Invasive meningococcal disease among university 
undergraduates: association with universities providing 
relatively large amounts of catered hall accommodation

The incidence of invasive meningococcal disease (IMD) among UK university students and non-students of similar age was investigated. In addition, we sought to identify structural risk factors associated with high rates of IMD in individual universities. Cases were ascertained via Consultants in Communicable Disease Control (or equivalent officers) between September 1994 and March 1997. Data on individual universities were obtained from university accommodation officers.University students had an increased annual rate of invasive meningococcal disease (13·2/105, 95% CI 11·2–15·2) compared with non-students of similar age in the same health districts (5·5/105, CI 4·7–6·4) and in those health districts without universities (3·7/105, CI 2·9–4·4). This trend was highly significant. Regression analysis demonstrated catered hall accommodation to be the main structural risk factor. Higher rates of disease were observed at universities providing catered hall places for >10% of their student population (15·3/105, CI 11·8–18·8) compared with those providing places for <10% of students (5·9/105, CI 4·1–7·7). The majority of IMD amongst students was caused by serogroup B organisms.University students in the UK are at increased risk of IMD compared with non-students of a similar age. The incidence of IMD tends to be greatest at universities with a high provision of catered hall accommodation.

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Meningococcal carriage in periods of high and low invasive meningococcal disease incidence in the UK: comparison of UKMenCar1–4 cross-sectional survey results

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(20)30842-2 ◽

2021 ◽

Author(s):

Jenny M MacLennan ◽

Charlene M C Rodrigues ◽

Holly B Bratcher ◽

Aiswarya Lekshmi ◽

Adam Finn ◽

...

Keyword(s):

Meningococcal Disease ◽

Disease Incidence ◽

Invasive Meningococcal Disease ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Survey Results ◽

The Uk

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Declining Incidence of Invasive Meningococcal Disease in South Africa: 2003–2016

Clinical Infectious Diseases ◽

10.1093/cid/ciy914 ◽

2018 ◽

Vol 69 (3) ◽

pp. 495-504

Author(s):

Susan Meiring ◽

Cheryl Cohen ◽

Linda de Gouveia ◽

Mignon du Plessis ◽

Ranmini Kularatne ◽

...

Keyword(s):

South Africa ◽

Meningococcal Disease ◽

Severe Disease ◽

National Laboratory ◽

Case Fatality ◽

Invasive Meningococcal Disease ◽

Relative Risk Ratio ◽

Surveillance Program ◽

Adjusted Relative Risk ◽

Increased Risk

Abstract Background Invasive meningococcal disease (IMD) is endemic to South Africa, where vaccine use is negligible. We describe the epidemiology of IMD in South Africa. Methods IMD cases were identified through a national, laboratory-based surveillance program, GERMS-SA, from 2003–2016. Clinical data on outcomes and human immunodeficiency virus (HIV) statuses were available from 26 sentinel hospital sites. We conducted space-time analyses to detect clusters of serogroup-specific IMD cases. Results Over 14 years, 5249 IMD cases were identified. The incidence was 0.97 cases per 100 000 persons in 2003, peaked at 1.4 cases per 100 000 persons in 2006, and declined to 0.23 cases per 100 000 persons in 2016. Serogroups were confirmed in 3917 (75%) cases: serogroup A was present in 4.7% of cases, B in 23.3%, C in 9.4%; W in 49.5%; Y in 12.3%, X in 0.3%; Z in 0.1% and 0.4% of cases were non-groupable. We identified 8 serogroup-specific, geo-temporal clusters of disease. Isolate susceptibility was 100% to ceftriaxone, 95% to penicillin, and 99.9% to ciprofloxacin. The in-hospital case-fatality rate was 17% (247/1479). Of those tested, 36% (337/947) of IMD cases were HIV-coinfected. The IMD incidence in HIV-infected persons was higher for all age categories, with an age-adjusted relative risk ratio (aRRR) of 2.5 (95% confidence interval [CI] 2.2–2.8; P < .001) from 2012–2016. No patients reported previous meningococcal vaccine exposure. Patients with serogroup W were 3 times more likely to present with severe disease than those with serogroup B (aRRR 2.7, 95% CI 1.1–6.3); HIV coinfection was twice as common with W and Y diseases (aRRR W = 1.8, 95% CI 1.1–2.9; aRRR Y = 1.9, 95% CI 1.0–3.4). Conclusions In the absence of significant vaccine use, IMD in South Africa decreased by 76% from 2003–2016. HIV was associated with an increased risk of IMD, especially for serogroup W and Y diseases.

