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Longitudinal study of meningococcal carrier rates in teenagers

I C Glitza1, I Ehrhard, B Müller-Pebody

  • 1Abt. Hygiene und Med. Mikrobiologie, Hygiene-Institut, Universität Heidelberg, Im Neuenheimer Feld 346 (Dekanat), D-69120 Heidelberg, Germany.

International Journal of Hygiene and Environmental Health
|November 6, 2007
PubMed

Insights

This study investigated Neisseria meningitidis carriage in German teenagers, finding an 18.8% carrier rate with significant regional variations. Serogroup B was most common, but serogroup C predominated during an outbreak, highlighting the importance of ongoing surveillance for meningococcal disease prevention.

Area of Science:

  • Microbiology
  • Epidemiology
  • Public Health

Background:

  • Oropharyngeal carriage of Neisseria meningitidis is a key factor in meningococcal disease transmission.
  • Teenagers represent a significant reservoir for Neisseria meningitidis, contributing to community spread.
  • Understanding carriage dynamics in specific regions with increased disease incidence is crucial for targeted interventions.

Purpose of the Study:

  • To determine the prevalence and characteristics of Neisseria meningitidis oropharyngeal carriage in German adolescents aged 15-18 years.
  • To investigate variations in carriage rates across different schools, towns, and counties.
  • To identify dominant serogroups, serotypes, and clones of Neisseria meningitidis strains circulating in the study population.

Main Methods:

  • Longitudinal study involving three throat swab collections from 901 teenagers over a 4-month period.
  • Comprehensive strain characterization using serological methods (serogrouping, serotyping/serosubtyping) and molecular techniques (polymerase chain reaction [PCR], pulsed-field gel electrophoresis [PFGE]).
  • Analysis of carrier duration and strain acquisition rates among participants.

Main Results:

  • An overall average Neisseria meningitidis carrier rate of 18.8% was observed across the three collection periods.
  • Significant geographical variations in carrier rates were noted between schools, towns, and counties.
  • Serogroup B was the most prevalent (12.3%), followed by Y (9.0%) and C (3.6%), with PCR enhancing these figures. Serotyping revealed 305 distinct phenotypes, and PFGE identified numerous clones.
  • In a region with a prolonged outbreak, serogroup C (14.8%) was predominant, with specific clones linked to the outbreak.

Conclusions:

  • Oropharyngeal carriage of Neisseria meningitidis is common among German teenagers, with considerable heterogeneity in prevalence and strain types.
  • The study identified specific serogroups and clones associated with carriage and outbreaks, underscoring the need for continuous epidemiological surveillance.
  • Findings emphasize the importance of understanding carriage dynamics for effective prevention and control strategies against meningococcal diseases, particularly in high-incidence areas.

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