Abstract
Understanding predisposing factors for meningococcal carriage may identify targets for public health interventions. Before mass vaccination with meningococcal group C conjugate vaccine began in autumn 1999, we took pharyngeal swabs from ≈14,000 UK teenagers and collected information on potential risk factors. Neisseria meningitidis was cultured from 2,319 (16.7%) of 13,919 swabs. In multivariable analysis, attendance at pubs/clubs, intimate kissing, and cigarette smoking were each independently and strongly associated with increased risk for meningococcal carriage (p<0.001). Carriage in those with none of these risk factors was 7.8%, compared to 32.8% in those with all 3. Passive smoking was also linked to higher risk for carriage, but age, sex, social deprivation, home crowding, or school characteristics had little or no effect. Social behavior, rather than age or sex, can explain the higher frequency of meningococcal carriage among teenagers. A ban on smoking in public places may reduce risk for transmission.
Highlights
Understanding predisposing factors for meningococcal carriage may identify targets for public health interventions
We identified risk factors for carriage among 14,000 teenagers as an integral part of a large, 3-year, multicenter study to determine the effect of this mass vaccination program on the carriage of meningococci
The study size gave us high statistical power to investigate the independent effects of risk factors at both individual and school levels
Summary
Understanding predisposing factors for meningococcal carriage may identify targets for public health interventions. Attendance at pubs/clubs, intimate kissing, and cigarette smoking were each independently and strongly associated with increased risk for meningococcal carriage (p
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