We reported 2 cases of fatal W135 meningococciemia in Hajj pilgrims 1995 (1). We, were, to our knowledge, the first to highlight the need for vaccination for Neisseria meningitidis type W135 to be included in the polyvalent vaccination to prevent meningococcal infection among Hajj pilgrims. It was not until an epidemic involving this organism in 2000 among Hajj pilgrims that polyvalent meningococcal vaccine including serogroup W135 was widely manadated and since then there is very good control of meningococcal infection in this population of patients.
Does anyone in the researchgate community of medical researcher know any report of meningococcal infection by serogroup W135 before our report?
1. Yousuf M, Nadeem A. Fatal meningococcaemia due to group W135 amongst
Hajj pilgrims: implications for future vaccination policy. Ann Trop Med Parasitol
1995;89:321-322.
Short answer is No. I conducted an extensive literature survey last year and your two papers Ann Trop Med 1995 and J Pak Med Ass 2000 were the earliest reports of W135 in the region. Unfortunately, I was unable to access the full text of the Ann Trop Med 1995 paper so I ended up citing only the JPMA paper.
A lot of infectious disease prevention is reactive because it is difficult to justify costly immunization campaigns when the preponderance of evidence suggested low epidemc potential for W at the time. However, with hind sight one could say meningococcal ought to have been strengthened in the 1990s especially in light of the 1987 epidemics. Earlier detection of the epidemic strain could have reduced number of cases and possibly saved lives.
http://dx.doi.org/10.1016/j.vaccine.2016.02.014
Note: A relatively recent paper reported a small W outbreak in Kuwait in 1989.
https://www.ncbi.nlm.nih.gov/pubmed/25779346
Serogroup W-135 meningococcal disease did definitely exist before the publication of your article. There are several strains in the UK historical invasive meningococcal isolate collection from the 1980's that express the W serogroup and are from the same clonal complex (cc11). The clone that circulating now is distinct from the Hajj clone and originated from S.America where it emerged in the early 2000s.
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