BMJ 2000;320:846-849 ( 25 March )

General Practice

Changing carriage rate of Neisseria meningitidis among university students during the first week of term: cross sectional study

Keith R Neal, senior lecturer, ^a Jonathan S Nguyen-Van-Tam, senior lecturer, ^a Nicholas Jeffrey, medical student, ^a Richard C B Slack, senior lecturer, ^b Richard J Madeley, professor, ^a Kamel Ait-Tahar, PhD student, ^b Katy Job, medical student, ^a Martin C J Wale, regional epidemiologist, ^c Dlawer A A Ala'Aldeen, reader. ^b

^a Department of Public Health Medicine and Epidemiology, University of Nottingham, Queen's Medical Centre, Nottingham NG7 2UH, ^b Meningococcal Research Group, Division of Microbiology, Queen's Medical Centre, ^c Communicable Disease Surveillance Centre Trent, Queen's Medical Centre

Correspondence to: K R Neal keith.neal{at}nott.ac.uk

Objective: To determine the rates of, and risk factors for, meningococcal carriage and acquisition among university students.
Design: Repeated cross sectional study.
Participants: 2507 students in their first year at university.
Main outcome measures: Prevalence of carriage of meningococci and risk factors for carriage and acquisition of meningococci.
Results: Carriage rates for meningoccoci increased rapidly in the first week of term from 6.9% on day 1, to 11.2% on day 2, to 19.0% on day 3, and to 23.1% on day 4. The average carriage rate during the first week of term in October among students living in catered halls was 13.9%. By November this had risen to 31.0% and in December it had reached 34.2%. Independent associations for acquisition of meningococci in the autumn term were frequency of visits to a hall bar (5-7 visits: odds ratio 2.7, 95% confidence interval 1.5 to 4.8), active smoking (1.6, 1.0 to 2.6), being male (1.6, 1.2 to 2.2), visits to night clubs (1.3, 1.0 to 1.6), and intimate kissing (1.4, 1.0 to 1.8). Lower rates of acquisition were found in female only halls (0.5, 0.3 to 0.9). The most commonly acquired meningococcal strain was C2a P1.5 (P1.2), which has been implicated in clusters of invasive meningococcal disease at other UK universities.
Conclusions: Carriage rates of meningococci among university students increase rapidly in the first week of term, with further increases during the term. The rapid rate of acquisition may explain the increased risk of invasive meningococcal disease and the timing of cases and outbreaks in university students.

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