Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T18:46:07.404Z Has data issue: false hasContentIssue false
  • English
  • Français

Meningococcal carriage in close contacts of cases

Published online by Cambridge University Press:  15 May 2009

K. A. V. Cartwright ,
J. M. Stuart  and
P. M. Robinson
K. A. V. Cartwright
Affiliation:
Gloucester Public Health Laboratory, Gloucester GL1 3NN.
J. M. Stuart
Affiliation:
Gloucester Health Authority, Gloucester GL1 JLY
P. M. Robinson
Affiliation:
Gloucester Health Authority, Gloucester GL1 JLY
Rights & Permissions [Opens in a new window]

Summary

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

Between 1 October 1986 and 31 March 1987, 55 cases of meningococcal disease were identified in the South-West of England, an attack rate of 1·54 per 100000 during the study period. Antibiotics used in the treatment of the disease successfully eliminated nasopharyngeal carriage of meningococci in 13 out of 14 cases without use of rifampicin. The overall meningococcal carriage rate in 384 close contacts was 18·2% and the carriage rate of strains indistinguishable from the associated case strain was 11·1%. The carriage rate of indistinguishable strains in household contacts (16·0%) was higher than the carriage rate in contacts living at other addresses (7·0%, P > 0·05). A 2·day course of rifampicin successfully eradicated meningococci from 46 (98%) of 47 colonized contacts.

In one third of cases groupable meningococci were isolated from at least one household contact; 92% of these isolates were of the same serogroup as the associated case strain. When a meningococcus is not isolated from a deep site in a clinical case of meningococcal disease, culture of serogroup A or C strains from nasopharyngeal swabs of the case or of household contacts is an indication that the close contact group should be offered meningococcal A + C vaccine in addition to chemoprophylaxis. The failure in this and other studies to isolate meningococci from any household contact in the majority of cases may be due either to the relative insensitivity of nasopharyngeal swabbing in detecting meningococcal carriage or to the acquisition of meningococci by most index cases from sources outside the household.

Type
Research Article
Information
Epidemiology & Infection , Volume 106 , Issue 1 , February 1991 , pp. 133 - 141
Copyright
Copyright © Cambridge University Press 1991

References

1.Poolman, JT, Lind, I, Jonsdottir, K, Froholm, LO, Jones, DM, Zanen, HC. Meningococcal serotypes and serogroup B disease in north-west Europe. Lancet 1986; ii: 555–7.CrossRefGoogle Scholar
2.Cartwright, KAV. Stuart, JM. Noah, ND. An outbreak of meningococcal disease in Gloucestershire. Lancet 1986; ii: 558–61.CrossRefGoogle Scholar
3.Dawson, JA, Rickard, J, Wilkinson, PJ. Meningococcal disease in south-west of England. Lancet 1986; ii: 806–7.CrossRefGoogle Scholar
4.Bovre, K. Meningococcal disease in Norway. Antonie van Leeuwenhoek 1986; International Symposium: 208–11.Google Scholar
5.Cartwright, KAV, Stuart, JM, Jones, DM, Noah, ND. The Stonehouse survey: nasopharyngeal carriage of meningococci and Neisseria lactamica. Epidemiol Infect 1987; 99: 591–601.CrossRefGoogle ScholarPubMed
6.Pether, JVS, Lightfoot, NF, Scott, RJD, Morgan, J, Steele-Perkins, AP, Sheard, SC. Carriage of Neisseria meningitidis: investigation in a military establishment. Epidemiol Infect 1988; 101: 21–42.CrossRefGoogle Scholar
7.De Wals, P, Hertoghe, L, Borlee, Grime I et al. Meningococcal disease in Belgium. Secondary attack rate among household, day-care nursery and pre-elementary school contacts. J Infect 1981; 3 Suppl 1: 53–61.CrossRefGoogle ScholarPubMed
8.Meningococcal Disease Surveillance Group. Meningococcal disease secondary attack rate and chemoprophylaxis in the United States, 1974. JAMA 1976; 235: 261–5.CrossRefGoogle Scholar
9.Cooke, RPD, Riordan, T, Jones, DM, Painter, MJ. Secondary cases of meningococcal infection among close family and household contacts in England and Wales. Br Med J 1989; 298: 555–8.CrossRefGoogle ScholarPubMed
10.Broome, CV. The carrier state: Neisseria meningitidis. J Antimicrob Chemother 1986; 18 Suppl A: 25–34.CrossRefGoogle ScholarPubMed
11.Stuart, JM, Cartwright, KAV, Robinson, PM, Noah, ND. Does eradication of meningococcal carriage in household contacts prevent secondary cases of meningococcal disease ? Br Med J 1989: 298: 569–70.CrossRefGoogle ScholarPubMed
12.Abramson, JS. Spika, JS. Persistence of Neisseria meningitidis in the upper respiratory tract after intravenous antibiotic therapy for systemic meningococcal disease. J Infect Dis 1985; 151: 370–1.CrossRefGoogle ScholarPubMed
13.Stuart, JM, Cartwright, KAV, Jones, DM et al. , An outbreak of meningococcal disease in Stonehouse: planning and execution of a large-scale survey. Epidemiol Infect 1987; 99: 579–89.CrossRefGoogle ScholarPubMed
14.Munford, RS, Taunay, A de E, de Morais, JS, Fraser, DW, Feldman, RA. Spread of meningococcal infection within households. Lancet 1974; i: 1275–8.CrossRefGoogle Scholar
15.Marks, MI, Frasch, CE, Shaper, RM. Meningococcal colonisation and infection in children and their household contacts. Am J Epidemiol 1979; 109: 563–71.CrossRefGoogle ScholarPubMed
16.Blakebrough, IS, Gilles, HM. The effect of rifampicin on meningococcal carriage in family contacts in northern Nigeria. J Infect 1980; 2: 137–43.CrossRefGoogle ScholarPubMed
17.Olcen, P, Kjellander, J, Danielsson, D, Lindquist, 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: 105–9.CrossRefGoogle ScholarPubMed
18.Saez-Nieto, JA, Campos, J, Latorre, C et al. , Prevalence of Neisseria meningitidis in family members of patients with meningococcal infection. J Hyg 1982; 89: 139–48.CrossRefGoogle ScholarPubMed
19.Joint Committee on Vaccination and Immunisation. Immunisation against infectious disease. London: HMSO, 1990.Google Scholar
20.Cartwright, KAV, Jones, DM. Investigation of meningococcal disease. J Clin Pathol 1989; 43: 634–9.CrossRefGoogle Scholar
21.Richards, PG, Towu-Aghantse, E. Dangers of lumbar puncture. Br Med J 1986; 292: 605–6.CrossRefGoogle ScholarPubMed
22.Jewes, L, Norman, P, McKendrick, MW. Value of throat swabs in meningococcal meningitis. J Clin Pathol 1989: 42: 1229.CrossRefGoogle ScholarPubMed
23.Farries, JS, Dickson, W, Greenwood, E, Malhotra, TR, Abbott, JD, Jones, DM. Meningococcal infection in Bolton, 1971–74. Lancet 1975; ii: 118–21.CrossRefGoogle Scholar