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Cases of invasive meningococcal disease in Dijon

Between October 20 and November 8, 2016, two cases of invasive meningococcal disease (IMD) of serogroup W, one of which resulted in death, were reported to the Regional Health Agency (ARS) of Bourgogne-Franche-Comté among students at the University of Dijon. Antibiotic prophylaxis and vaccination were immediately initiated for close contacts. No direct contact between these students or their respective social circles was identified. The National Reference Center (CNR) for Meningococcal Diseases then reported to Santé publique France that these two students, along with three other cases reported in the department over the past twelve months, were carriers of the same clone that had recently emerged in France. It is linked to the strains of W-type IIM cases responsible for the increase in W-type IIM in South America starting in 2008/2009 and in the United Kingdom starting in 2009/2010. In the outbreak described in the United Kingdom, cases more often presented with atypical forms, including septic arthritis, respiratory infections (pneumonia, epiglottitis), or abdominal forms. The case fatality rate was also higher than for other serogroups. On December 22, 2016, the ARS was notified of a death in Belgium of a third student from the University of Dijon following a W IIM. Genotypic analysis by the Belgian National Reference Center will not be available until January, but there is a high probability that the strain belongs to the new variant, which is currently the predominant strain within serogroup W in France. The emergence of this third case of meningitis W in less than three months among the 30,000 students attending the Dijon campus indicates an epidemic situation (the occurrence within the same community, within a period of three months or less, of at least three cases with no direct contact between them, linked to identical strains or strains that cannot be differentiated, with a primary attack rate of at least 10 cases per 100,000) with the bacterium circulating in the community via asymptomatic carriers. A vaccination campaign, aimed at reducing the risk of further cases of WIM on campus, was decided upon the very next day by health authorities, in the presence of the relevant partners. This large-scale vaccination campaign was planned during the Christmas break, announced to the media on January 3, and launched on January 4. To achieve its goal, this campaign must vaccinate the vast majority of students.