Social behavior and meningococcal carriage in British teenagers.
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.
MacLennan
Jenny
J
University of Oxford, Oxford, United Kingdom.
Kafatos
George
G
Neal
Keith
K
Andrews
Nick
N
Cameron
J Claire
JC
Roberts
Richard
R
Evans
Meirion R
MR
Cann
Kathy
K
Baxter
David N
DN
Maiden
Martin C J
MC
Stuart
James M
JM
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