Canada; 2024 https://www.canada.ca/en/public-health/services/provincial-territorial-immunization-information/provincial-territorial-routine-vaccination-programs-infants-children.html accessed 21 October 2024
  29. Tsang RSW, Law DKS, De Paola R, Giuliani M, Stella M et al. Culture-confirmed Invasive meningococcal disease in Canada, 2010 to 2014: Characterization of Serogroup B Neisseria meningitidis strains and their predicted coverage by the 4CMenB vaccine. mSphere 2020; 5:e00883-19 [View Article] [PubMed]
     [Google Scholar]
  30. Statistics Canada Table 17-10-005-01: population estimates on July 1st in Canada by provinces, both sexes. Statistics Canada, Ottawa, Canada 2024 https://www150.statcan.gc.ca/t1/tbl1/en/tv.action?pid=1710000501 accessed 29 October 2024
     [Google Scholar]
  31. Matthews TC, Bristow FR, Griffiths EJ, Petkau A, Adam J et al. The Integrated Rapid Infectious Disease Analysis (IRIDA) Platform. bioRxiv 2018 [View Article]
     [Google Scholar]
  32. Jolley KA, Maiden MCJ. BIGSdb: Scalable analysis of bacterial genome variation at the population level. BMC Bioinformatics 2010; 11:595 [View Article] [PubMed]
     [Google Scholar]
  33. Tenny S, Hoffman MR. Odds Ratio Treasure Island (FL): StatPearls Publishing; 2023 May 22. In: StatPearls [Internet] [PubMed]
     [Google Scholar]
  34. GraphPad Software (2009) Prism 5 for Windows5.03 2009 www.graphpad.com
  35. Statistics Kindgom Statistics online; 2017 https://www.statskingdom.com/index.html
  36. Microsoft Excel Microsoft Corporation; 2016 https://office.microsoft.com/excel
  37. Fraser Health News Release Interior health authority declared an invasive meningococcal disease outbreak in their Okanagan health service delivery areas. December 18, 2017; 2017 https://www.fraserhealth.ca/news/2017/Dec/meningococcal-outbreak-in-interior-health accessed 26 October 2024
  38. Manitoba Health Meningococcal disease (Neisseria meningitidis); 2024 https://www.gov.mb.ca/health/publichealth/diseases/meningococcus.html
  39. Tsang RSW, Deeks SL, Wong K, Marchand-Austin A, Jamieson FB. Invasive serogroup W Neisseria meningitidis (MenW) in Ontario, Canada shows potential clonal replacement during the period January 1, 2009 to June 30, 2016. Can Commun Dis Rep 2016; 42:263–266 [View Article] [PubMed]
     [Google Scholar]
  40. Valenzuela MT, Moreno G, Vaquero A, Seoane M, Hormazábal JC et al. Emergence of W135 meningococcal serogroup in Chile during 2012. Rev Med Chil 2013; 141:959–967 [View Article] [PubMed]
     [Google Scholar]
  41. Hong E, Barret A-S, Terrade A, Denizon M, Antona D et al. Clonal replacement and expansion among invasive meningococcal isolates of serogroup W in France. J Infect 2018; 76:149–158 [View Article] [PubMed]
     [Google Scholar]
  42. Lucidarme J, Hill DMC, Bratcher HB, Gray SJ, du Plessis M et al. Genomic resolution of an aggressive, widespread, diverse and expanding meningococcal serogroup B, C and W lineage. J Infect 2015; 71:544–552 [View Article] [PubMed]
     [Google Scholar]
  43. Comité sur l’Immunisation du Québec Avis sur la pertinence d’une intervention visant à contrôler une incidence elevée d’infections invasives à méningocoque de sérogroupe B dans l’est du québec. Quebec City, Canada: Institut National de Santé Publique du Québec; 2014 https://www.inspq.qc.ca/publications/1801
  44. De Wals P, Deceuninck G, Lefebvre B, Tsang R, Law D et al. Impact of an Immunization Campaign to Control an Increased Incidence of Serogroup B meningococcal disease in one region of Quebec, Canada. Clin Infect Dis 2017; 64:1263–1267 [View Article] [PubMed]
     [Google Scholar]
