Skip to main content
Journal of Clinical Microbiology logoLink to Journal of Clinical Microbiology
. 1994 Feb;32(2):323–330. doi: 10.1128/jcm.32.2.323-330.1994

Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population.

D A Caugant 1, E A Høiby 1, P Magnus 1, O Scheel 1, T Hoel 1, G Bjune 1, E Wedege 1, J Eng 1, L O Frøholm 1
PMCID: PMC263032  PMID: 8150942

Abstract

To estimate the extent of meningococcal carriage in the Norwegian population and to investigate the relationship of several characteristics of the population to the carrier state, 1,500 individuals living in rural and small-town areas near Oslo were selected at random from the Norwegian National Population Registry. These persons were asked to complete a questionnaire and to volunteer for a bacteriological tonsillopharyngeal swab sampling. Sixty-three percent of the selected persons participated in the survey. Ninety-one (9.6%) of the volunteers harbored Neisseria meningitidis. The isolates were serogrouped, serotyped, tested for antibiotic resistance, and analyzed by multilocus enzyme electrophoresis. Eight (8.8%) of the 91 isolates represented clones of the two clone complexes that have been responsible for most of the systemic meningococal disease in Norway in the 1980s. Age between 15 and 24, male sex, and active and passive smoking were found to be independently associated with meningococcal carriage in logistic regression analyses. Working outside the home and having an occupation in transportation or industry also increased the risk for meningococcal carriage in individuals older than 17, when corrections for gender and smoking were made. Assuming that our sample is representative of the Norwegian population, we estimated that about 40,000 individuals in Norway are asymptomatic carriers of isolates with epidemic potential. Thus, carriage eradication among close contacts of persons with systemic disease is unlikely to have a significant impact on the overall epidemiological situation.

