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

Ana Belén Ibarz-Pavón, Jenny MacLennan, Nicholas J. Andrews, Stephen J. Gray, Rachel Urwin, Stuart C. Clarke, A. Mark Walker, Meirion R. Evans, J. Simon Kroll, Keith R. Neal, Dlawer Ala'aldeen, Derrick W. Crook, Kathryn Cann, Sarah Harrison, Richard Cunningham, David Baxter, Edward Kaczmarski, Noel D. McCarthy, Keith A. Jolley, J. Claire CameronJames M. Stuart, Martin C. J. Maiden

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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.

Original languageEnglish
Pages (from-to)1046-1053
Number of pages8
JournalJournal of Infectious Diseases
Volume204
Issue number7
DOIs
Publication statusPublished - 1 Oct 2011
Externally publishedYes

Bibliographical note

Copyright the Author(s) 2011. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

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