Genetics in Meningococcal Disease: One Step Beyond

Extract

Neisseria meningitidis is the leading cause of meningitis and septicemia among young adults [1]. The incidence of meningococcal disease for high-income countries is 0.9-1.5 cases per 100,000 population [1]. For low-income countries, incidences are estimated to be much higher, with the highest burden occurring in sub-Saharan Africa (“the Meningitis Belt”), with rates of up to 1000 cases per 100,000 population [1]. The World Health Organization is committed to eliminating this important and preventable health problem [2].

Several risk factors for meningococcal disease have been identified, but the cause of basic differences in susceptibility and outcome between individuals and populations remains unknown. In the 1980s, studies of adopted children and twins revealed that genetics are major determinants of susceptibility to infectious diseases [3, 4]. Recently, several other studies further suggested that genetics play a role in susceptibility and outcome of meningococcal disease [5-7].

New techniques in genetic research emerged in the 1990s, creating useful tools for meningococcal disease. The standard for epidemiologic research has become multilocus sequence typing. Multilocus sequence typing analysis determines genetic variation in 7 housekeeping genes of the meningococcus and has shown that most cases of disease are caused by a few clonal complexes of related sequence types, the hypervirulent lineages [8, 9].