Meningococcal Carrier Studies

Phair, John J.; Schoenbach, Emanuel B.; Root, Charlotte M.

doi:10.2105/ajph.34.2.148

Cited by 28 publications

(7 citation statements)

References 4 publications

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“…Meningitis and septicemia are rare outcomes of meningococcal infection, and most infections with Neisseria meningitidis result in asymptomatic pharyngeal carriage. Therefore, the underlying transmission dynamics can be determined accurately only by study of carriage and disease, a feature of N. meningitidis infection first recognized 70 years ago [ 3 ].…”

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confidence: 99%

The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine

et al. 2015

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Background. Study of meningococcal carriage is essential to understanding the epidemiology of Neisseria meningitidis infection.Methods. Twenty cross-sectional carriage surveys were conducted in 7 countries in the African meningitis belt; 5 surveys were conducted after introduction of a new serogroup A meningococcal conjugate vaccine (MenAfriVac). Pharyngeal swab specimens were collected, and Neisseria species were identified by microbiological and molecular techniques.Results. A total of 1687 of 48 490 participants (3.4%; 95% confidence interval [CI], 3.2%–3.6%) carried meningococci. Carriage was more frequent in individuals aged 5–14 years, relative to those aged 15–29 years (adjusted odds ratio [OR], 1.41; 95% CI, 1.25–1.60); in males, relative to females (adjusted OR, 1.17; 95% CI, 1.10–1.24); in individuals in rural areas, relative to those in urban areas (adjusted OR, 1.44; 95% CI, 1.28–1.63); and in the dry season, relative to the rainy season (adjusted OR, 1.54; 95% CI, 1.37–1.75). Forty-eight percent of isolates had genes encoding disease-associated polysaccharide capsules; genogroup W predominated, and genogroup A was rare. Strain diversity was lower in countries in the center of the meningitis belt than in Senegal or Ethiopia. The prevalence of genogroup A fell from 0.7% to 0.02% in Chad following mass vaccination with MenAfriVac.Conclusions. The prevalence of meningococcal carriage in the African meningitis belt is lower than in industrialized countries and is very diverse and dynamic, even in the absence of vaccination.

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The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine

et al. 2015

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“…A number of studies made in military establishments during the epidemic prevalence of meningitis between the years 1942-1945 have shown that the administration of sulfadiazine not only acts as a prophylactic against meningitis, but results in a prompt clearing of carriage of the organism for varying periods of time, apparently dependent upon the dosage employed (25,26,27,28).…”

Section: Control Of Menngococcus Carragementioning

confidence: 99%

Meningococcus Carrier Rates and Meningitis Incidence 1

Aycock¹,

Mueller²,

Carroll³

1950

Bacteriological Reviews

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The purpose of this paper is to review certain general features of the epidemiology of meningococcus meningitis in the light of a survey of meningococcus carriage which was carried on continuously from December, 1941, to May, 1945, with a final carrier test in December, 1946. This was part of a survey including hemolytic streptococci, Corynibacterium diphtheriae and Hemophilus influenzae, which was conducted by the Commission on Pre-epidemic Survey in the First Service Command under the Board for the Investigation and Control of Influenza and Other Epidemic Diseases in the Army, Preventive Medicine Division, Office of the Surgeon General, United States Army. Of the group of diseases on which carrier studies were done, meningitis was the only one that presented an epidemic situation during the period of the study which made worthwhile a more extensive study of the relationship of findings in the carrier studies to the occurrence of meningitis during the same period, and as well to the epidemiology of meningitis in general. As it happened, the carrier study embraced the whole period of one of the cyclic increases and decreases in the occurrence of meningitis to be pointed out, and extended through four seasonal waves of the disease. Thus, the data available for analysis are unique in that carrier rates for the several types of meningococci are now known both for epidemic and interepidemic periods, as well as for epidemic and interepidemic seasons. This should not only provide a better understanding of the role of the carrier rate in the epidemiology of meningitis but at the same time should clarify certain questions concerning the mechanisms which influence the carrier rate-chiefly that of "overcrowding", long held to be a major determinant first in an increase in carrier rates and, in turn, in an increase in the disease, particularly under conditions of mobilization. Meningitis is extraordinary in the wide extent to which its infectious agent is distributed in the population and the comparative infrequency of disease in those harboring the organism. Furthermore, there is no reliable evidence that immunity from previous exposure is a determinant in restricting the occurrence of the disease, nor that population immunity, as is clearly the case with a number of virus diseases, stands in the way of repeated harborage and transmission of the organism by the same individual. Nonetheless, it has become clear that the extent of the occurrence of the disease is by no means wholly a simple function of the prevalence of meningococcus carriers. Epidemics may occur in certain 1 These studies were supported in part through the Commission on Epidemiological Survey of the Army Epidemiological Board, Office of the Surgeon General, United States Army.

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“…Infection with Neisseria meningitidis (the meningococcus) usually results in an asymptomatic, or only mildly symptomatic, infection of the pharynx; invasion of the blood stream and invasive disease is a rare event. Study of pharyngeal carriage is, therefore, essential for a full understanding of the epidemiology of meningococcal infection [ 1 ]. The importance of carriage has been emphasised by the demonstration that the success of meningococcal conjugate vaccines in containing outbreaks of meningococcal disease in both industrialised countries [ 2 , 3 ] and in the African meningitis belt [ 4 , 5 ] is very dependent upon their ability to prevent carriage.…”

Section: Introductionmentioning

confidence: 99%

Investigation of correlates of protection against pharyngeal carriage of Neisseria meningitidis genogroups W and Y in the African meningitis belt

et al. 2017

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BackgroundSerum bactericidal antibody titres that correlate with protection against invasive meningococcal disease have been characterised. However, titres that are associated with protection against acquisition of pharyngeal carriage of Neisseria meningitidis are not known.MethodsSera were obtained from the members of a household in seven countries of the African meningitis belt in which a pharyngeal carrier of N. meningitidis had been identified during a cross-sectional survey. Serum bactericidal antibody titres at baseline were compared between individuals in the household of the carrier who became a carrier of a meningococcus of the same genogroup during six months of subsequent follow-up and household members who did not become a carrier of a meningococcus of this genogroup during this period.ResultsSerum bacterial antibody titres were significantly higher in carriers of a serogroup W or Y meningococcus at the time of recruitment than in those who were not a carrier of N. meningitidis of the same genogroup. Serum bactericidal antibody titres to a strain of N. meningitis of the same genogroup as the index cases were no different in individuals who acquired carriage with a meningococcus of the same genogroup as the index case than in those who did not become a carrier during six months of follow-up.ConclusionSerum bacterial antibody titres to N. meningitidis of genogroup W or Y in the range of those acquired by natural exposure to meningococci of these genogroups, or with cross-reactive bacteria, are not associated with protection against acquisition of carriage with meningococci of either of these genogroups.

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Meningococcal Carrier Studies

Cited by 28 publications

References 4 publications

The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine

The Diversity of Meningococcal Carriage Across the African Meningitis Belt and the Impact of Vaccination With a Group A Meningococcal Conjugate Vaccine

Meningococcus Carrier Rates and Meningitis Incidence 1

Investigation of correlates of protection against pharyngeal carriage of Neisseria meningitidis genogroups W and Y in the African meningitis belt

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