Changes in serogroup and genotype prevalence among carried meningococci in the United Kingdom during vaccine implementation.


Ibarz-Pavón, AB; Maclennan, J; Andrews, NJ; Gray, SJ; Urwin, R; Clarke, SC; Walker, AM; Evans, MR; Kroll, JS; Neal, KR; Ala'aldeen, D; Crook, DW; Cann, K; Harrison, S; Cunningham, R; Baxter, D; Kaczmarski, E; McCarthy, ND; Jolley, KA; Cameron, JC; Stuart, JM; Maiden, MC; (2011) Changes in serogroup and genotype prevalence among carried meningococci in the United Kingdom during vaccine implementation. The Journal of infectious diseases, 204 (7). pp. 1046-53. ISSN 0022-1899 DOI: 10.1093/infdis/jir466

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Abstract

BACKGROUND Herd immunity is important in the effectiveness of conjugate polysaccharide vaccines against encapsulated bacteria. A large multicenter study investigated the effect of meningococcal serogroup C conjugate vaccine introduction on the meningococcal population. METHODS Carried meningococci in individuals aged 15-19 years attending education establishments were investigated before and for 2 years after vaccine introduction. Isolates were characterized by multilocus sequence typing, serogroup, and capsular region genotype and changes in phenotypes and genotypes assessed. RESULTS A total of 8462 meningococci were isolated from 47 765 participants (17.7%). Serogroup prevalence was similar over the 3 years, except for decreases of 80% for serogroup C and 40% for serogroup 29E. Clonal complexes were associated with particular serogroups and their relative proportions fluctuated, with 12 statistically significant changes (6 up, 6 down). The reduction of ST-11 complex serogroup C meningococci was probably due to vaccine introduction. Reasons for a decrease in serogroup 29E ST-254 meningococci (from 1.8% to 0.7%) and an increase in serogroup B ST-213 complex meningococci (from 6.7% to 10.6%) were less clear. CONCLUSIONS Natural fluctuations in carried meningococcal genotypes and phenotypes a can be affected by the use of conjugate vaccines, and not all of these changes are anticipatable in advance of vaccine introduction.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Vaccine Centre
PubMed ID: 21881120
Web of Science ID: 294595900012
URI: http://researchonline.lshtm.ac.uk/id/eprint/62142

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