title: Social behavior and meningococcal carriage in British teenagers.
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 approximately 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.
authors.affiliation: University of Oxford, Oxford, United Kingdom.
authors.forename: Jenny
authors.initials: J
authors.lastname: MacLennan
authors.forename: George
authors.initials: G
authors.lastname: Kafatos
authors.forename: Keith
authors.initials: K
authors.lastname: Neal
authors.forename: Nick
authors.initials: N
authors.lastname: Andrews
authors.forename: J Claire
authors.initials: JC
authors.lastname: Cameron
authors.forename: Richard
authors.initials: R
authors.lastname: Roberts
authors.forename: Meirion R
authors.initials: MR
authors.lastname: Evans
authors.forename: Kathy
authors.initials: K
authors.lastname: Cann
authors.forename: David N
authors.initials: DN
authors.lastname: Baxter
authors.forename: Martin C J
authors.initials: MC
authors.lastname: Maiden
authors.forename: James M
authors.initials: JM
authors.lastname: Stuart
mesh_terms: D000293:Adolescent; D000328:Adult; D002353:Carrier State / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology / Q000382:microbiology*; D015999:Multivariate Analysis; D009345:Neisseria meningitidis / Q000302:isolation & purification*; D010614:Pharynx / Q000382:microbiology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking; D012923:Social Class; D013334:Students; D006113:United Kingdom / Q000453:epidemiology