دورية أكاديمية
أعرض في EDS

Meningococcal carriage in periods of high and low invasive meningococcal disease incidence in the UK: comparison of UKMenCar1-4 cross-sectional survey results.

التفاصيل البيبلوغرافية
العنوان: Meningococcal carriage in periods of high and low invasive meningococcal disease incidence in the UK: comparison of UKMenCar1-4 cross-sectional survey results.
المؤلفون: MacLennan JM; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Rodrigues CMC; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Bratcher HB; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Lekshmi A; Meningococcal Reference Unit, Public Health England, Manchester Public Health Laboratory, Manchester Royal Infirmary, Manchester, UK., Finn A; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK., Oliver J; School of Cellular and Molecular Medicine, University of Bristol, Bristol, UK., Wootton M; Division of Public Health Wales, Temple of Peace and Health, Cardiff, UK., Ray S; Division of Public Health Wales, Temple of Peace and Health, Cardiff, UK., Cameron C; NHS National Services Scotland, Health Protection Scotland, Glasgow, UK., Smith A; Glasgow Dental School, University of Glasgow, UK; Scottish Microbiology Reference Laboratory, NHS Greater Glasgow & Clyde, Glasgow, UK., Heath PT; St George's Vaccine Institute, Institute of Infection & Immunity, St George's University of London, London, UK., Bartolf A; St George's Vaccine Institute, Institute of Infection & Immunity, St George's University of London, London, UK., Nolan T; Research and Development Department, Maidstone and Tunbridge Wells NHS Trust, Maidstone, Kent, UK., Hughes S; Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK., Varghese A; Central Manchester University Hospitals, NHS Foundation Trust, Manchester, UK., Snape MD; Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK., Sewell R; Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK., Cunningham R; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Stolton A; Microbiology Department, University Hospitals Plymouth NHS Trust, UK., Kay C; Lancashire and South Cumbria NHS Foundation Trust, Preston, Lancashire, UK., Palmer K; Lancashire and South Cumbria NHS Foundation Trust, Preston, Lancashire, UK., Baxter D; Stockport NHS Foundation Trust, Stepping Hill Hospital, Stockport, UK., Suggitt D; Stockport NHS Foundation Trust, Stepping Hill Hospital, Stockport, UK., Zipitis CS; Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; Department of Paediatrics, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK., Pemberton N; Clinical Trials Department, Wrightington Wigan and Leigh NHS Foundation Trust, Wigan, UK., Jolley KA; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Bray JE; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Harrison OB; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK., Ladhani SN; Paediatric Infectious Diseases Research Group, St George's University of London, London, UK; Immunisation and Countermeasures Division, Public Health England, London, UK., Pollard AJ; Oxford Vaccine Group, Department of Paediatrics, University of Oxford and the National Institute for Health Research Oxford Biomedical Research Centre, Oxford, UK., Borrow R; Meningococcal Reference Unit, Public Health England, Manchester Public Health Laboratory, Manchester Royal Infirmary, Manchester, UK., Gray SJ; Meningococcal Reference Unit, Public Health England, Manchester Public Health Laboratory, Manchester Royal Infirmary, Manchester, UK., Trotter C; Disease Dynamics Unit, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK., Maiden MCJ; Department of Zoology, Peter Medawar Building for Pathogen Research, University of Oxford, Oxford, UK. Electronic address: martin.maiden@zoo.ox.ac.uk.
