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Secondhand smoke associated with invasive meningococcal disease

Lee CC. PLoS Med. 2010;doi:10.1371/journal.pmed.1000374.

Exposure to secondhand smoke appeared to be associated with invasive meningococcal disease, according to researchers from the Harvard School of Public Health.

“Since the 1980s, epidemiologic studies have found an association between secondhand smoke exposure and invasive bacterial disease or bacterial carriage, including those related to [Neisseria] meningitidis, Haemophilus influenzae type b and [Streptococcus] pneumoniae, which suggests that secondhand smoke might be an independent risk factor of invasive bacterial disease,” the researchers wrote. “To our knowledge, no reviews have systematically investigated the quality and consistency of epidemiological evidence on this association.”

The researchers conducted a systematic review and meta-analysis on 30 studies about secondhand smoke and invasive bacterial disease. They identified the studies using Medline and Embase databases.

There were 16 studies with invasive meningococcal disease as the primary outcome. When all of the studies were considered together, secondhand smoke exposure was associated with an increased risk for invasive meningococcal disease. There were four studies on secondhand smoke and invasive pneumococcal disease. The researchers found a nonsignificant association between secondhand smoke exposure and invasive pneumococcal disease. For invasive Hib disease, there were 12 studies. There was a nonsignificant association between secondhand smoke and Hib disease.

Based on five cross-sectional surveys on the pharyngeal carriage of N. meningitidis, there was a significant positive association between N. meningitidis and secondhand smoke exposure. In five cross-sectional surveys on the pharyngeal carriage of S. pneumoniae, there was a significant association between S. pneumoniae and secondhand smoke. Lastly, there was no association between Hib and secondhand smoke, based on the data of two cross-sectional surveys.

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