Fig. 7: Proposed model for epidemic dynamics in N. meningitidis and other bacterial pathogens.

a Certain local endemic lineage enhanced its virulence or transmissibility by gaining new genes or mutations, and (b) led to population expansion and diversification into multiple sub-populations. c Some of the subpopulations might be transmitted into other geographic regions. d Most of the transmissions did not last very long but some survived, resulting in epidemics or global pandemics. e The lineage could remain epidemic for several years, and finally be swept out in the long term by local lineages.