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Protecting university students in the UK against meningococcal disease: vaccination is the way forward

Perspectives in Public Health ◽

10.1177/1757913913475758 ◽

2013 ◽

Vol 133 (2) ◽

pp. 90-91

Keyword(s):

University Students ◽

Meningococcal Disease ◽

The Uk ◽

The Way

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Latest Evidence on Non-Communicable Disease Management (NCD) during COVID-19 Pandemic

International Journal of Human and Health Sciences (IJHHS) ◽

10.31344/ijhhs.v5i0.301 ◽

2021 ◽

Vol 5 ◽

pp. 10

Author(s):

Abdul Rashid Abdul Rahman

Keyword(s):

New York ◽

Observational Studies ◽

Communicable Disease ◽

Angiotensin Receptor Blockers ◽

Sglt2 Inhibitors ◽

Diabetic Patients ◽

Recommended Care ◽

Increased Risk ◽

Raas Inhibitors ◽

The Uk

The year 2020 has been dominated by a communicable disease which most did not see coming and are ill- prepared to handle. While daily headlines the world over are dominated by new cases and death from COVID-19, other major health issues must not take a back seat. As of 30thNovember this year, 357 people have died of COVID-19 in Malaysia,while close to 15,000 Malaysians died of Ischemic Heart Disease (IHD) alone. With IHD and cerebrovascular accident (CVA) being the number 1 and number 3 causes of death (15% and 8% of all death, respectively) our focus on COVID-19 must not distract us from the ‘elephant in the room’. Evidence from UK showed that while hospitalization due to acute myocardial infarction (AMI) has significantly decreased by 50%, out of hospital cardiac arrest has significantly increased by 56%; and in hospital mortality from AMI has increased by at least 35% during the pandemic. Patients are shying away from coming for scheduled follow ups, and there has been a reduction in guideline recommended care for NCD. This is confounded by early scare which suggested that treatment of risk factors for NCDs, especially for hypertension, dyslipidemia, and diabetes, may increase susceptibility to and worsen prognosis for patients with COVID-19. Since COVID-19 is a new entity, latest evidence generated are mainly from observational studies with few clinical trials with the exception of vaccine trials. What do we know about management of NCD in the COVID-era?Since the discovery that SARS-COV-2 virus attached itself to the ACE2 receptors before entering cells, alarm bells were sounded that patients treated with RAAS inhibitors may be susceptible to and have worse prognosis. Withup to 60% of hypertensiveworldwide taking this class of drugs, the concern is understandable. Reassuringly, 6 observational studies from 4 countries and 1 RCT from a 5th country showed this not to be true. Studies from China and Italy showed that those on RAAS inhibitors have better prognosis and this has triggered an RCT which hypothesized that pre-treatment with angiotensin receptor blockers may be beneficial in preventing pulmonary damage in these patients. Another RCT is looking at recombinant human ACE2 as treatment for patients with COVID-19. In diabetic patients, an observational study from New York showed those on statin has reduced mortality compared to non-user and in a large UK based primary care setting there was no increased risk of COVID-19 among patients prescribed SGLT2 inhibitors. The SGLT2 inhibitors have been proven to improve clinical outcome including mortality in diabetics and could be safely used to treat patients during the pandemic. Based on a nationwide retrospective cohort in the UK, overall mortality was higher for diabetics admitted to ICU or HDU and with greatest mortality impact in younger patients.The next few months will see more prospective intervention studies publishedaddressing the various unanswered questions. It is worth remembering that substandard care is responsible for upto 84% of CV death. Hence, we shouldnot let our guards down with NCDs even when the world’s attention is focused on COVID-19.International Journal of Human and Health Sciences Supplementary Issue: 2021 Page: S10

