Rise in Group W Meningococcal Carriage in University Students, United Kingdom

Oldfield, Neil J.; Cayrou, Caroline; Aljannat, Mahab; Al-Rubaiawi, Ali Abdulwahid Abed; Green, Luke R.; Dada, Shehzan; Steels, Oliver D.; Stirrup, Christopher; Wanford, Joseph J.; Atwah, Banan A.Y.; Bayliss, Christopher D.; Turner, David P. J.

doi:10.3201/eid2306.161768

Cited by 34 publications

(42 citation statements)

References 15 publications

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“…The vaccine was administered to adolescents aged 14 and 15 years old, as well as students attending university for the first time ( Figure 2, [99]). However, despite 71% vaccination coverage with the MenACWY conjugate vaccine at one university, a crosssectional study showed that carriage of MenW increased substantially in first-year university students [100]. Additionally, the introduction of a monovalent MenA conjugate vaccine in Africa successfully reduced invasive disease and carriage rates by inducing direct and indirect (herd) protection, respectively [101][102][103][104].…”

Section: Lessons Learned From Immunization Programs and Research Worlmentioning

confidence: 99%

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

159

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2019) The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and highrisk populations, Expert Review of Vaccines, 18:1, 15-30, ABSTRACT Introduction: The 2018 Global Meningococcal Initiative (GMI) meeting focused on evolving invasive meningococcal disease (IMD) epidemiology, surveillance, and protection strategies worldwide, with emphasis on emerging antibiotic resistance and protection of high-risk populations. The GMI is comprised of a multidisciplinary group of scientists and clinicians representing institutions from several continents. Areas covered: Given that the incidence and prevalence of IMD continually varies both geographically and temporally, and surveillance systems differ worldwide, the true burden of IMD remains unknown. Genomic alterations may increase the epidemic potential of meningococcal strains. Vaccination and (to a lesser extent) antimicrobial prophylaxis are the mainstays of IMD prevention. Experiences from across the globe advocate the use of conjugate vaccines, with promising evidence growing for protein vaccines. Multivalent vaccines can broaden protection against IMD. Application of protection strategies to high-risk groups, including individuals with asplenia, complement deficiencies and human immunodeficiency virus, laboratory workers, persons receiving eculizumab, and men who have sex with men, as well as attendees at mass gatherings, may prevent outbreaks. There was, however, evidence that reduced susceptibility to antibiotics was increasing worldwide. Expert commentary: The current GMI global recommendations were reinforced, with several other global initiatives underway to support IMD protection and prevention. ARTICLE HISTORY

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Section: Lessons Learned From Immunization Programs and Research Worlmentioning

confidence: 99%

The Global Meningococcal Initiative meeting on prevention of meningococcal disease worldwide: Epidemiology, surveillance, hypervirulent strains, antibiotic resistance and high-risk populations

Acevedo

Bai

Borrow

et al. 2018

Expert Review of Vaccines

159

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“…Though we did not detect differences in carriage prevalence by MenACWY vaccination status, the recovery of few serogroup C or Y isolates and no serogroup W isolates among a highly-vaccinated university population suggests a potential impact of MenACWY on meningococcal carriage in U.S. university students. However, impact of MenACWY on meningococcal carriage in this population remains poorly understood, with a recent evaluation in the United Kingdom demonstrating a rise in serogroup W carriage despite 71% MenACWY vaccination coverage in university students [42]. …”

Section: Discussionmentioning

confidence: 99%

Meningococcal carriage among a university student population – United States, 2015

Breakwell

Whaley

Khan

et al. 2018

Vaccine

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Objectives Several outbreaks of serogroup B meningococcal disease have occurred among university students in recent years. In the setting of high coverage of the quadrivalent meningococcal conjugate vaccine and prior to widespread use of serogroup B meningococcal vaccines among adolescents, we conducted surveys to characterize the prevalence and molecular characteristics of meningococcal carriage among university students. Methods Two cross-sectional oropharyngeal carriage surveys were conducted among undergraduates at a Rhode Island university. Isolates were characterized using slide agglutination, real-time polymerase chain reaction (rt-PCR), and whole genome sequencing. Adjusted prevalence ratios and 95% confidence intervals were calculated using Poisson regression to determine risk factors for carriage. Results A total of 1837 oropharyngeal specimens were obtained from 1478 unique participants. Overall carriage prevalence was 12.7–14.6% during the two survey rounds, with 1.8–2.6% for capsular genotype B, 0.9–1.0% for capsular genotypes C, W, or Y, and 9.9–10.8% for nongroupable strains by rt-PCR. Meningococcal carriage was associated with being male, smoking, party or club attendance, recent antibiotic use (inverse correlation), and recent respiratory infections. Conclusions In this university setting, the majority of meningococcal carriage was due to nongroupable strains, followed by serogroup B. Further evaluation is needed to understand the dynamics of serogroup B carriage and disease among university students.

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“…Fifteen studies that sampled only university students met the inclusion criteria. Six studies were cross-sectional studies (Aliyu and Olayinka, 2017;Bali et al, 2017;Rizek et al, 2016;Rodrigues et al, 2015;Rodriguez et al, 2014;Tryfinopoulou et al, 2016;Takahashi et al, 2016), six were repeat cross-sectional studies with a nested cohort (either intentional or unintentional) (Ala'aldeen et al, 2011;Breakwell et al, 2018;Durey et al, 2012;McNamara et al, 2017b;Oldfield et al, 2017;Soeters et al, 2017), two were cohort studies (Bidmos et al, 2011;Gilca et al, 2013), and one was a randomized controlled trial investigating the impact of vaccination on carriage (Read et al, 2014). The majority of studies were conducted in the region of the Americas (n = 6) or the European region (n = 6), and no study was identified from the Eastern Mediterranean region.…”

Section: University Studentsmentioning

confidence: 99%