Abstract
A population-based study was carried out in Catalonia (Spain) from May 1998 to April 1999 to determine the prevalence of Neisseria meningitidis strains in meningococcal disease (MD) cases and their contacts, as well as the prevalence of meningococci in close contacts of patients with MD, and risk factors for its carriage. A total of 364 close contacts of 87 patients with MD were studied. Throat samples were collected by hospital staff before rifampicin chemoprophylaxis was begun. For each contact, a questionnaire was completed for sociodemographic and epidemiological data. A total of 61 contacts (an overall prevalence of 16.8%) were carriers of meningococcal strains (40 B, 10 C, 1 Z and 10 non-groupable isolates). This prevalence is two to three times higher than in the general population (5–10%). In 33/61 microbiologically confirmed cases (54%) and in 9/26 probable cases (35%), contacts carrying N. meningitidis were found. In 22/33 confirmed cases with carrier contacts, it was possible to study the phenotype of the carrier and patient strains (serogroup, serotype and serosubtype). In 14 cases (64%), both strains were identical, in four cases, only a minor change was observed, in three cases, some strain (from the case or from his contact) was non-serotypable and non-serosubtypable, and in one case, both isolates were completely different. Bivariate analysis identified five statistically significant risk factors for meningococcal carriage: age (5–9 years old), meningococcal A + C vaccination, severe household overcrowding, social class and heavy active smoking (>20 cigarettes a day). Multivariate analysis revealed that of these five variables, only heavy active smoking remained statistically significant when the other factors were controlled.
Similar content being viewed by others
References
Harrison L, Broome CV. The epidemiology of meningococcal meningitis in the United States civilian population. In: Vedros N (ed.), The Evolution of Meningococcal Meningitis. Vol. I. Boca Raton: CRC Press. Inc., 1987; 27–45.
Lystad A, Aasen S. The epidemiology of meningococcal disease in Norway 1975–1991. NIPH Ann 1991; 14: 57–66.
Meningococcal Disease Surveillance Group. Meningococcal disease secondary attack rate and chemoprophylaxis in the United States. 1974. JAMA 1976; 235: 261–265.
Munford RS, Taunay AE, de Morais JS, Fraser DW, Feldman RA. Spread of meningococcal infection within household. Lancet 1974; i: 1275–8.
Kristiansen BE, Tveten Y, Ask E, et al. Preventing secondary cases of meningococcal disease by identifying and eradicating disease-causing strains in close contacts of patients. Scand J Infect Dis 1992; 24: 165–173.
Cratwright KAV, Stuart JM, Robinson PM. Meningococcal carriage in close contacts of cases. Epidemiol Infect 1991; 106: 133–141.
Vázquez JA, Marcos C, Berrón S. Sero/subtyping of Neisseria meningitidis isolated from patients in Spain. Epidemiol Infect 1994; 113(2): 267–274.
Greenfield S, Sheehe PR, Feldman HA. Meningococcal carriage in population of ‘normal’ families. J Infect Dis 1971; 123: 67–73.
Domínguez A, Cardeñosa N, Izquierdo C, et al. Prevalence of Neisseria meningitidis carriers in the school population of Catalonia, Spain. Epidemiol Infect 2001; 127: 425–433.
Kristiansen BE, Tveten Y, Jenkins A. Which contacts of patients with meningococcal disease carry the pathogenic strain of Neisseria meningitidis? A population based study. Br Med J 1998; 317: 621–625.
Greenfield S, Feldman H. Familial carriers and meningococcal meningitis. New Engl J Med 1967; 277: 497–502.
Marks MW, Frasch CE, Shapera RM. Meningococcal colonization and infection in children and their household contacts. Am J Epidemiol 1979; 109: 563–571.
Blakebrough IS, Greenwood BM, Whittle HC, Bradley AK. Failure of meningococcal vaccination to stop the transmission of meningococci in Nigerian schoolboys. Ann Trop Med Parasitol 1983; 77: 175–178.
Olcén P, Kjellander J, Danielsson D, Lindsquit BL. Epidemiology of Neisseria meningitidis: prevalence and symptoms from the upper respiratory tract in family members to patients with meningococcal disease. Scand J Infect Dis 1981; 13: 105–109.
Suker J, Feavers IM, Achtman M, Morelli G, Wang JF, Maiden MC. The porA gene in serogroup A meningococci: Evolutionary stability and mechanism of genetic variation. Mol Microbiol 1994; 12: 253–265.
Swartley JS, Marfin AA, Edupuganti S, et al. Capsule switching of Neisseria meningitidis. Proc Natl Acad Sci USA 1997; 94: 271–276.
Vogel U, Morelli G, Zurth K, et al. Necessity of molecular techniques to distinguish between Neisseria meningitidis strains isolated from patients with meningococcal disease and from their healthy contacts. J Clin Microbiol 1998; 36: 2465–2470.
Caugant DA, Hoiby EA, Magnus P, et al. Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population. J Clin Microbiol 1994; 32: 323–330.
Cartwright KAV, Stuart JM, Jones DM, Noah ND. The Stonehouse survey: Nasopharyngeal carriage of meningococci and Neisseria lactamica. Epidemiol Infect 1987; 99: 591–601.
Haneberg B, Tonjum T, Rodahl K, Gedde-Dahl TW. Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, stressful events, physical fitness and general symptoms of ill health. NIPH Ann 1983; 6: 169–173.
Stuart JM, Cartwright KAV, Dawson A, Rickard J, Noah ND. Risk factors for meningococcal disease: A case control study in south west England. Comm Med 1998; 10: 139–146.
Stuart JM, Cartwright KAV, Robinson PM, Noah ND. Effect of smoking on meningococcal carriage. Lancet 1989; 23: 723–725.
Dye JA, Adler KB. Effects of cigarette smoke on epithelial cells of the respiratory tract. Thorax 1994; 49: 825–834.
Fischer M, Hedberg K, Cardosi P, et al. Tobacco smoke as a risk factor for meningococcal disease. Pediatr Infect Dis J 1997; 16: 979–983.
Yusuf HR, Rochat RW, Baughman WS, et al. Maternal cigarette smoking and invasive meningococcal disease: A cohort study among young children in Metropolitan Atlanta, 1989–1996. Am J Public Health 1999; 89: 712–717.
Kriz P, Bobak M, Kriz B. Parental smoking, socioeconomic factors, and risk of invasive meningococcal disease in children: a population based case–control study. Arch Dis Child 2000; 83: 117–121.
Kaiser AB, Hennekens CH, Saslaw MS, Hayes PS, Bennet SV. Seroepidemiology and chemoprophylaxis of disease due to sulphonamide-resistant Neisseria meningitidis in a civilian population. J Infect Dis 1974; 130: 217–224.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Cardeñosa, N., Domínguez, A., Orcau, A. et al. Carriers of Neisseria meningitidis in household contacts of meningococcal disease cases in Catalonia (Spain). Eur J Epidemiol 17, 877–884 (2001). https://doi.org/10.1023/A:1015696513062
Issue Date:
DOI: https://doi.org/10.1023/A:1015696513062