  45. Tsang RSW, Law DKS, Gad R, Mailman T, German G et al. Characterization of invasive Neisseria meningitidis from Atlantic Canada, 2009 to 2013: With special reference to the nonpolysaccharide vaccine targets (PorA, factor H binding protein, Neisseria heparin-binding antigen and Neisseria adhesin A). Can J Infect Dis Med Microbiol 2015; 26:299–304 [View Article] [PubMed]
     [Google Scholar]
  46. Dalhousie University Public health investigating two cases of meningococcal disease at dalhousie university, death of one student; 2022 https://www.dal.ca/news/2022/12/16/public-health-investigating-two-cases-of-meningococcal-disease-a.html accessed 27 October 2024
  47. Government of Nova Scotia Health and wellness news release. More Nova Scotians Eligible for Meningococcal B Vaccine; 2023 https://news.novascotia.ca/en/2023/05/25/more-nova-scotians-eligible-meningococcal-b-vaccine accessed 10 May 2024
  48. Nova Scotia Health Nova scotia meningococcal B vaccine program B vaccine program; 2024 https://physicians.nshealth.ca/sites/default/files/2024-06/Men%20B%20vaccine_FAQ%20for%20Youth_June%202024.pdf accessed 27 October 2024
  49. Pham-Huy A, Zafack J, Primeau C, Baclic O, Salvadori M et al. Advisory committee statement. A national advisory committee on immunization (NACI) update on invasive meningococcal disease (IMD) epidemiology and program-relevant considerations for preventing IMD in individuals at high risk of exposure. CCDR 2023; 49:358–367 [View Article]
     [Google Scholar]
  50. Oviedo-Orta E, Ahmed S, Rappuoli R, Black S. Prevention and control of meningococcal outbreaks: the emerging role of serogroup B meningococcal vaccines. Vaccine 2015; 33:3628–3635 [View Article] [PubMed]
     [Google Scholar]
  51. US Centers for Disease Control and Prevention (CDC) Health Alert Network Increase in invasive serogroup Y meningococcal disease in the United States; 2024 https://emergency.cdc.gov/han/2024/han00505.asp accessed 27 October 2024
  52. Law DKS, Stoltz J, Henderson AM, Tsang RSW. Antigenic and genetic characterization of serogroup C meningococci isolated from invasive meningococcal disease cases in Canada from 1999 to 2003. Can J Microbiol 2005; 51:523–530 [View Article] [PubMed]
     [Google Scholar]
  53. Diggle MA, Clarke SC. Increased genetic diversity of Neisseria meningitidis isolates after the introduction of meningococcal serogroup C polysaccharide conjugate vaccines. J Clin Microbiol 2005; 43:4649–4653 [View Article] [PubMed]
     [Google Scholar]
  54. Campbell H, Andrews N, Parikh S, Ribeiro S, Gray S et al. Variable clinical presentation by the main capsular groups causing invasive meningococcal disease in England. J Infect 2020; 80:182–189 [View Article] [PubMed]
     [Google Scholar]
  55. Gyamfi-Brobbey G, Clark SA, Campbell H, Lekshmi A, Ribeiro S et al. An analysis of Neisseria meningitidis strains causing meningococcal septic arthritis in England and Wales: 2010–2020. J Infect 2022; 85:390–396 [View Article]
     [Google Scholar]
  56. Masson-Behar V, Jacquier H, Richette P, Ziza J-M, Zeller V. Arthritis secondary to meningococcal disease a case series of 7 patients. Med 2017; 96:e7573 [PubMed]
     [Google Scholar]
/content/journal/jmm/10.1099/jmm.0.001979
Loading
Geographical and temporal variations of serogroups and clonal types of Neisseria meningitidis involved in culture-confirmed invasive meningococcal disease in Canada, 2015–2023
J. Med. Microbiol. 74, 001979 (2025); https://doi.org/10.1099/jmm.0.001979
/content/journal/jmm/10.1099/jmm.0.001979
/content/journal/jmm/10.1099/jmm.0.001979
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF

Most cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An error occurred
Approval was partially successful, following selected items could not be processed due to error