Letters

Carriage rate of Neisseria meningitidis among university students

BMJ 2000; 321 doi: https://doi.org/10.1136/bmj.321.7257.383 (Published 05 August 2000) Cite this as: BMJ 2000;321:383

Further data are needed

  1. Anna Gilmore, senior registrar in public health medicine (anna.gilmore@lshtm.ac.uk),
  2. James Stuart, consultant epidemiologist
  1. London School of Hygiene and Tropical Medicine, London WC1E 7HT
  2. Communicable Disease Surveillance Centre (South West), Public Health Laboratory, Gloucester
  3. Department of Public Health Medicine and Epidemiology
  4. Department of Public Health Medicine and Epidemiology
  5. Department of Public Health Medicine and Epidemiology
  6. Meningococcal Research Group, Division of Microbiology
  7. Department of Public Health Medicine and Epidemiology
  8. Meningococcal Research Group, Division of Microbiology
  9. Department of Public Health Medicine and Epidemiology
  10. Communicable Disease Surveillance Centre Trent
  11. Meningococcal Research Group, Division of Microbiology, University of Nottingham, Queens Medical Centre, Nottingham, NG7 2UH

    EDITOR—The paper by Neal et al documenting risk factors for acquisition of Neisseria meningitidis among university students helps further our understanding of the aetiology of outbreaks of meningococcal disease at universities.1 Several outbreaks have now been linked to bars and nightclubs.2 3 By showing that social factors such as attendance at bars influence acquisition, the study helps substantiate evidence that social behaviour is important in determining outbreak occurrence.

    However, the threefold rise in carriage rates in the first four days of term is unexpected. The initial carriage rate (6.9%), as Neal et al acknowledge, is surprisingly low. In 16–24 year olds, carriage rates in both outbreak and non-outbreak situations are usually 20% or higher.4 5 The sudden increase, in a cross sectional study, to rates that would be normal for this age group suggests potential confounding. Carriage has been clearly documented to vary with age and sex, 2 4 5 yet no comparison of the age and sex of the four groups is presented, nor are these variables included in …

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