Abstract
Meningococcal meningitis poses a persistent public health threat globally, with evolving epidemic serogroups complicating prevention especially in China in recent years. On May 27, 2024, Hubei Province (central China) reported its first laboratory-confirmed case of serogroup Y Meningococcal meningitis in a student aged 14 from L County, E City. This study aimed to characterize the outbreak, identify transmission drivers, and provide evidence for targeted control strategies. A field investigation was conducted involving case definition (suspected/probable/confirmed cases, carriers), epidemiological interviews (symptom onset, vaccination history, exposures), and laboratory testing. We analyzed 199 close contacts and expanded sampling population via nucleic acid testing and bacterial culture. Isolated serogroup Y strains were subjected to whole-genome sequencing, phylogenetic analysis, and antibiotic susceptibility testing. One confirmed serogroup Y meningococcal meningitis case and 13 Neisseria meningitidis (Nm) carriers (Five serogroup Y) were identified. The index case (an eighth grade student) had completed the national serogroup A / serogroups A and C meningococcal vaccination schedule (last dose: 2016), but serogroup Y vaccination was absent in the index case and all classmates. Nucleic acid testing positivity of Nm was 6.5% (13/199) among contacts and expanded sampling population, with 2.5% (5/199) serogroup Y carriers. All five serogroup Y isolates (LF-strains) belonged to ST-1655 (ST-23 clonal complex) and were phylogenetically close to strains from other Chinese provinces. Antibiotic susceptibility testing confirmed susceptibility to six antibiotics (Penicillin, Ampicillin, Ciprofloxacin, Ceftriaxone, Azithromycin and Rifampicin). Emergency ACYW135 vaccination achieved 57.5% coverage in the affected school, with no secondary cases. This is the first report of serogroup Y Meningococcal meningitis in Hubei Province, caused by the hyper-invasive ST-1655 (ST-23 clonal complex). Adolescent immunity gaps to serogroup Y were the primary driver. To combat meningococcal meningitis in China, we recommend integrating serogroup Y into routine vaccination especially for adolescents, strengthening serogroup-specific surveillance, and enhancing local laboratory capacity for rapid meningococcal meningitis diagnosis.
Data availability
The original contributions presented in the study are included, further inquiries can be requested from the corresponding author for academic use.
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Funding
The author(s) declare that financial support was received for the research and/or publication of this article. This work was supported by Natural Science Foundation of Hubei Province (Grant No. 2024AFB1046); National Natural Science Foundation of China (Grant No. S2022CF11); Peking University–Merck Joint Laboratory of Infectious Disease Prevention and Control Technology Medical Innovation Fund (Grant No. 10001202401). National Key Research and Development Program of China (2021YFC2301600); the National Health Public Talent Program of the National Disease Control and Prevention Administration (Grant No. S2025CF02).
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Dan Li wrote the manuscript text and conducted the investigastion. Lei Wang guided the conduct of investigations and reviewed the manuscript. Jing Lv guided the the performance of experiments and reviewed the manuscript. Siquan Wang, Zhao Jiang and Xiang Zhang conducted the investigastion. Fei He, Bingqing Zhu and Hongmei Yang did the experiments.
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The authors declare that the research was conducted in the absence of any commercial or financial relationships that could.
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The requirement of ethical approval was waived by Hubei Provincial Center for Disease Control and Prevention for the studies involving humans because meningococcal meningitis is a statutory infectious disease in China. The research involves meningococcal meningitis outbreak response and is exempt from ethical review according to the Law of the People’s Republic of China on Prevention and Control of Infectious Diseases. This exemption is in accordance with the Declaration of Helsinki.
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This study involved public health outbreak response for a statutory infectious disease. All participants (or their guardians for minors) provided informed consent for epidemiological investigation, laboratory testing, and data collection. The study complied with the Declaration of Helsinki, and ethical approval was waived as per relevant regulations for infectious disease surveillance and response according to the Law of the People’s Republic of China on Prevention and Control of Infectious Diseases.
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Li, D., Wang, S., Jiang, Z. et al. First serogroup Y meningitis outbreak in Hubei Province Central China linked to adolescent immunization gaps. Sci Rep (2026). https://doi.org/10.1038/s41598-026-42174-y
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DOI: https://doi.org/10.1038/s41598-026-42174-y
