Neisseria meningitidis serogroup C clonal complex 10217 outbreak in West Kpendjal prefecture, Togo 2019

In early 2019, a NmC outbreak was detected in the Savanes region of Togo and its investigation is described here. Under case-based surveillance, epidemiological and clinical data, and cerebrospinal fluid specimens were collected for every suspected case of meningitis. Specimens were tested for meningitis pathogens using confirmatory microbiological and molecular methods. During epidemic weeks 9-15, 199 cases were reported, with 178 specimens being available for testing and 173/178 specimens (97.2%) were tested by at least one confirmatory method. The NmC was the predominant pathogen confirmed (up to 93.9%), belonging to sequence type (ST)-9367 of clonal complex (CC) 10217. All NmC cases were localized to the West Kpendjal district of the Savanes region with attack rates ranging from 4.1 to 18.8 per 100,000 population and case fatality rates ranging up to 2.2% during weeks 9-15. Of the 92 NmC confirmed cases, 63% were males and 88% were in the 5-29 age group. This is the first report of a NmC meningitis outbreak in Togo. For the phylogenetic analysis, Togo outbreak isolates determined to be CC10217 were compared against 216 invasive CC10217 isolates collected from meningitis belt countries between 2013-2019.