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Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy

Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy
Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy
Objectives
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.
Neisseria meningitides, serogroup, carriage, factor h binding protein, adolescents
0163-4453
1-10
Jeppesen, C.A.
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Snape, M.D.
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Robinson, H..
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Gossger, N.
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John, T.M.
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Voysey, M.
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Ladhani, S.
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Okike, I.O.
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Oeser, C.
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Kent, A.
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Oliver, J.
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Taylor, Peter K.
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Morales-Aza, B.
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Clarke, Stuart C.
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Casey, M.
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Martins, F.
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Kitchin, N.R.
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Anderson, A.S.
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Jones, H.
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Jansen, K.U.
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Eiden, J.
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Peneault, L.
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Heath, P.T.
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Finn, A.
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Faust, S.N.
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Pollard, A.J.
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Jeppesen, C.A.
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Snape, M.D.
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Robinson, H..
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Gossger, N.
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John, T.M.
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Voysey, M.
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Ladhani, S.
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Okike, I.O.
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Oeser, C.
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Kent, A.
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Oliver, J.
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Taylor, Peter K.
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Morales-Aza, B.
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Clarke, Stuart C.
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Casey, M.
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Martins, F.
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Kitchin, N.R.
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Anderson, A.S.
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Jones, H.
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Jansen, K.U.
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Eiden, J.
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Peneault, L.
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Heath, P.T.
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Finn, A.
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Faust, S.N.
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Pollard, A.J.
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Jeppesen, C.A., Snape, M.D., Robinson, H.., Gossger, N., John, T.M., Voysey, M., Ladhani, S., Okike, I.O., Oeser, C., Kent, A., Oliver, J., Taylor, Peter K., Morales-Aza, B., Clarke, Stuart C., Casey, M., Martins, F., Kitchin, N.R., Anderson, A.S., Jones, H., Jansen, K.U., Eiden, J., Peneault, L., Heath, P.T., Finn, A., Faust, S.N. and Pollard, A.J. (2015) Meningococcal carriage in adolescents in the United Kingdom to inform timing of an adolescent vaccination strategy. Journal of Infection, 1-10. (doi:10.1016/j.jinf.2015.02.006). (PMID:25709085)

Record type: Article

Abstract

Objectives
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.

Full text not available from this repository.

More information

Accepted/In Press date: 16 February 2015
e-pub ahead of print date: 20 February 2015
Keywords: Neisseria meningitides, serogroup, carriage, factor h binding protein, adolescents
Organisations: Faculty of Medicine

Identifiers

Local EPrints ID: 375908
URI: http://eprints.soton.ac.uk/id/eprint/375908
ISSN: 0163-4453
PURE UUID: 36e27ee2-74ff-46a9-badc-2c8561ed65c5
ORCID for Stuart C. Clarke: ORCID iD orcid.org/0000-0002-7009-1548
ORCID for S.N. Faust: ORCID iD orcid.org/0000-0003-3410-7642

Catalogue record

Date deposited: 20 Apr 2015 12:25
Last modified: 18 Feb 2021 17:08

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Contributors

Author: C.A. Jeppesen
Author: M.D. Snape
Author: H.. Robinson
Author: N. Gossger
Author: T.M. John
Author: M. Voysey
Author: S. Ladhani
Author: I.O. Okike
Author: C. Oeser
Author: A. Kent
Author: J. Oliver
Author: Peter K. Taylor
Author: B. Morales-Aza
Author: M. Casey
Author: F. Martins
Author: N.R. Kitchin
Author: A.S. Anderson
Author: H. Jones
Author: K.U. Jansen
Author: J. Eiden
Author: L. Peneault
Author: P.T. Heath
Author: A. Finn
Author: S.N. Faust ORCID iD
Author: A.J. Pollard

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