Meningococcal Carriage Evaluation in Response to a Serogroup B Meningococcal Disease Outbreak and Mass Vaccination Campaign at a College—Rhode Island, 2015–2016

Details

• Alternative Title:
  Clin Infect Dis
• Personal Author:
  Soeters, Heidi M. ; Whaley, Melissa ; Alexander-Scott, Nicole ; Kanadanian, Koren V. ; MacNeil, Jessica R. ; Martin, Stacey W. ; McNamara, Lucy A. ; Sicard, Kenneth ; Vanner, Cynthia ; Vuong, Jeni ; Wang, Xin ; Bandy, Utpala ; Patel, Manisha
• Description:
  Background
  
  Serogroup B meningococcal disease caused 7 US university outbreaks during 2013–2016. Neisseria meningitidis can be transmitted via asymptomatic nasopharyngeal carriage. MenB-FHbp (factor H binding protein), a serogroup B meningococcal (MenB) vaccine, was used to control a college outbreak. We investigated MenB-FHbp impact on meningococcal carriage.
  
  Methods
  
  Four cross-sectional surveys were conducted in conjunction with MenB-FHbp vaccination campaigns. Questionnaires and oropharyngeal swabs were collected from students. Specimens were evaluated using culture, slide agglutination, real-time polymerase chain reaction (rt-PCR), and whole genome sequencing. Adjusted prevalence ratios (aPRs) were calculated using generalized estimating equations.
  
  Results
  
  During each survey, 20%–24% of participants carried any meningococcal bacteria and 4% carried serogroup B by rt-PCR. The outbreak strain (ST-9069) was not detected during the initial survey; 1 student carried ST-9069 in the second and third surveys. No carriage reduction was observed over time or with more MenB-FHbp doses. In total, 615 students participated in multiple surveys: 71% remained noncarriers, 8% cleared carriage, 15% remained carriers, and 7% acquired carriage. Ten students acquired serogroup B carriage: 3 after 1 MenB-FHbp dose, 4 after 2 doses, and 3 after 3 doses. Smoking (aPR, 1.3; 95% confidence interval [CI], 1.1–1.5) and male sex (aPR, 1.3; 95% CI, 1.1–1.5) were associated with increased meningococcal carriage.
  
  Conclusions
  
  Carriage prevalence on campus remained stable, suggesting MenB-FHbp does not rapidly reduce meningococcal carriage or prevent serogroup B carriage acquisition. This reinforces the need for high vaccination coverage to protect vaccinated individuals and chemoprophylaxis for close contacts during outbreaks.
  
  
• Keywords:
  Meningococcal Disease Nasopharyngeal Carriage Outbreak Serogroup B Vaccines
• Source:
  Clin Infect Dis. 64(8):1115-1122
• Pubmed Central ID:
  PMC5682920
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  64
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:211d5e4f6115f8bceae8109ba828734f7aabbdb607a1b7fbd0d62d9f8a6554a4
• Download URL:
  https://stacks.cdc.gov/view/cdc/137425/cdc_137425_DS1.pdf
• File Type:
  [PDF - 101.88 KB ]