Social Behavior and Meningococcal Carriage in British Teenagers
Jenny M. MacLennan,George Kafatos,Keith R. Neal,Nick Andrews,J. Claire Cameron,Richard J. Roberts,Meirion Rhys Evans,Kathy Cann,David Baxter,Martin C. J. Maiden,James M. Stuart +10 more
TLDR
Attention at pubs/clubs, intimate kissing, and cigarette smoking were each independently and strongly associated with increased risk for meningococcal carriage, but age, sex, social deprivation, home crowding, or school characteristics had little or no effect.Abstract:
Understanding predisposing factors for meningococcal carriage may identify targets for public health interventions. Before mass vaccination with meningococcal group C conjugate vaccine began in autumn 1999, we took pharyngeal swabs from ≈14,000 UK teenagers and collected information on potential risk factors. Neisseria meningitidis was cultured from 2,319 (16.7%) of 13,919 swabs. In multivariable analysis, attendance at pubs/clubs, intimate kissing, and cigarette smoking were each independently and strongly associated with increased risk for meningococcal carriage (p<0.001). Carriage in those with none of these risk factors was 7.8%, compared to 32.8% in those with all 3. Passive smoking was also linked to higher risk for carriage, but age, sex, social deprivation, home crowding, or school characteristics had little or no effect. Social behavior, rather than age or sex, can explain the higher frequency of meningococcal carriage among teenagers. A ban on smoking in public places may reduce risk for transmission.read more
Citations
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TL;DR: Estimates of carriage prevalence across all ages are provided, which is important for understanding the epidemiology and transmission dynamics of meningococcal infection.
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Impact of meningococcal serogroup C conjugate vaccines on carriage and herd immunity
Martin C. J. Maiden,Ana Belén Ibarz-Pavón,Rachel Urwin,Stephen J. Gray,Nick Andrews,Stuart C. Clarke,A. Mark Walker,Meirion Rhys Evans,J. Simon Kroll,Keith R. Neal,Dlawer A. A. Ala'Aldeen,Derrick W. Crook,Kathryn Cann,Sarah Harrison,R. Cunningham,David Baxter,Edward B. Kaczmarski,Jenny M. MacLennan,J. Claire Cameron,James M. Stuart +19 more
TL;DR: The impact of vaccination with MCC vaccine on the prevalence of carriage of group C meningococci was consistent with herd immunity, and the high impact on the carriage of ST-11 complex serogroup C could be attributed to high levels of capsule expression.
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Maintaining protection against invasive bacteria with protein-polysaccharide conjugate vaccines.
TL;DR: How vaccine-induced immunity wanes rapidly after vaccination in early childhood is described and it is argued that strategies that sustain protection in the population must be considered.
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