Skip to main content
×
Home
    • Aa
    • Aa

Risk factors for Neisseria meningitides carriage in a school during a community outbreak of meningococcal infection

  • A. L. Davies (a1), D. O'Flanagan (a2), R. L. Salmon (a1) and T. J. Coleman (a3)
Summary
Summary

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.

Copyright
Corresponding author
* Dr A. L. Davies, Department of Public Health Medicine, Shropshire Health, William Farr House, Royal Shrewsbury Hospital, Shrewsbury, Shropshire SY3 8XL.
References
Hide All
1.Cartwright K, Evans B, Hall S, Healing T, Noone A, Reeves W. Communicable diseases review. J Publ Hlth Med 1992; 14: 410–12.
2.Greenfield S, Sheehe P, Feldman H. Meningococcal carriage in a population of ‘normal’ families. J Infect Dis 1971; 123: 6773.
3.Greenfield S, Feldman H. Familial carriers and meningococcal meningitis. New Eng J Med 1967; 277: 497502.
4.Marks M, Frasch C, Shapera R. Meningococcal colonization and infection in children and their household contacts. Am J Epidemiol 1979; 109: 563–71.
5.Pether J, Lightfoot N, Scott R, Morgan J, Steele-Perkins A, Sheard S. Carriage of Neisseria meningitidis: investigations in a military establishment. Epidemiol Infect 1988; 101: 2142.
6.Blakebrough I, Greenwood B, Whittle H, Bradley A. Failure of meningococcal vaccination to stop the transmission of meningococci in Nigerian schoolboys. Ann Trop Med Parasitol 1983; 77: 175–8.
7.Olcen P, Kjellander J, Danielsson D, Lindquist B. Epidemiology of Neisseria meningitis: prevalence and symptoms from the upper respiratory tract in family members to patients with meningococcal disease. Scand J Infect Dis 1981; 13: 105–9.
8.Aycock W, Mueller J. Meningococcus carrier rates and meningitidis incidence. Bact Rev 1950; 14: 115–60.
9.Fraser P, Bailey G, Abbott J, Gill J, Walker D. The meningococcal carrier rate. Lancet 1973; i: 1235–7.
10.Wilson GS. Bacterial meningitis. In: Topley and Wilson's principles of bacteriology, virology and immunity, vol 3. London: Edward Arnold, 1984; 369–81.
11.Blackwell C, Tzanakaki G, Kremastinou J, et al. Factors affecting carriage of Neisseria meningitidis among Greek military recruits. Epidemiol Infect 1992; 108: 441–8.
12.Epiinfo V6.02. A word processing, database and statistics program for public health. USA: Center for Disease Control and Prevention (CDC), 1994.
13.Campos-Filho BS, Franco EL, Multlr . A microcomputer program for multiple logistic regression. Am J Epidemiol 1989; 129: 439–44.
14.Altman DG. Practical statistics for medical research. London: Chapman and Hall, 1991: 340–5.
15.Chief Medical Officer. Meningococcal infection: meningitis and septicaemia. PL CMO(94)2. London: Department of Health, 1994.
16.Caugant D, Holby F, Magnus P, et al. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population. J Clin Microbiol 1994; 32: 323–30.
17.Odugbemi T, Ademidum O, Agbabiaka A, Banjo T. Nasopharyngeal carriage of Neisseria meningitidis among school children at Ijede, Lagos State, Nigeria. Ethiop Med J 1992; 30: 33–6.
18.Conley Thomas J, Bendana N, Waterman S, et al. Risk factors for carriage of meningococcus in the Los Angeles County men's jail system. Am J Epidemiol 1991; 133: 286–95.
19.Stuart J, Cartwright K, Robinson P, Noah N. Effect of smoking on meningococcal carriage. Lancet 1989; 2: 723–5.
20.Stanwell Smith R, Stuart J, Hughes A, Robinson P, Griffin M, Cartwright K. Smoking, the environment and meningococcal disease: a case control study. Epidemiol Infect 1994; 112: 315–28.
21.Haneberg B, Tonjum T, Rodahl K, Gedde-Dahl T. Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, stressful events, physical fitness and general symptoms of illhealth. NIPH Ann 1983; 6: 169–74.
22.Morrow H, Slaten D, Reingold A, Werner B, Fernstersheib M. Risk factors associated with a school related outbreak of serogroup C meningococcal disease. Paediatr Infect Dis J 1990; 9: 394–8.
23.Young L, Laforce F, Hed J, Feeley J, Bennett J. A simultaneous outbreak of meningococcal and influenza infections. New Eng J Med 1972; 287: 59.
24.Jones D, Kaczmarski E. Meningococcal infections in England and Wales: 1991. Commun Dis Rep 1992; 2: R61–3.
25.Hubert B, Watier L, Garnerin P, Richardson S. Meningoccal disease and influenza-like syndrome: a new approach to an old question. J Infect Dis 1992; 166: 542–5.
26.Reilly S, Gaunt P. Influenza A and meningococcal disease. Lancet 1991; 338: 1143–4.
27.Krasinski K, Nelson J, Butler S, Luby J, Kusmiesz H. Possible association of mycoplasma and viral respiratory tract infections with bacterial meningitis. Am J Epidemiol 1987; 125: 499508.
28.Harrison L, Armstrong C, Jenkins S et al. A cluster of meningococcal disease on a school bus following epidemic influenza. Arch Intern Med 1991; 151: 1005–9.
29.Kristiansen B, Elverland H. Increased meningococcal carrier rate after tonsillectomy. BMJ 1984; 288: 974.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 4 *
Loading metrics...

Abstract views

Total abstract views: 80 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 20th October 2017. This data will be updated every 24 hours.