Distinct evolutionary patterns of Neisseria meningitidis serogroup B disease outbreaks at two universities in the USA Hao, Li and Holden, Matthew T. G. and Wang, Xin and Andrew, Lubomira and Wellnitz, Sabine and Hu, Fang and Whaley, Melissa and Sammons, Scott and Knipe, Kristen and Frace, Mike and McNamara, Lucy A. and Liberator, Paul and Anderson, Annaliesa S.,, 4, e000155 (2018), doi = https://doi.org/10.1099/mgen.0.000155, publicationName = Microbiology Society, issn = , abstract= Neisseria meningitidis serogroup B (MnB) was responsible for two independent meningococcal disease outbreaks at universities in the USA during 2013. The first at University A in New Jersey included nine confirmed cases reported between March 2013 and March 2014. The second outbreak occurred at University B in California, with four confirmed cases during November 2013. The public health response to these outbreaks included the approval and deployment of a serogroup B meningococcal vaccine that was not yet licensed in the USA. This study investigated the use of whole-genome sequencing(WGS) to examine the genetic profile of the disease-causing outbreak isolates at each university. Comparative WGS revealed differences in evolutionary patterns between the two disease outbreaks. The University A outbreak isolates were very closely related, with differences primarily attributed to single nucleotide polymorphisms/insertion-deletion (SNP/indel) events. In contrast, the University B outbreak isolates segregated into two phylogenetic clades, differing in large part due to recombination events covering extensive regions (>30 kb) of the genome including virulence factors. This high-resolution comparison of two meningococcal disease outbreaks further demonstrates the genetic complexity of meningococcal bacteria as related to evolution and disease virulence., language=, type=