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

Clin Infect Dis. 2017 Apr 15;64(8):1115-1122. doi: 10.1093/cid/cix091.


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; serogroup B; vaccines; outbreak.

MeSH terms

  • Adult
  • Carrier State / epidemiology*
  • Carrier State / microbiology
  • Carrier State / prevention & control
  • Cross-Sectional Studies
  • Disease Outbreaks*
  • Female
  • Humans
  • Male
  • Mass Vaccination*
  • Meningococcal Infections / epidemiology*
  • Meningococcal Infections / microbiology
  • Meningococcal Infections / prevention & control
  • Meningococcal Vaccines / administration & dosage*
  • Neisseria meningitidis, Serogroup B / isolation & purification*
  • Prevalence
  • Rhode Island / epidemiology
  • Young Adult


  • Meningococcal Vaccines