Meningococcal Carriage Among Georgia and Maryland High School Students

• Type of Material: Article
• Authors: Lee H. Harrison, Johns Hopkins Bloomberg School of Public Health; Kathleen A. Shutt, University of Pittsburgh; Kathryn E. Arnold, Georgia Department Human of Resources; Eric J. Stern, Centers for Disease Control and Prevention; Tracy Pondo, Centers for Disease Control and Prevention; Julia A. Kiehlbauch, Maryland Department of Health and Mental Hygiene; Robert A. Myers, Maryland Department of Health and Mental Hygiene; Rosemary A. Hollick, Johns Hopkins Bloomberg School of Public Health; Susanna Schmink, Centers for Disease Control and Prevention; Marianne Vello, Georgia Department Human of Resources; David S Stephens, Emory University; Nancy E. Messonnier, Centers for Disease Control and Prevention; Leonard Mayer, Centers for Disease Control and Prevention; Thomas A. Clark, Centers for Disease Control and Prevention
• Language: English
• Date: 2015-06-01
• Publisher: Oxford University Press
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2014 The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1093/infdis/jiu679
• Title of Journal or Parent Work: Journal of Infectious Diseases
• ISSN: 0022-1899
• Volume: 211
• Issue: 11
• Start Page: 1761
• End Page: 1768
• Grant/Funding Information: This work was supported by Sanofi Pasteur (grant to the Centers for Disease Control and Prevention Foundation).
• Keywords: HERD-IMMUNITY; meningococcal; Neisseria meningitidis; oropharyngeal carriage; SEROGROUP; Life Sciences & Biomedicine; Microbiology; UNIVERSITY-STUDENTS; UNITED-STATES; AGED 13-17 YEARS; meningococcal conjugate vaccine; NEISSERIA-MENINGITIDIS; meningococcus; Science & Technology; high school students; CONJUGATE VACCINE; Infectious Diseases; Immunology; ADOLESCENTS; COLLEGE-STUDENTS; RISK-FACTORS
• Research Categories: Health Sciences, Epidemiology; Health Sciences, Public Health

Abstract

Background. Meningococcal disease incidence in the United States is at an all-time low. In a previous study of Georgia high school students, meningococcal carriage prevalence was 7%. The purpose of this study was to measure the impact of a meningococcal conjugate vaccine on serogroup Y meningococcal carriage and to define the dynamics of carriage in high school students. Methods. This was a prospective cohort study at 8 high schools, 4 each in Maryland and Georgia, during a school year. Students at participating schools received quadrivalent meningococcal conjugate vaccine that uses diphtheria toxoid as the protein carrier (MCV4-DT). In each state, 2 high schools were randomly assigned for MCV4-DT receipt by students at the beginning of the study, and 2 were randomly assigned for MCV4-DT receipt at the end. Oropharyngeal swab cultures for meningococcal carriage were performed 3 times during the school year. Results. Among 3311 students, the prevalence of meningococcal carriage was 3.21%-4.01%. Phenotypically nongroupable strains accounted for 88% of carriage isolates. There were only 5 observed acquisitions of serogroup Y strains during the study; therefore, the impact of MCV4-DT on meningococcal carriage could not be determined. Conclusions. Meningococcal carriage rates in US high school students were lower than expected, and the vast majority of strains did not express capsule. These findings may help explain the historically low incidence of meningococcal disease in the United States.