title: Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study.
abstract: OBJECTIVE
  To determine the rates of, and risk factors for, meningococcal carriage and acquisition among university students.
  
  
  METHODS
  Repeated cross sectional study.
  
  
  METHODS
  2,507 students in their first year at university.
  
  
  METHODS
  Prevalence of carriage of meningococci and risk factors for carriage and acquisition of meningococci.
  
  
  RESULTS
  Carriage rates for meningoccoci increased rapidly in the first week of term from 6.9% on day 1, to 11.2% on day 2, to 19.0% on day 3, and to 23.1% on day 4. The average carriage rate during the first week of term in October among students living in catered halls was 13.9%. By November this had risen to 31.0% and in December it had reached 34. 2%. Independent associations for acquisition of meningococci in the autumn term were frequency of visits to a hall bar (5-7 visits: odds ratio 2.7, 95% confidence interval 1.5 to 4.8), active smoking (1.6, 1.0 to 2.6), being male (1.6, 1.2 to 2.2), visits to night clubs (1. 3, 1.0 to 1.6), and intimate kissing (1.4, 1.0 to 1.8). Lower rates of acquisition were found in female only halls (0.5, 0.3 to 0.9). The most commonly acquired meningococcal strain was C2a P1.5 (P1.2), which has been implicated in clusters of invasive meningococcal disease at other UK universities.
  
  
  CONCLUSIONS
  Carriage rates of meningococci among university students increase rapidly in the first week of term, with further increases during the term. The rapid rate of acquisition may explain the increased risk of invasive meningococcal disease and the timing of cases and outbreaks in university students.
authors.affiliation: Department of Public Health Medicine and Epidemiology, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH. keith.neal@nott.ac.uk
authors.forename: K R
authors.initials: KR
authors.lastname: Neal
authors.forename: J S
authors.initials: JS
authors.lastname: Nguyen-Van-Tam
authors.forename: N
authors.initials: N
authors.lastname: Jeffrey
authors.forename: R C
authors.initials: RC
authors.lastname: Slack
authors.forename: R J
authors.initials: RJ
authors.lastname: Madeley
authors.forename: K
authors.initials: K
authors.lastname: Ait-Tahar
authors.forename: K
authors.initials: K
authors.lastname: Job
authors.forename: M C
authors.initials: MC
authors.lastname: Wale
authors.forename: D A
authors.initials: DA
authors.lastname: Ala'Aldeen
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002353:Carrier State / Q000175:diagnosis / Q000382:microbiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008589:Meningococcal Infections / Q000175:diagnosis / Q000382:microbiology* / Q000635:transmission; D010614:Pharynx / Q000382:microbiology; D012307:Risk Factors; D013334:Students; D013997:Time Factors