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The natural history of meningococcal carriage and disease

Published online by Cambridge University Press:  20 October 2005

C. L. TROTTER
Affiliation:
Modelling & Economics Unit, Health Protection Agency Centre for Infections, London, UK
N. J. GAY
Affiliation:
Modelling & Economics Unit, Health Protection Agency Centre for Infections, London, UK
W. J. EDMUNDS
Affiliation:
Modelling & Economics Unit, Health Protection Agency Centre for Infections, London, UK
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Abstract

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The 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.

Type
Research Article
Copyright
2005 Cambridge University Press