Sustained reduction in the carriage of <i>Neisseria meningitidis</i>
 
as a result of a community meningococcal disease control programme

Irwin, David J.; Davies, S. H.; Kaczmarski, Edward B.; Wale, M. C. J.

doi:10.1017/s0950268898001502

Cited by 10 publications

(17 citation statements)

References 20 publications

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“…The decrease in carriers observed among the 10-14 and 15-19 age groups is similar to that observed by Neal et al (1998), yet in this latter study subjects received chemoprophylaxis in addition to vaccine, a factor which could be expected to exert an effect on the reduction in carriers. The slight rise in prevalence observed in the 5-9-year-olds could, in part, be explained by the attenuated effect that polysaccharide vaccine has among the youngest age groups.…”

Section: Discussionsupporting

confidence: 84%

“…Although other N. meningitidis C carrier studies have also reported a decline in carriage rates, over different periods of time, following vaccination with polysaccharide vaccine (Gotschlich et al, 1969;Stroffolini et al, 1990;Di Martino et al, 1990;Neal et al, 1998), we nevertheless feel that the high number of specimens analysed renders the data yielded by our study of considerable interest.…”

Section: Discussionmentioning

confidence: 51%

See 1 more Smart Citation

Impact of meningococcal vaccination with combined serogroups A and C polysaccharide vaccine on carriage of Neisseria meningitidis C

Fernández

Arreaza

Santiago

et al. 2003

Journal of Medical Microbiology

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Two studies of meningococcal carriage state were carried out in Galicia (Spain) before and after a mass vaccination campaign between December 1996 and January 1997 against Neisseria meningitidis serogroup C with meningococcal serogroups A and C polysaccharide vaccine. The studies covered two areas with different incidence rates of meningococcal disease in 1996 (high and low incidence). Carriage rates of serogroup C showed a decrease in both areas, 47 and 65 % respectively, before and after the vaccination. Results showed a decrease in carrier state in the age groups 10-14-and 15-19-year-olds, but not in the 5-9-year-olds. These results demonstrate the effect of immunization on the reduction of the carriage state. INTRODUCTIONIn Galicia, a region situated in north-west Spain (population, 2·7 million), meningococcal disease is an endemic disease. During the early part of the 1990s, the approximate incidence rate of meningococcal disease was three cases per 100 000 population, but by 1995/1996, the incidence had risen sharply to 11 cases per 100 000 population. Unlike previous years, when Neisseria meningitidis serogroup B was the most frequently isolated serogroup, the increased incidence registered in 1995/1996 was caused by N. meningitidis serogroup C (Direcció n Xeral de Saú de, 1995). Faced with this situation, the Galician Regional Public Health Authorities looked into different disease prevention and control measures, and eventually decided to conduct a N. meningitidis C vaccination campaign, using meningococcal group A and C polysaccharide vaccine and targeting all residents in Galicia aged 18 months to 19 years. The campaign was carried out in the period December 1996-January 1997, with a total of 472 465 vaccinated persons.In the wake of the vaccination campaign, a marked decline in the incidence of meningococcal disease was observed. By 1998, 1 year after vaccination, the incidence rate had declined from a pre-vaccination figure of 10·42 to 4·3 cases per 100 000 population (Direcció n Xeral de Saú de, 1998). At this time, it was decided that, in view of the importance of healthy carriers in the epidemiology of meningococcal disease (Broome, 1986), a study should be undertaken immediately prior to vaccination, aimed at ascertaining the incidence of carriers of N. meningitidis C : 2b : P1.2.5 -the strain most frequently isolated during the epidemic period -and studying the relationship between carriage and incidence of meningococcal disease (Fernández et al., 1999). For study purposes, two areas that registered different meningococcal disease incidence were therefore demarcated.In 1998, 1 year after the vaccination campaign, a new N. meningitidis C carriage study was carried out, with the aim of determining any possible differences in carriage prevalence before and after vaccination with meningococcal group A and C polysaccharide vaccine. This paper reports the differences between the above two studies, which covered the segment of the population aged 5-19 years. METHODSPopulation and selection of sample. ...

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 51%

Impact of meningococcal vaccination with combined serogroups A and C polysaccharide vaccine on carriage of Neisseria meningitidis C

Fernández

Arreaza

Santiago

et al. 2003

Journal of Medical Microbiology

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“…Whereas carriage rates of serogroup C meningococci are significantly lower than for serogroup B or non-groupable meningococci, and typically less than 1% even in outbreaks, 12 14 17 our study found serogroup carriage rates of 3% by December. This level increases the risk of outbreaks.…”

Section: Discussioncontrasting

confidence: 60%

“…The first was an improvement in swabbing techniques over the first week of the study. Although we were unable to identify the person who took each swab, most were taken by one person (KRN) with considerable experience 12. KRN also supervised the technique of the other operators.…”

Section: Discussionmentioning

confidence: 99%

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study

Neal

2000

BMJ

128

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“…2006) and seven were cross‐sectional surveys carried out post‐vaccination (Hassan‐King et al. 1988; Neal et al. 1998; Smith et al.…”

Section: Resultsmentioning

confidence: 99%

Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci

Dellicour

Greenwood

2007

Tropical Med Int Health

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Summaryobjective To investigate the effect of meningococcal vaccines on pharyngeal carriage of meningococci. methods Systematic review. MEDLINE and EMBASE were searched for relevant studies. Controlled trials and observational studies which used comparison groups or compared carriage rates before and after vaccination were included in the review.results Twenty-nine studies satisfied the inclusion criteria. Twenty-five studies reported the effect of a polysaccharide vaccine, one the effect of a serogroup C conjugate vaccine and three the impact of serogroup B outer-membrane vaccines on overall and ⁄ or serogroup-specific meningococcal carriage rates. Ten studies of meningococcal polysaccharide vaccines found reduced serogroup-specific carriage; seven of these focussed on high-risk groups and had a short follow-up period. Only one of five studies of civilian populations in Africa showed a significantly reduced carriage. Many studies had methodological shortcomings. The one study which assessed the effect of a meningococcal conjugate vaccine on carriage showed a significant impact. Three studies of serogroup B outer-membrane protein vaccines showed no effect on carriage.conclusions A few well-designed trials of the impact of meningococcal vaccines on carriage have been undertaken. Such studies should be an essential component of the evaluation of new meningococcal vaccines, particularly those introduced to control epidemic meningococcal disease in Africa.keywords meningococcal meningitis, vaccination, carrier state, herd immunity

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Sustained reduction in the carriage of Neisseria meningitidis as a result of a community meningococcal disease control programme

Cited by 10 publications

References 20 publications

Impact of meningococcal vaccination with combined serogroups A and C polysaccharide vaccine on carriage of Neisseria meningitidis C

Impact of meningococcal vaccination with combined serogroups A and C polysaccharide vaccine on carriage of Neisseria meningitidis C

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study

Systematic review: Impact of meningococcal vaccination on pharyngeal carriage of meningococci

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