Serotypes of Neisseria meningitidis associated with an increased incidence of meningitis cases in the Hamilton area, Ontario, during 1978 and 1979

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Abstract
The distribution of serotypes among strains of N. meningitidis responsible for a marked increase of meningitis cases in the Hamilton area, Ontario, in 1978 and 1979 was determined. Serogroup B (26) and 2 serogroup W135 strains isolated from CSF, blood and skin of 28 patients were serotyped by agar gel double diffusion. Of the group B strains, 21 (81%) were serotype 2b as judged by the formation of characteristic serotype precipitin bands with the specific anti-2996 (type 2b) serum. Fourteen of the serotype 2b strains also reacted with anti-77252 serum, which suggested that 1 strain or several closely related strains were mainly responsible for the increase in meningitis during the 2 yr period. Examination of the outer membrane complexes (OMC) of the strains by sodium docecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) revealed that all 21 of the serotype 2b strains contained the class 2 protein (MW 41,500) which is the site of the serotype 2b determinant. Further characterization of the serotype 2b, 77252 strains by enzyme-linked immunosorbent assays and SDS-PAGE suggested that the 77252 determinant was present in the class 1 proteins of these strains. The serotype 2b containing strains were isolated from 77.7 and 70% of males an females, respectively, from 81.8% of children < 5 yr of age and from 75.0% of patients of all age groups. The study indicates the important role of serotype 2b meningococci in causing the increased incidence of meningitis, and further substantiates the important association of the serotype 2b determinant with group B serotype 2 meningococcal disease in Canada.