Full text

PDF
323

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Blackwell C. C., Tzanakaki G., Kremastinou J., Weir D. M., Vakalis N., Elton R. A., Mentis A., Fatouros N. Factors affecting carriage of Neisseria meningitidis among Greek military recruits. Epidemiol Infect. 1992 Jun;108(3):441–448. doi: 10.1017/s0950268800049943. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Blackwell C. C., Weir D. M., James V. S., Todd W. T., Banatvala N., Chaudhuri A. K., Gray H. G., Thomson E. J., Fallon R. J. Secretor status, smoking and carriage of Neisseria meningitidis. Epidemiol Infect. 1990 Apr;104(2):203–209. doi: 10.1017/s0950268800059367. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Blakebrough I. S., Greenwood B. M., Whittle H. C., Bradley A. K., Gilles H. M. The epidemiology of infections due to Neisseria meningitidis and Neisseria lactamica in a northern Nigerian community. J Infect Dis. 1982 Nov;146(5):626–637. doi: 10.1093/infdis/146.5.626. [DOI] [PubMed] [Google Scholar]
  4. Broome C. V. The carrier state: Neisseria meningitidis. J Antimicrob Chemother. 1986 Jul;18 (Suppl A):25–34. doi: 10.1093/jac/18.supplement_a.25. [DOI] [PubMed] [Google Scholar]
  5. Bøvre K., Gedde-Dahl T. W. Epidemiological patterns of meningococcal disease in Norway 1975-1979. NIPH Ann. 1980 Dec;3(2):9–22. [PubMed] [Google Scholar]
  6. Cartwright K. A., Jones D. M., Smith A. J., Stuart J. M., Kaczmarski E. B., Palmer S. R. Influenza A and meningococcal disease. Lancet. 1991 Aug 31;338(8766):554–557. doi: 10.1016/0140-6736(91)91112-8. [DOI] [PubMed] [Google Scholar]
  7. Cartwright K. A., Stuart J. M., Jones D. M., Noah N. D. The Stonehouse survey: nasopharyngeal carriage of meningococci and Neisseria lactamica. Epidemiol Infect. 1987 Dec;99(3):591–601. doi: 10.1017/s0950268800066449. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Caugant D. A., Bol P., Høiby E. A., Zanen H. C., Frøholm L. O. Clones of serogroup B Neisseria meningitidis causing systemic disease in The Netherlands, 1958-1986. J Infect Dis. 1990 Oct;162(4):867–874. doi: 10.1093/infdis/162.4.867. [DOI] [PubMed] [Google Scholar]
  9. Caugant D. A., Bøvre K., Gaustad P., Bryn K., Holten E., Høiby E. A., Frøholm L. O. Multilocus genotypes determined by enzyme electrophoresis of Neisseria meningitidis isolated from patients with systemic disease and from healthy carriers. J Gen Microbiol. 1986 Mar;132(3):641–652. doi: 10.1099/00221287-132-3-641. [DOI] [PubMed] [Google Scholar]
  10. Caugant D. A., Høiby E. A., Rosenqvist E., Frøholm L. O., Selander R. K. Transmission of Neisseria meningitidis among asymptomatic military recruits and antibody analysis. Epidemiol Infect. 1992 Oct;109(2):241–253. doi: 10.1017/s0950268800050196. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Caugant D. A., Kristiansen B. E., Frøholm L. O., Bøvre K., Selander R. K. Clonal diversity of Neisseria meningitidis from a population of asymptomatic carriers. Infect Immun. 1988 Aug;56(8):2060–2068. doi: 10.1128/iai.56.8.2060-2068.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. De Wals P., Gilquin C., De Maeyer S., Bouckaert A., Noel A., Lechat M. F., Lafontaine A. Longitudinal study of asymptomatic meningococcal carriage in two Belgian populations of schoolchildren. J Infect. 1983 Mar;6(2):147–156. doi: 10.1016/s0163-4453(83)92756-1. [DOI] [PubMed] [Google Scholar]
  13. Goldschneider I., Gotschlich E. C., Artenstein M. S. Human immunity to the meningococcus. II. Development of natural immunity. J Exp Med. 1969 Jun 1;129(6):1327–1348. doi: 10.1084/jem.129.6.1327. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Griffiss J. M. Epidemic meningococcal disease: synthesis of a hypothetical immunoepidemiologic model. Rev Infect Dis. 1982 Jan-Feb;4(1):159–172. doi: 10.1093/clinids/4.1.159. [DOI] [PubMed] [Google Scholar]
  15. Haneberg B., Tønjum T., Rodahl K., Gedde-Dahl T. W. Factors preceding the onset of meningococcal disease, with special emphasis on passive smoking, symptoms of ill health. NIPH Ann. 1983 Dec;6(2):169–173. [PubMed] [Google Scholar]
  16. Hinton A. Passive smoking and otitis media with effusion. BMJ. 1992 Jan 4;304(6818):53–53. doi: 10.1136/bmj.304.6818.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Kristiansen B. E., Elverland H. Increased meningococcal carrier rate after tonsillectomy. Br Med J (Clin Res Ed) 1984 Mar 31;288(6422):974–974. doi: 10.1136/bmj.288.6422.974. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kristiansen B. E., Lind K. W., Mevold K., Sørensen B., Frøholm L. O., Bryn K., Tjade T., Bøvre K. Meningococcal phenotypic and genotypic characteristics and human antibody levels. J Clin Microbiol. 1988 Oct;26(10):1988–1992. doi: 10.1128/jcm.26.10.1988-1992.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Kristiansen B. E., Tveten Y., Ask E., Reiten T., Knapskog A. B., Steen-Johnsen J., Hopen G. Preventing secondary cases of meningococcal disease by identifying and eradicating disease-causing strains in close contacts of patients. Scand J Infect Dis. 1992;24(2):165–173. doi: 10.3109/00365549209052608. [DOI] [PubMed] [Google Scholar]
  20. Moore P. S., Hierholzer J., DeWitt W., Gouan K., Djoré D., Lippeveld T., Plikaytis B., Broome C. V. Respiratory viruses and mycoplasma as cofactors for epidemic group A meningococcal meningitis. JAMA. 1990 Sep 12;264(10):1271–1275. [PubMed] [Google Scholar]
  21. Olcén P., Kjellander J., Danielsson D., Lindquist B. L. 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(2):105–109. doi: 10.3109/inf.1981.13.issue-2.05. [DOI] [PubMed] [Google Scholar]
  22. Olsen S. F., Djurhuus B., Rasmussen K., Joensen H. D., Larsen S. O., Zoffman H., Lind I. Pharyngeal carriage of Neisseria meningitidis and Neisseria lactamica in households with infants within areas with high and low incidences of meningococcal disease. Epidemiol Infect. 1991 Jun;106(3):445–457. doi: 10.1017/s0950268800067492. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Reller L. B., MacGregor R. R., Beaty H. N. Bactericidal antibody after colonization with Neisseria meningitidis. J Infect Dis. 1973 Jan;127(1):56–62. doi: 10.1093/infdis/127.1.56. [DOI] [PubMed] [Google Scholar]
  24. Rosenqvist E., Høiby E. A., Wedege E., Kusecek B., Achtman M. The 5C protein of Neisseria meningitidis is highly immunogenic in humans and induces bactericidal antibodies. J Infect Dis. 1993 May;167(5):1065–1073. doi: 10.1093/infdis/167.5.1065. [DOI] [PubMed] [Google Scholar]
  25. Sandven P., Solberg O., Odegaard K., Myhre G. Improved medium for the transportation of gonococcal specimens. Acta Pathol Microbiol Immunol Scand B. 1982 Feb;90(1):73–77. doi: 10.1111/j.1699-0463.1982.tb00083.x. [DOI] [PubMed] [Google Scholar]
  26. Stuart J. M., Cartwright K. A., Jones D. M., Noah N. D., Wall R. J., Blackwell C. C., Jephcott A. E., Ferguson I. R. An outbreak of meningococcal disease in Stonehouse: planning and execution of a large-scale survey. Epidemiol Infect. 1987 Dec;99(3):579–589. doi: 10.1017/s0950268800066437. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Stuart J. M., Cartwright K. A., Robinson P. M., Noah N. D. Does eradication of meningococcal carriage in household contacts prevent secondary cases of meningococcal disease? BMJ. 1989 Mar 4;298(6673):569–570. doi: 10.1136/bmj.298.6673.569. [DOI] [PMC free article] [PubMed] [Google Scholar]
  28. Stuart J. M., Cartwright K. A., Robinson P. M., Noah N. D. Effect of smoking on meningococcal carriage. Lancet. 1989 Sep 23;2(8665):723–725. doi: 10.1016/s0140-6736(89)90781-2. [DOI] [PubMed] [Google Scholar]
  29. Wedege E., Høiby E. A., Rosenqvist E., Frøholm L. O. Serotyping and subtyping of Neisseria meningitidis isolates by co-agglutination, dot-blotting and ELISA. J Med Microbiol. 1990 Mar;31(3):195–201. doi: 10.1099/00222615-31-3-195. [DOI] [PubMed] [Google Scholar]
  30. Young L. S., LaForce F. M., Head J. J., Feeley J. C., Bennett J. V. A simultaneous outbreak of meningococcal and influenza infections. N Engl J Med. 1972 Jul 6;287(1):5–9. doi: 10.1056/NEJM197207062870102. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Microbiology are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES