Risk factors forNeisseria meningitidescarriage in a school during a community outbreak of meningococcal infection

Abstract

As part of the management of an outbreak of meningococcal infection, 119 school contacts of an index case were swabbed for nasopharyngeal carriage. In a cohort study, risk factors for Neisseria meningitidis carriage were ascertained by means of a questionnaire, completed by 114 (96%) of those swabbed. Twenty five (21%) cultures were identified as "neisseria positive'; of which there were 18 (15%) Neisseria meningitidis isolates, 2 (2%) Neisseria lactamica isolates and 5 (4%) showed contaminants only. Two (2%) carriers were identified as harbouring the implicated outbreak strain. Single variable analysis identified six statistically significant risk factors for meningococcal carriage; increasing age, female sex, manual social class, personal smoking, regular attendance at a discotheque and rhinorrhoea. Multivariate analysis, using logistic regression modelling, found that of these six variables only age, sex and social class remained statistically significant when the other factors were controlled for. Nevertheless the role of smoking, social events and respiratory/viral infections in nasopharyngeal carriage, and other plausible mechanisms whereby age, sex and social class might exert their effect, could usefully be investigated further.

Neisseria meningitidis: an overview of the carriage state

“…Smoking, passive as well as active, is a risk factor that increases the possibility of individuals to become carriers. Socio-economic conditions also appear to influence the carriage rate of meningococci (Davies et al, 1996): people with low socio-economic status, whatever their ethnic origin, are more likely to be carriers and develop meningococcal disease (Stuart et al, 1988). There are slightly more male carriers than females.…”

Cost impact of complications in meningococcal disease: Evidence from a United States managed care population

“…The risk factors of N. meningitidis infections include prior viral infection, living in closed or semi-closed settings, smoking, chronic illness and socioeconomic status. 5,6 Worldwide, 13 N. meningitidis serogroups have been identified, five of which (A, B, C, W-135 and Y) have been most commonly reported as the cause of IMD. 6,7 In the US, however, most of the reported cases are due to serogroups B, C and Y.…”

Effectiveness of a mass immunization campaign against serogroup C meningococci in children in the Federal State of Santa Catarina, Brazil

“…This is due to the multiplicative nature of the carry-over effect in high incidence areas because of the increased prevalence of meningococci carriers and, therefore, higher probability of exposure. To illustrate this point, we cite Davies, et al [20] who …”