Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-22T15:48:31.915Z Has data issue: false hasContentIssue false

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

Published online by Cambridge University Press:  15 May 2009

A. L. Davies*
Affiliation:
PHLS Communicable Disease Surveillance Centre, Abton House, Wedal Road, Roath, Cardiff CF4 3QX
D. O'Flanagan
Affiliation:
Department of Public Health Medicine, Powys Health, Mansion House, Bronllys Hospital, Bronllys, Powys LD3 OLU
R. L. Salmon
Affiliation:
PHLS Communicable Disease Surveillance Centre, Abton House, Wedal Road, Roath, Cardiff CF4 3QX
T. J. Coleman
Affiliation:
3Public Health Laboratory, County Hospital, Hereford HR1 2ER
*
* Dr A. L. Davies, Department of Public Health Medicine, Shropshire Health, William Farr House, Royal Shrewsbury Hospital, Shrewsbury, Shropshire SY3 8XL.
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

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.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1996

References

1.Cartwright, K, Evans, B, Hall, S, Healing, T, Noone, A, Reeves, W. Communicable diseases review. J Publ Hlth Med 1992; 14: 410–12.Google Scholar
2.Greenfield, S, Sheehe, P, Feldman, H. Meningococcal carriage in a population of ‘normal’ families. J Infect Dis 1971; 123: 6773.Google Scholar
3.Greenfield, S, Feldman, H. Familial carriers and meningococcal meningitis. New Eng J Med 1967; 277: 497502.Google Scholar
4.Marks, M, Frasch, C, Shapera, R. Meningococcal colonization and infection in children and their household contacts. Am J Epidemiol 1979; 109: 563–71.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
8.Aycock, W, Mueller, J. Meningococcus carrier rates and meningitidis incidence. Bact Rev 1950; 14: 115–60.Google Scholar
9.Fraser, P, Bailey, G, Abbott, J, Gill, J, Walker, D. The meningococcal carrier rate. Lancet 1973; i: 1235–7.Google Scholar
10.Wilson, GS. Bacterial meningitis. In: Topley and Wilson's principles of bacteriology, virology and immunity, vol 3. London: Edward Arnold, 1984; 369–81.Google Scholar
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.Google Scholar
12.Epiinfo V6.02. A word processing, database and statistics program for public health. USA: Center for Disease Control and Prevention (CDC), 1994.Google Scholar
13.Campos-Filho, BS, Franco, EL, Multlr, . A microcomputer program for multiple logistic regression. Am J Epidemiol 1989; 129: 439–44.Google Scholar
14.Altman, DG. Practical statistics for medical research. London: Chapman and Hall, 1991: 340–5.Google Scholar
15.Chief Medical Officer. Meningococcal infection: meningitis and septicaemia. PL CMO(94)2. London: Department of Health, 1994.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
19.Stuart, J, Cartwright, K, Robinson, P, Noah, N. Effect of smoking on meningococcal carriage. Lancet 1989; 2: 723–5.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
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.Google Scholar
24.Jones, D, Kaczmarski, E. Meningococcal infections in England and Wales: 1991. Commun Dis Rep 1992; 2: R61–3.Google Scholar
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.Google Scholar
26.Reilly, S, Gaunt, P. Influenza A and meningococcal disease. Lancet 1991; 338: 1143–4.Google Scholar
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.CrossRefGoogle Scholar
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.Google Scholar
29.Kristiansen, B, Elverland, H. Increased meningococcal carrier rate after tonsillectomy. BMJ 1984; 288: 974.Google Scholar