Umrah- and travel-associated meningococcal disease due to multiple serogroup W ST-11 sub-strains pre-Hajj 2024
Bibliographic record
Abstract
OBJECTIVES: Collectively, the Hajj and Umrah pilgrimages draw >30 million pilgrims to the Kingdom of Saudi Arabia (KSA) each year. Before Hajj 2024 (14 to 19 June), the meningococcal serogroup W ST-11 complex (W:cc11) Hajj-strain sublineage caused multiple international cases of invasive meningococcal disease (IMD) associated with travel to the Middle East and Asia. Here we identify and characterise the strains responsible. METHODS: All Hajj strain sublineage genomes on PubMLST.org underwent core genome MLST comparisons (PubMLST.org). RESULTS: Isolates from 30 cases, across seven countries, formed five phylogenetic clusters within two distinct strains. Travel histories included KSA, other Middle Eastern countries, India, Mauritius, Kenya via Turkey, and no known associated travel. The prevalent strain, representing four clusters, had no African, and limited Middle Eastern, representation. The geo-temporal distribution of available genomes indicated Eastern Europe as a possible source. CONCLUSIONS: The rapid expansion of Umrah/travel-related W:cc11 IMD cases in early 2024 was due to multiple strains/sublineages. Despite the involvement of non-KSA travel-destinations, the coincidence of cases with the busy month of Ramadan, and the abrupt cessation during Hajj (when vaccine compliance is maximal), suggest that Umrah was a key driver and highlight the need to reinforce mandatory vaccination whilst maintaining global vigilance.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".