Objective  To understand the etiological characteristics of a death of suspected meningococcal meningitis in a boarding school in Fuyang, Anhui province, in January 2020, identify its transmission route and source of infection, and provide scientific evidence for the timely and effective control of the spread of the epidemic.

  Methods  On the basis of the diagnosis criteria for meningococcal meningitis (WS 295—2019), blood samples of the cases and throat swabs of close contacts were collected, and field inoculation, heat preservation and timely transfer of the samples were conducted for pathogen culture in laboratory, at the same time polymerase chain reaction (PCR) was used for specific identification of serogroup. K-B disk diffusion method and E-test strip method were used for antimicrobial susceptibility test. The homology of the strains was analyzed by pulsed field gel electrophoresis (PFGE).

  Results  A total of 13 strains of Neisseria meningitidis were isolated from the blood samples of cases and throat swabs of close contacts. All the strains belonged to serogroup W. The carriage rate of N. meningitidis W in close contacts was 66.67% (12/18). PFGE showed that the patterns of the strains isolated from the cases and close contacts were highly similar, and the similarity was 92.59%−100.00%. All the strains were sensitive to ceftriaxone, cefotaxime, chloramphenicol, rifampicin, meropenem, azithromycin, minocycline, intermediate to penicillin and ampicillin, and resistant to ciprofloxacin, compound sulfamethoxazole and levofloxacin.

  Conclusion  N. meningitidis W was detected in both the cases and the close contacts. Epidemiological investigation revealed that the death was the first case caused by infection of N. meningitidis W in Fuyang. The pathogen carriage rate in close contacts was high, suggesting the risk of epidemic caused by N. meningitidis W. It is necessary to strengthen the surveillance for N. meningitidis W, take timely intervention measures, and pay attention to the rational use of antibiotics.