An attempt at an epidemiological explanation - Epib.nl

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Chapler 3was found in 1980 (B:NT:P1.4). After 1980 the proportion of P1.4 isolates increasedto 41% of all serogroup B isolates in 1990' From 1980 to 1985 subtype P1.4 wasmainly found in combination with serotype 4, but thereafter an increasing number ofNT strains and isolates with serotype 14 and 15 were encountered among P1.4isolates (Table 1).Tnble l. Distribution of scrotypes among 595 scrogroup B sUbtypc P1.4 meningococcal isolates,obtained in tbe Netherlands between 1958 and 1990No. of isolatcs in indicated ycar(s)Serotype
Evolution of meningococcal clonesTable 2. Distribution of clone li neage III among 101 scrogroup B meningococcal isolates, obtained inthe Netherlands between 1958 and 1990, according to phenotype and ycar(s) of recoveryNo. of isolates in indicated ycnr(s)Phenotype'Total no.of isolatestested< 1980Lineage:III other1980Lineage:III other1984·86Lineage:III other1990 ToLalLineage: Lineage:III other III otherB:4:P1.4B:14:P1.4B:15:P1.4B:NT:PL4B:4:NSTB:4:Pl.·'B:4:othcc"To tal199511l324210122318262246114242 31 1224 166 195 t 9I 3 24 8 33 5 822 5 3 3921 6 47 54tfNT = nonscrotypcablc; NST = nonsubtypcablcincludes onc B:4!14:P1.4 isolateno class 1 outer membrane protein presentsubtype other than P1.4 or NST; in lineage Ill: B:4:Pl.2 (1984), B:4:Pl.7 (1990) and B:4:PLl2(1990)other than PL4 differed from those of lineage Ill, with the exception of 3 isolateswhich were in lineage III (ET-24). These 3 isolates were all recovered after 1980 andexpressed the subtypes PL2 (recovered in 1985), PL7 (1990) and P1.12 (1990),respectively.Genotypic and phenotypic changes in lineage IIIThe first representatives of lineage III were encountered in 1980. During theperiod 1980-1983 only ET-24 was found in this lineage, but from 1984 onwards otherETs also appeared. The distribution of phenotypes over the various ETs of isolates oflineage III (n = 60) is shown in Table 3. From 1980 to 1983 ET-24 was solelyrepresented by isolates of the phenotype B:4:PL4, but subsequently isolates of tbeserotypes 14, 4/14, NT isolates, isolates of the subtypes P1.2, PL7, PL12 and NSTisolates appeared in this clone. The other ETs of lineage III were each representedby 1 to 8 isolates of various phenotypes, including B:4:PL4. All isolates of theseclones were of subtype Pl.4, with the exception of one ET-25 isolate recovered in1986, wbich was NST. This isolate, as well as the other 4 NST isolates of clonelineage Ill, expressed a class 1 OMP, indicating tbe presence of at least one otber,but yet unknown subtype among clones of lineage Ill.41
Page 1 and 2: An attempt at an epidemiological ex
Page 3 and 4: VRIJE UNIVERSITEITTHE INCREASED INC
Page 5 and 6: CONTENTSChapter 1 General introduct
Page 7 and 8: Chapter 1Meningococcal disease (MD)
Page 9 and 10: Chapter 1Antigenic variation in the
Page 11 and 12: Chapter 1by electrophoretic typing.
Page 13 and 14: Chapter 1is assumed to be the main
Page 15 and 16: CluJpter 1Study objectives and cont
Page 17 and 18: Chapter 125 Crowe BA. Wall RA. Kuse
Page 19 and 20: Chapter 170 Brandtzacg P, Kicrulf P
Page 21 and 22: Chapler 2ABSTRACfIn order to explai
Page 23 and 24: Chapter 2MATERIALS AND METHODSBacte
Page 25 and 26: Chapter 2Table 2. An nual number of
Page 27 and 28: Chapter 2the age-distribution to ol
Page 29 and 30: Chapter 2of serotype 4 strains vari
Page 31 and 32: Chapter 2Table 6. Relative distribu
Page 33 and 34: Chapter 2endemicity in the Netherla
Page 35 and 36: Chapter 2REFERENCESde Marie S. Epid
Page 37 and 38: CHAPTER 3PHENOTYPIC AND GENOTYPIC C
Page 39 and 40: Evolution of meningococcal cionesIN
Page 41: Evolution of meningococcal clonesme
Page 45 and 46: Evolution of meningococcal clonesli
Page 47 and 48: CHAPTER 4LIPOOLIGOSACCHARIDE IMMUNO
Page 49 and 50: LOS immunotyping of N. meningitidis
Page 57 and 58: LOS immunolyping of N. meningilidis
Page 59 and 60: LOS immunolyping of N. meningilidis
Page 65 and 66: Chapter 5ABSTRACfThe aim of this pr
Page 67 and 68: Chapter 5tive lung disease, chronic
Page 69 and 70: Chapter 5distribution of the clinic
Page 71 and 72: Chapter 5The striking difference in
Page 73 and 74: Chapter 510-19 and ~50 years, in wh
Page 75 and 76: Chapter 5REFERENCES1 Andersen BM. M
Page 77 and 78: Chapter 6ABSTRACfObjectives: To ass
Page 79 and 80: Chapter 6PATIENTS AND METHODSThis s
Page 81 and 82: Chapler 6case. In 28 household cont
Page 83 and 84: Chapter 6rifampicin witb oral contr
Page 85 and 86: CHAPTER 7GENERAL DISCUSSION ANDRECO
Page 87 and 88: General discussionexample of the ab
Page 89 and 90: General discussionPossible changes
Page 91 and 92: General discussionBrazilian study,
Page 93 and 94:
General discussionIt is very diffic
Page 95 and 96:
General discussionREFERENCES1 Pelto
Page 97 and 98:
SUMMARY
Page 99 and 100:
Summaryemergence of a meningococcal
Page 101 and 102:
Summaryexplains part of the rise. T
Page 103 and 104:
SamenvattingMeningokokkenziekte (me
Page 105 and 106:
Samenvatting57 isolaten was bet imm
Page 107 and 108:
AFFILIATIONS OF CO-AUTHORSHenk A. B
Page 109 and 110:
DaJl /..:woordVele" hebben meegewer
Page 111:
DanklVoordMijD ouders dank ik voor
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An attempt at an epidemiological explanation - Epib.nl

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