المصدر: The Lancet. Infectious diseases [Lancet Infect Dis] 2021 May; Vol. 21 (5), pp. 677-687. Date of Electronic Publication: 2021 Jan 19.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Science Country of Publication: United States NLM ID: 101130150 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1474-4457 (Electronic) Linking ISSN: 14733099 NLM ISO Abbreviation: Lancet Infect Dis Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001-
مواضيع طبية MeSH: Carrier State/*prevention & control , Meningococcal Infections/*epidemiology , Meningococcal Infections/*prevention & control , Meningococcal Vaccines/*immunology, Adolescent ; Cross-Sectional Studies ; Female ; Humans ; Incidence ; Male ; Neisseria meningitidis ; Neisseria meningitidis, Serogroup C ; Prevalence ; Risk Factors ; Serogroup ; United Kingdom/epidemiology ; Vaccination ; Young Adult
مستخلص: Background: The incidence of invasive meningococcal disease in the UK decreased by approximately four times from 1999 to 2014, with reductions in serogroup C and serogroup B disease. Lower serogroup C invasive meningococcal disease incidence was attributable to implementation of the meningococcal serogroup C conjugate vaccine in 1999, through direct and indirect protection, but no vaccine was implemented against serogroup B disease. UK Meningococcal Carriage surveys 1-3 (UKMenCar1-3), conducted in 1999, 2000, and 2001, were essential for understanding the impact of vaccination. To investigate the decline in invasive meningococcal disease incidence, we did a large oropharyngeal carriage survey in 2014-15, immediately before the changes to meningococcal vaccines in the UK national immunisation schedule.
Methods: UKMenCar4 was a cross-sectional survey in adolescents aged 15-19 years who were enrolled from schools and colleges geographically local to one of 11 UK sampling centres between Sept 1, 2014, and March 30, 2015. Participants provided an oropharyngeal swab sample and completed a questionnaire on risk factors for carriage, including social behaviours. Samples were cultured for putative Neisseria spp, which were characterised with serogrouping and whole-genome sequencing. Data from this study were compared with the results from the UKMenCar1-3 surveys (1999-2001).
Findings: From the 19 641 participants (11 332 female, 8242 male, 67 not stated) in UKMenCar4 with culturable swabs and completed risk-factor questionnaires, 1420 meningococci were isolated, with a carriage prevalence of 7·23% (95% CI 6·88-7·60). Carriage prevalence was substantially lower in UKMenCar4 than in the previous surveys: carriage prevalence was 16·6% (95% CI 15·89-17·22; 2306/13 901) in UKMenCar1 (1999), 17·6% (17·05-18·22; 2873/16 295) in UKMenCar2 (2000), and 18·7% (18·12-19·27; 3283/17 569) in UKMenCar3 (2001). Carriage prevalence was lower for all serogroups in UKMenCar4 than in UKMenCar1-3, except for serogroup Y, which was unchanged. The prevalence of carriage-promoting social behaviours decreased from 1999 to 2014-15, with individuals reporting regular cigarette smoking decreasing from 2932 (21·5%) of 13 650 to 2202 (11·2%) of 19 641, kissing in the past week from 6127 (44·8%) of 13 679 to 7320 (37·3%) of 19 641, and attendance at pubs and nightclubs in the past week from 8436 (62·1%) of 13 594 to 7662 (39·0%) of 19 641 (all p<0·0001).
Interpretation: We show that meningococcal carriage prevalence in adolescents sampled nationally during a low incidence period (2014-15) was less than half of that in an equivalent population during a high incidence period (1999-2001). Disease and carriage caused by serogroup C was well controlled by ongoing vaccination. The prevalence of behaviours associated with carriage declined, suggesting that public health policies aimed at influencing behaviour might have further reduced disease.
Funding: Wellcome Trust, UK Department of Health, and National Institute for Health Research.
(Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)
التعليقات: Erratum in: Lancet Infect Dis. 2021 May;21(5):e122. (PMID: 33894853)
Erratum in: Lancet Infect Dis. 2021 Jul;21(7):e182. (PMID: 33965063)
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معلومات مُعتمدة: United Kingdom WT_ Wellcome Trust
المشرفين على المادة: 0 (Meningococcal Vaccines)
0 (serogroup C meningococcal conjugate vaccine)
تواريخ الأحداث: Date Created: 20210122 Date Completed: 20210517 Latest Revision: 20210630
رمز التحديث: 20221213
مُعرف محوري في PubMed: PMC8064914
DOI: 10.1016/S1473-3099(20)30842-2
PMID: 33482143
قاعدة البيانات: MEDLINE
الوصف
تدمد:1474-4457
DOI:10.1016/S1473-3099(20)30842-2