Smoking, the environment and meningococcal disease: a case control study

Stanwell‐Smith, Rosalind; Stuart, James M.; Hughes, Anthony; Robinson, P. M.; Griffin, Mark; Cartwright, Keith

doi:10.1017/s0950268800057733

Cited by 136 publications

(106 citation statements)

References 43 publications

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“…This implies that while most of the secondary peak in disease in young adults can be accounted for by increased transmission, there may also be other factors, independent of transmission, which increase susceptibility to disease in this age group. These may include passive smoking, to which exposure seems likely to increase during teenage and is associated with an increased risk of meningococcal disease [17]. It would be helpful to identify these secondary factors, but it may also be desirable to investigate the potential for control measures aimed at reducing transmission and exposure to meningococci in teenagers (although an improved understanding of the way episodes of carriage contribute to protection from disease would be important).…”

Section: Discussionmentioning

confidence: 99%

The natural history of meningococcal carriage and disease

2005

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SUMMARYThe prevalence of Neisseria meningitidis carriage is highest in teenagers and lowest in young children. In contrast, invasive meningococcal disease is most common in young children with a smaller secondary peak in teenagers. Data on carriage and disease were analysed to quantify the risks of infection and disease by age and serogroup. The forces of infection for serogroups B, C, other meningococci and Neisseria lactamica were modelled together with the risk of disease given infection for serogroups B and C, using maximum likelihood to fit the models to the available data. The risk of meningococcal disease given infection declines steeply through childhood and is higher for serogroup C than for serogroup B. The secondary peak in disease in teenagers appears to be explained mostly by increased transmission although there is a suggestion that other factors may also contribute. These analyses provide important insights and may be used to guide further data collection and modelling studies.

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Section: Discussionmentioning

confidence: 99%

The natural history of meningococcal carriage and disease

2005

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“…A number of studies have shown associations between meningococcal disease and either smoking (FISCHER et al, 1997;COOKSON et al, 1998) or passive exposure to tobacco smoke (HANEBERG et al, 1983;STANWELL-SMITH et al. 1994: FISCHER et al.…”

Section: Discussionmentioning

confidence: 99%

“…In industrialized countries, crowding (STANWELL-SMITH et al, 1994;MOODLEY et al, 1999) conditions, nor overcrowding, nor other socio-economic factors could explain why some people became ill and others did not. This is very likely to be because there were only small variations in these variables in the study population, among whom extreme poverty is almost universal.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for meningococcal disease in industrialized countries include overcrowding (STANWELL-SMITH et al, 1994), passive exposure to tobacco smoke (HANEBERG et al, 1983;STANWELL-SMITH et al, 1994;FISCHER et al, 1997), kisses on the mouth (STANWELL-SMITH et al, 1994), preceding respiratory infections (CARTWRIGHT et al. 199 1: HARRISON et al.…”

Section: Introductionmentioning

confidence: 99%

“…199 1: HARRISON et al. 1991), dus't exposure (STANW&L-SMITH et al, 1994); and stress (HANEBERG et al, 1983;STANWELL-SMITH et al, 1994).…”

Section: Introductionmentioning

confidence: 99%

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Risk factors for meningococcal meningitis in northern Ghana

Hodgson

Smith

Gagneux

et al. 2001

Transactions of the Royal Society of Tropical Medicine and Hygi

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Meningococcal meningitis is a major cause of morbidity and mortality in the meningitis belt of subSaharan Africa where it occurs in epidemics every 8-12 years. Risk factors for the disease in this setting remain largely unknown. We carried out a case-control study to investigate possible risk factors among survivors of a meningitis epidemic occurring in 1997 in northern Ghana. A structured questionnaire on socio-economic factors, housing and household overcrowding, smoking and exposure to smoke and close contact with a case was administered to 505 of the survivors and 505 of age-, sex-and location-matched controls. Cooking in kitchens with firewood stoves (OR 9.00, CI 1.25-395) and sharing a bedroom with a case (OR 2.18 CI 1.43-3.4) were found to be risk factors for disease. Socio-economic factors, overcrowding, smoking and passive exposure to tobacco smoke were not found to be risk factors. Exposure to smoke from cooking fires or close contact with a case puts people at risk of contracting meningococcal meningitis. In the hot dry months, exposure to smoke from cooking fires should be minimized by encouraging alternatives to cooking over wood fires, or cooking outside. If wood-burning stoves cannot be avoided, kitchens should be made larger with improved ventilation. Meningitis cases should be nursed in well-ventilated rooms and the number of people sharing a room with a case kept at a minimum.

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Serogroup Y Meningococcal Disease in Chicago, 1991-1997

Racoosin¹

1998

JAMA

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Context.-In 1994, surveillance by the Chicago Department of Public Health detected a growing trend in the proportion of invasive meningococcal infections caused by serogroup Y. Objective.-To examine the emergence of serogroup Y meningococcal disease and compare its clinical characteristics with those of other meningococcal serogroups. Design.-Population-based retrospective review of surveillance records; medical record review and cohort analysis of serogroup Y vs non-serogroup Y case patients. Setting.-Chicago, Ill. Participants.-City residents with Neisseria meningitidis isolated from a normally sterile site from January 1, 1991, through December 31, 1997; cohort analysis included those identified through March 31, 1996. Main Outcome Measures.-Serogroup-specific incidence, demographics, and clinical outcomes. Results.-We identified 214 case patients; 53 (25%) had serogroup Y. The attack rate of serogroup Y meningococcal disease increased from 0.04 cases per 100 000 in 1991 to a peak of 0.82 cases per 100 000 in 1995 and subsequently decreased to 0.26 cases per 100 000 and 0.34 cases per 100 000 in 1996 and 1997, respectively. Compared with patients infected by other serogroups, patients with serogroup Y were older (median age, 16 years vs 1 year; P = .001) and more likely to have a chronic underlying illness (prevalence ratio, 2.3; 95% confidence interval, 1.2-4.4). Outcome did not differ significantly between the 2 groups. Multilocus enzyme electrophoresis typing of isolates from 19 case patients identified 5 different types. We found no clustering among the enzyme types by age, race/ethnicity, community area, or time. Conclusions.-Serogroup Y emerged as the most frequent cause of meningococcal disease in Chicago in 1995 and accounted for a substantial proportion of cases in 1996 and 1997. Current data suggest that the magnitude of serogroup Y meningococcal disease is sufficient for vaccine developers to incorporate serogroup Y into new vaccines.

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Smoking, the environment and meningococcal disease: a case control study

Cited by 136 publications

References 43 publications

The natural history of meningococcal carriage and disease

The natural history of meningococcal carriage and disease

Risk factors for meningococcal meningitis in northern Ghana

Serogroup Y Meningococcal Disease in Chicago, 1991-1997

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