721. Meningococcal Carriage Evaluation in Response to a Serogroup B Meningococcal Disease Outbreak and Mass Vaccination Campaign at a College — Rhode Island, 2015–2016
Session: Poster Abstract Session: Vaccines: Adolescent HPV and Meningococcal
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • SOETERS IDWeek 2016 poster PC MenB 101916v2.pdf (422.8 kB)
  • Background: Serogroup B meningococcal disease is a rare but severe infection and caused 6 US university outbreaks since 2013. Asymptomatic nasopharyngeal carriage of Neisseria meningitidis is the primary source of transmission. MenB-FHbp, a recently-licensed serogroup B meningococcal (MenB) vaccine, was used to control a 2015 college outbreak in Rhode Island. We investigated MenB impact on carriage.

    Methods: Four cross-sectional carriage surveys were conducted in conjunction with MenB vaccination campaigns. Questionnaires and oropharyngeal swabs were collected from undergraduates and graduate students living on campus. Specimens were evaluated using culture, slide agglutination, real-time PCR, and whole genome sequencing. Prevalence ratios (PR) were calculated using general estimating equations for repeat measures.

    Results: Campus-wide vaccine coverage for the 3 MenB doses was 97%, 80%, and 77%, respectively. During each survey 20–24% of participants carried any meningococcal bacteria and 4% carried serogroup B by PCR. Among 2,843 specimens, <1% were serogroups C, W, X, and Y, and 17% were nongroupable N. meningitidis by PCR. The outbreak strain (ST-9069) was not detected at baseline; it was detected in one student in the second and third surveys, though it did not express the serogroup B capsule via slide agglutination. 615 students participated in multiple surveys: 436 (71%) remained non-carriers, 50 (8%) cleared carriage, 89 (15%) remained carriers, and 45 (7%) acquired carriage. During the evaluation, 10 students acquired serogroup B carriage: 3 after one MenB dose, 4 after two doses, and 3 after three doses. Overall, smoking (PR 1.3, 95% confidence interval [CI] 1.1–1.5) and male sex (PR 1.3, 95% CI 1.1–1.5) were associated with increased meningococcal carriage.

    Conclusion: Despite high vaccination coverage, carriage prevalence on campus remained stable, suggesting MenB-FHbp does not rapidly reduce meningococcal carriage or prevent serogroup B carriage acquisition. However, vaccination remains the most important measure to protect individuals against meningococcal disease during outbreaks. Molecular testing is ongoing to improve our understanding of carriage dynamics over time. These findings inform MenB vaccine policy.

    Heidi Soeters, PhD, MPH1, Melissa Whaley, MS, MPH1, Xin Wang, PhD1, Nicole Alexander-Scott, MD, MPH2, Kristine Goodwin, BA3, Koren Kanadanian, MS, CEM3, Catherine Kelleher, RN3, Jessica Macneil, MPH1, Stacey W. Martin, MS1, Lucy Mcnamara, PhD, MS1, Steven Sears, Ed.D, MBA3, Cindy Vanner, BS, CLS2, Jeni Vuong, BS1, Utpala Bandy, MD, MPH2, Kenneth Sicard, OP, PhD3, Manisha Patel, MD, MS1 and Rhode Island Meningococcal Carriage Evaluation Team, (1)National Center for Immunization and Respiratory Diseases, CDC, Atlanta, GA, (2)Rhode Island Department of Health, Providence, RI, (3)Providence College, Providence, RI

    Disclosures:

    H. Soeters, None

    M. Whaley, None

    X. Wang, None

    N. Alexander-Scott, None

    K. Goodwin, None

    K. Kanadanian, None

    C. Kelleher, None

    J. Macneil, None

    S. W. Martin, None

    L. Mcnamara, None

    S. Sears, None

    C. Vanner, None

    J. Vuong, None

    U. Bandy, None

    K. Sicard, None

    M. Patel, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.