{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:08:45Z","timestamp":1788754125477,"version":"build-2803163510"},"reference-count":19,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/publicdomain\/zero\/1.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>High quality surveillance data are important to monitor U.S. epidemiology of meningococcal disease. Enhanced Meningococcal Disease Surveillance (EMDS) was established in 2015 to collect additional data and isolates from reported cases.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Epidemiologic information and isolates obtained through EMDS for meningococcal disease cases reported through the National Notifiable Diseases Surveillance System (NNDSS) during 2015<jats:bold>\u2013<\/jats:bold>2019 were included in the analysis. Isolates were characterized by serogrouping and molecular typing using either Sanger sequencing or whole genome sequencing. Case fatality ratios (CFRs) were calculated using cases with known outcome as the denominator. Odds ratios (ORs) were calculated using logistic regression.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 1,806 meningococcal disease cases were reported during 2015<jats:bold>\u2013<\/jats:bold>2019. The average annual incidence was 0.11 cases per 100,000 population. For key variables already collected through NNDSS, EMDS improved completeness over NNDSS by 21%-39% each year during 2015\u20132019. Completeness of key variables in EMDS improved over time by an average of 18%. Testing of isolates submitted through EMDS showed that serogroups B and C were predominant in all five years. For serogroup B, the most common clonal complex (CC) was CC32 in 2015<jats:bold>\u2013<\/jats:bold>2017 and CC41\/44 in 2018<jats:bold>\u2013<\/jats:bold>2019; for serogroup C, CC11 was most common in 2015<jats:bold>\u2013<\/jats:bold>2017 and CC103 in 2018<jats:bold>\u2013<\/jats:bold>2019. The CFR was significantly lower for CC103 (6.7%) compared to other CCs (13.6%) (OR 0.44, 95% CI: 0.22\u20130.89).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>U.S. incidence of meningococcal disease remained low during 2015<jats:bold>\u2013<\/jats:bold>2019. Data and isolates obtained from EMDS supplement NNDSS and are critical to monitor U.S. meningococcal disease epidemiology.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0319940","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T17:54:09Z","timestamp":1749491649000},"page":"e0319940","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Enhanced Surveillance for Meningococcal Disease\u2014United States, 2015\u20132019"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0472-6314","authenticated-orcid":true,"given":"Amy B.","family":"Rubis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7887-1453","authenticated-orcid":true,"given":"Daya","family":"Marasini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Howie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Basanta","family":"Wagle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shalabh","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4922-3787","authenticated-orcid":true,"given":"Brittney","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8188-0323","authenticated-orcid":true,"given":"Sara","family":"Eisen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandip","family":"Shrestha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henju","family":"Marjuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy A.","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"issue":"8","key":"pone.0319940.ref001","doi-asserted-by":"crossref","first-page":"1276","DOI":"10.1093\/cid\/cix993","article-title":"Current epidemiology and trends in meningococcal disease-united states, 1996-2015","volume":"66","author":"JR MacNeil","year":"2018","journal-title":"Clin Infect Dis"},{"key":"pone.0319940.ref002","author":"Centers for Disease Control and Prevention"},{"issue":"3","key":"pone.0319940.ref003","doi-asserted-by":"crossref","first-page":"434","DOI":"10.3201\/eid2503.181574","article-title":"University-based outbreaks of meningococcal disease caused by serogroup B, United States, 2013-2018","volume":"25","author":"HM Soeters","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"pone.0319940.ref004","volume-title":"Risk factors for meningococcal disease among adults experiencing homelessness in Boston\u2014Massachusetts, 2016. Council of State and Territorial Epidemiologists Conference","author":"JO Otshudiema","year":"2017"},{"key":"pone.0319940.ref005","volume-title":"Investigation of invasive meningococcal disease outbreak among the homeless community in Los Angeles County","author":"M Adeyemo","year":"2011"},{"issue":"5","key":"pone.0319940.ref006","doi-asserted-by":"crossref","first-page":"756","DOI":"10.1093\/cid\/cix438","article-title":"Increased risk for meningococcal disease among men who have sex with men in the United States, 2012-2015","volume":"65","author":"TA Folaranmi","year":"2017","journal-title":"Clin Infect Dis"},{"key":"pone.0319940.ref007","doi-asserted-by":"crossref","unstructured":"Mbaeyi S, Bozio C, Duffy J. Meningococcal vaccination: recommendations of the Advisory Committee on Immunization Practices, United States, 2020. MMWR Recomm Rep 2020;69(No. RR-9):1\u201341.","DOI":"10.15585\/mmwr.rr6909a1"},{"issue":"9","key":"pone.0319940.ref008","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.3201\/eid2109.141333","article-title":"Twenty Years of Active Bacterial Core Surveillance","volume":"21","author":"G Langley","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"pone.0319940.ref009","author":"CDC","year":"2015"},{"key":"pone.0319940.ref010","first-page":"1","article-title":"Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"62","author":"AC Cohn","year":"2013","journal-title":"MMWR Recomm Rep"},{"key":"pone.0319940.ref011","author":"CDC","year":"2017"},{"key":"pone.0319940.ref012","author":"D Ingram","year":"2014"},{"key":"pone.0319940.ref013","author":"World Health Organization, Centers for Disease Control and Prevention US","year":"2011"},{"key":"pone.0319940.ref014","doi-asserted-by":"crossref","DOI":"10.3389\/fgene.2020.601870","article-title":"Web-based genome analysis of bacterial meningitis pathogens for public health applications using the bacterial meningitis genomic analysis platform (BMGAP)","volume":"11","author":"SA Buono","year":"2020","journal-title":"Front Genet"},{"key":"pone.0319940.ref015","author":"National Center for Health Statistics"},{"issue":"52","key":"pone.0319940.ref016","doi-asserted-by":"crossref","first-page":"7655","DOI":"10.1016\/j.vaccine.2021.11.004","article-title":"Serogroup B meningococcal disease in persons previously vaccinated with a serogroup B meningococcal vaccine - United States, 2014-2019","volume":"39","author":"HE Reese","year":"2021","journal-title":"Vaccine"},{"issue":"21","key":"pone.0319940.ref017","doi-asserted-by":"crossref","first-page":"2768","DOI":"10.1016\/j.vaccine.2019.04.020","article-title":"Case fatality rates of invasive meningococcal disease by serogroup and age: A systematic review and meta-analysis","volume":"37","author":"B Wang","year":"2019","journal-title":"Vaccine"},{"issue":"52","key":"pone.0319940.ref018","doi-asserted-by":"crossref","first-page":"7541","DOI":"10.1016\/j.vaccine.2021.11.035","article-title":"Serogroup A, C, W, and Y meningococcal disease in persons previously vaccinated with a serogroup ACWY meningococcal vaccine - United States, 2014-2018","volume":"39","author":"AE Blain","year":"2021","journal-title":"Vaccine"},{"issue":"7","key":"pone.0319940.ref019","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1093\/cid\/ciab358","article-title":"Acquisition of Ciprofloxacin Resistance Among an Expanding Clade of \u03b2-Lactamase-Positive, Serogroup Y Neisseria meningitidis in the United States","volume":"73","author":"CC Potts","year":"2021","journal-title":"Clin Infect Dis"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319940","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T17:54:13Z","timestamp":1749491653000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0319940"}},"subtitle":[],"editor":[{"given":"Nicole E.","family":"Basta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,9]]},"references-count":19,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0319940","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,9]]}}}