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A cluster of invasive meningococcal disease (IMD) caused by Neisseria meningitidis serogroup W among university students, France, February to May 2017

Eurosurveillance ◽

10.2807/1560-7917.es.2017.22.28.30574 ◽

2017 ◽

Vol 22 (28) ◽

Cited By ~ 18

Author(s):

Clément Bassi ◽

Muhamed-Kheir Taha ◽

Christian Merle ◽

Eva Hong ◽

Daniel Lévy-Bruhl ◽

...

Keyword(s):

University Students ◽

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Vaccination Campaign ◽

Invasive Meningococcal Disease ◽

South American ◽

The South ◽

International University

Between February and May 2017, two cases of invasive meningococcal disease caused by a new, rapidly expanding serogroup W meningococci variant were reported among students of an international university in Paris. Bacteriological investigations showed that isolates shared identical genotypic formula (W:P1.5,2:F1–1:cc11) and belonged to the South American/UK lineage. A vaccination campaign was organised that aimed at preventing new cases linked to potential persistence of the circulation of the bacteria in the students.

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Increased Risk of Invasive Meningococcal Disease, Pregnancy, and Confounding: In Reply

PEDIATRICS ◽

10.1542/peds.2005-1548 ◽

2005 ◽

Vol 116 (3) ◽

pp. 799-799

Author(s):

E. J. van Gils

Keyword(s):

Meningococcal Disease ◽

Invasive Meningococcal Disease ◽

Increased Risk

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Increased Risk of Invasive Meningococcal Disease, Pregnancy, and Confounding

PEDIATRICS ◽

10.1542/peds.2005-1183 ◽

2005 ◽

Vol 116 (3) ◽

pp. 798-799

Author(s):

A. E. Tozzi

Keyword(s):

Meningococcal Disease ◽

Invasive Meningococcal Disease ◽

Increased Risk

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UKMenCar4: A cross-sectional survey of asymptomatic meningococcal carriage amongst UK adolescents at a period of low invasive meningococcal disease incidence

Wellcome Open Research ◽

10.12688/wellcomeopenres.15362.2 ◽

2019 ◽

Vol 4 ◽

pp. 118

Author(s):

Holly B. Bratcher ◽

Charlene M. C. Rodrigues ◽

Adam Finn ◽

Mandy Wootton ◽

J. Claire Cameron ◽

...

Keyword(s):

Neisseria Meningitidis ◽

Meningococcal Disease ◽

Disease Incidence ◽

Invasive Meningococcal Disease ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Adolescent Population ◽

Population Immunity ◽

Behavioural Factors ◽

The Uk

Carriage of Neisseria meningitidis, the meningococcus, is a prerequisite for invasive meningococcal disease (IMD), a potentially devastating infection that disproportionately afflicts infants and children. Humans are the sole known reservoir for the meningococcus, and it is carried asymptomatically in the nasopharynx of ~10% of the population. Rates of carriage are dependent on age of the host and social and behavioural factors. In the UK, meningococcal carriage has been studied through large, multi-centre carriage surveys of adolescents in 1999, 2000, and 2001, demonstrating carriage can be affected by immunisation with the capsular group C meningococcal conjugate vaccine, inducing population immunity against carriage. Fifteen years after these surveys were carried out, invasive meningococcal disease incidence had declined from a peak in 1999. The UKMenCar4 study was conducted in 2014/15 to investigate rates of carriage amongst the adolescent population during a period of low disease incidence. The protocols and methodology used to perform UKMenCar4, a large carriage survey, are described here.

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