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J Infect. 2015 Jul;71(1):43-52. doi: 10.1016/j.jinf.2015.02.006. Epub 2015 Feb 21.

Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy.

Author information

1
Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK. Electronic address: Catherine.jeppesen@dchft.nhs.uk.
2
Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
3
Primary Care Clinical Trials Unit, University of Oxford, Oxford, UK.
4
Health Protection Services, Immunisation, Hepatitis and Blood Safety Department, Public Health England, 61 Colindale Avenue, London, UK.
5
Vaccine Institute & Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St George's, University of London, UK.
6
Bristol Children's Vaccine Centre, University of Bristol, School of Cellular and Molecular Medicine and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
7
Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK; Public Health England, Southampton, UK.
8
Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
9
Vaccine Research, Pfizer Ltd., Maidenhead, UK.
10
Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
11
Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK; Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Abstract

OBJECTIVES:

Recent development of serogroup B meningococcal (MenB) vaccines highlights the importance of pharyngeal carriage data, particularly in adolescents and young adults, to inform implementation strategies. We describe current UK carriage prevalence in this high risk population and compare methods of carriage detection.

METHODS:

In this multisite study, pharyngeal swabs were collected on 3-4 occasions over 6-12 months, from 1040 school and university students, aged 10-25 years. Meningococcal carriage was detected by standard culture combined with seroagglutination or PCR of cultured isolates, or by direct PCR from swab. The factor H binding protein (fHBP) variants present in meningococcal isolates were determined.

RESULTS:

Meningococcal serogroups B and Y were most common, with carriage up to 6.5% and 5.5% respectively, increasing throughout adolescence. Identification by seroagglutination was often unreliable, and the sensitivity of direct PCR detection was 66% compared to culture combined with PCR. Of MenB isolates, 89.1% had subfamily A variants of fHBP. The acquisition rate of MenB carriage was estimated at 2.8 per 1000 person-months.

CONCLUSIONS:

If vaccination is to precede the adolescent rise in MenB carriage, these data suggest it should take place in early adolescence. Studies assessing vaccine impact should use molecular methods to detect carriage.

KEYWORDS:

Adolescents; Carriage; Factor H binding protein; Neisseria meningitidis; Serogroup

PMID:
25709085
DOI:
10.1016/j.jinf.2015.02.006
[Indexed for MEDLINE]
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