This article is more than 5 years old. Information may no longer be current.
MenB vaccination at R.I. college halts outbreak, carriage
Click Here to Manage Email Alerts
The timely use of antibiotic chemoprophylaxis and mass vaccination following a recent Neisseria meningitidis serogroup B outbreak at a Rhode Island college may have eradicated the strain in the student population, according to state and federal health officials.
Reporting in MMWR, researchers assessed the prevalence of nasopharyngeal carriage of a rare outbreak strain of N. meningitidis serogroup B, known as ST-9069, among 717 students at Providence College.
In early February, the Rhode Island Department of Health was notified of cases of meningococcal disease in two male students. In response to the outbreak, potential contacts of the students received ciprofloxacin prophylaxis, and a mass vaccination campaign with a recently licensed vaccine — Trumenba (MenB-FHbp, Pfizer) — was initiated on campus. No additional cases have been identified as of June 8.
According to the researchers, 98% of students received at least one dose of the MenB-FHbp vaccine. Of these, 25% were carriers of N. meningitidis. However, of the 31 students with serogroup B carriage, none carried ST-9069.
“There are several possible explanations for this finding,” the researchers wrote. “First, the outbreak strain ST-9069 might have a lower propensity for developing a carrier state. Second, the well-targeted chemoprophylaxis strategy, the vaccination campaign, or both, might have eradicated ST-9069 carriage on the campus before the carriage evaluation. Third, our sample size might not have been large enough to detect a very low prevalence of the outbreak strain.”
Further analysis suggests males (prevalence ratio [PR] = 1.5; 95% CI, 1.2-2), smokers (PR = 1.5; 95% CI, 1.1-2) and students who visited bars or nightclubs or had attended one or more parties each week (PR = 2.7; 95% CI, 1.8-4.2) were at increased risk for carriage. Conversely, antibiotic use was associated with decreased carriage (PR = 0.4; 95% CI, 0.2-0.7).
The researchers said additional laboratory testing, which is ongoing, should clarify the impact of the MenB vaccination campaign on carriage among students at the college and support recommendations for vaccination in other college settings.
N. meningitidis serogroup B, which is responsible for approximately half of all cases in people aged 17 to 22 years in the United States, has been associated with at least four other recent college outbreaks, according to the CDC.
In February, the Advisory Committee on Immunization Practices unanimously recommended MenB vaccination in people aged 10 years and older who are at high risk for the disease, which includes outbreaks. CDC interim guidance suggests consideration for vaccination in outbreak settings where two or more primary cases of N. meningitidis are reported in populations with fewer than 5,000 people within a 6-month period. – by John Schoen
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts