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

Raymond S W Tsang; Genevieve Deceuninck; Courtney Meilleur; Jianwei Zhou; Brigitte Lefebvre; Philippe De Wals

doi:10.1016/j.jinf.2024.106163

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 Apr 24;88(6):106163. doi: 10.1016/j.jinf.2024.106163. Online ahead of print.

Authors

Raymond S W Tsang¹, Genevieve Deceuninck², Courtney Meilleur³, Jianwei Zhou³, Brigitte Lefebvre⁴, Philippe De Wals⁵

Affiliations

¹ Vaccine Preventable Bacterial Disease, Reference Science and Surveillance Directorate, National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada. Electronic address: raymond.tsang@phac-aspc.gc.ca.
² Axe Maladies infectieuses et immunitaires, Centre de recherche du CHU de Québec - Université Laval, Québec City, Québec, Canada; Direction des risques biologiques, Institut National de Santé Publique du Québec, Québec City, Québec, Canada.
³ Vaccine Preventable Bacterial Disease, Reference Science and Surveillance Directorate, National Microbiology Laboratory Branch, Public Health Agency of Canada, Winnipeg, Manitoba, Canada.
⁴ Laboratoire de santé publique du Québec, Institut nationale de sante publique du Québec, Sainte-Anne-de-Bellevue, Québec, Canada.
⁵ Department of Social and Preventive Medicine, Laval University, Québec City, Québec, Canada.

PMID: 38670267
DOI: 10.1016/j.jinf.2024.106163

Abstract

Objective: To identify recent trends in invasive meningococcal diseases (IMD) in Quebec, Canada, with a focus on MenY cases and MenY strains.

Methods: IMD cases and MenY strains from January 1, 2015 to August 11, 2023 were analyzed for clonal analysis and prediction of susceptibility to MenB vaccines. MenY strains of ST-23 CC from Quebec were analyzed with global MenY strains by core-genomic multi-locus sequence typing (cg-MLST).

Results: Since 2015 the serogroup distribution of IMD in Quebec has shifted from predominantly MenB to mainly MenY, with most (80.9 %) of the latter belonging to ST-23 CC. The median age of MenY cases due to ST-23 CC were statistically younger than MenY cases due to non-ST-23 CC. MenY of ST-23 CC showed genetic diversity and the major genetic cluster were similar to the Swedish Y1 strain. The increase in invasive MenY disease in Quebec was due to a sub-clade of Lineage 23.1 which caused an elevated proportion of severe disease in young adults.

Conclusion: The increase in invasive MenY disease in Quebec, Canada was driven by the expansion of a sub-clade of Lineage 23.1 in young adults. Currently available quadrivalent A,C,W,Y-conjugate meningococcal vaccines were predicted to provide protection against these strains.

Keywords: Core-genome multi-locus sequence typing; Invasive meningococcal disease; ST-23 CC; Vaccine protection.