title: Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy.
abstract: OBJECTIVE
  Recent development of serogroup B meningococcal (MenB) vaccines highlights the importance of pharyngeal carriage data, particularly in adolescents and young adults, to inform implementation strategies. We describe current UK carriage prevalence in this high risk population and compare methods of carriage detection.
  
  
  METHODS
  In this multisite study, pharyngeal swabs were collected on 3-4 occasions over 6-12 months, from 1040 school and university students, aged 10-25 years. Meningococcal carriage was detected by standard culture combined with seroagglutination or PCR of cultured isolates, or by direct PCR from swab. The factor H binding protein (fHBP) variants present in meningococcal isolates were determined.
  
  
  RESULTS
  Meningococcal serogroups B and Y were most common, with carriage up to 6.5% and 5.5% respectively, increasing throughout adolescence. Identification by seroagglutination was often unreliable, and the sensitivity of direct PCR detection was 66% compared to culture combined with PCR. Of MenB isolates, 89.1% had subfamily A variants of fHBP. The acquisition rate of MenB carriage was estimated at 2.8 per 1000 person-months.
  
  
  CONCLUSIONS
  If vaccination is to precede the adolescent rise in MenB carriage, these data suggest it should take place in early adolescence. Studies assessing vaccine impact should use molecular methods to detect carriage.
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK. Electronic address: Catherine.jeppesen@dchft.nhs.uk.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: Jeppesen
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Snape
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Robinson
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Gossger
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
authors.forename: Tessa M
authors.initials: TM
authors.lastname: John
authors.affiliation: Primary Care Clinical Trials Unit, University of Oxford, Oxford, UK.
authors.forename: Merryn
authors.initials: M
authors.lastname: Voysey
authors.affiliation: Health Protection Services, Immunisation, Hepatitis and Blood Safety Department, Public Health England, 61 Colindale Avenue, London, UK.
authors.forename: Shamez
authors.initials: S
authors.lastname: Ladhani
authors.affiliation: Vaccine Institute & Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St George's, University of London, UK.
authors.forename: Ifeanyichukwu O
authors.initials: IO
authors.lastname: Okike
authors.affiliation: Vaccine Institute & Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St George's, University of London, UK.
authors.forename: Clarissa
authors.initials: C
authors.lastname: Oeser
authors.affiliation: Vaccine Institute & Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St George's, University of London, UK.
authors.forename: Alison
authors.initials: A
authors.lastname: Kent
authors.affiliation: Bristol Children's Vaccine Centre, University of Bristol, School of Cellular and Molecular Medicine and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Oliver
authors.affiliation: Bristol Children's Vaccine Centre, University of Bristol, School of Cellular and Molecular Medicine and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Pippa
authors.initials: P
authors.lastname: Taylor
authors.affiliation: Bristol Children's Vaccine Centre, University of Bristol, School of Cellular and Molecular Medicine and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Begonia
authors.initials: B
authors.lastname: Morales-Aza
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK; Public Health England, Southampton, UK.
authors.forename: Stuart C
authors.initials: SC
authors.lastname: Clarke
authors.affiliation: Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Michelle
authors.initials: M
authors.lastname: Casey
authors.affiliation: Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Filipa
authors.initials: F
authors.lastname: Martins
authors.affiliation: Vaccine Research, Pfizer Ltd., Maidenhead, UK.
authors.forename: Nicholas R E
authors.initials: NR
authors.lastname: Kitchin
authors.affiliation: Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
authors.forename: Annaliesa S
authors.initials: AS
authors.lastname: Anderson
authors.affiliation: Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
authors.forename: Hal
authors.initials: H
authors.lastname: Jones
authors.affiliation: Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
authors.forename: Kathrin U
authors.initials: KU
authors.lastname: Jansen
authors.affiliation: Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Eiden
authors.affiliation: Vaccine Research, Pfizer Inc., Pearl River, NY, USA.
authors.forename: Louise
authors.initials: L
authors.lastname: Pedneault
authors.affiliation: Vaccine Institute & Paediatric Infectious Diseases Research Group, Division of Clinical Sciences, St George's, University of London, UK.
authors.forename: Paul T
authors.initials: PT
authors.lastname: Heath
authors.affiliation: Bristol Children's Vaccine Centre, University of Bristol, School of Cellular and Molecular Medicine and University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
authors.forename: Adam
authors.initials: A
authors.lastname: Finn
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, UK; Southampton NIHR Wellcome Trust Clinical Research Facility, University Hospital Southampton NHS Foundation Trust, Southampton, UK.
authors.forename: Saul N
authors.initials: SN
authors.lastname: Faust
authors.affiliation: Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the NIHR Oxford Biomedical Research Centre, Oxford, UK.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Pollard
mesh_terms: D000293:Adolescent; D000328:Adult; D000372:Agglutination Tests; D000942:Antigens, Bacterial / Q000235:genetics; D001426:Bacterial Proteins / Q000235:genetics; D002353:Carrier State / Q000453:epidemiology*; D002648:Child; D016021:Epidemiologic Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008589:Meningococcal Infections / Q000453:epidemiology*; D009345:Neisseria meningitidis / Q000145:classification / Q000302:isolation & purification; D010614:Pharynx / Q000382:microbiology; D016133:Polymerase Chain Reaction; D065288:Serogroup; D006113:United Kingdom / Q000453:epidemiology; D014611:Vaccination; D055815:Young Adult
chemical_list: D000942:Antigens, Bacterial; D001426:Bacterial Proteins; C484699:factor H-binding protein, Neisseria meningitidis
keywords: Adolescents; Carriage; Factor H binding protein; Neisseria meningitidis; Serogroup