Re-emergence of meningococcal carriage on three-year follow-up of a kibbutz population after whole-community chemoprophylaxis

• Published in: European journal of clinical microbiology & infectious diseases Vol. 12; no. 7; pp. 505 - 511
• Main Authors: BLOCK, C, RAZ, R, FRASCH, C. E, EPHROS, M, GREIF, Z, TALMON, Y, ROSIN, D, BOGOKOWSKY, B
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01-07-1993
• Subjects: Adolescent; Adult; Aged; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Carrier State - epidemiology; Carrier State - microbiology; Child; Child, Preschool; Cohort Studies; Communicable Disease Control; Female; Follow-Up Studies; Humans; Infant; Israel - epidemiology; Male; Medical sciences; Meningitis, Meningococcal - drug therapy; Meningitis, Meningococcal - epidemiology; Meningitis, Meningococcal - microbiology; Meningitis, Meningococcal - prevention & control; Middle Aged; Neisseria meningitidis; Neisseria meningitidis - classification; Pharmacology. Drug treatments; Asia; Israel; Human; Treatment efficiency; Neisseriaceae; Neisseria meningitidis; Oropharynx; Epidemiology; Prevention; Chemotherapy; Treatment; Bacteria; Micrococcales; Antituberculous agent; Serotype; Carrier; Antibacterial agent; Sanitary surveillance; Colonization
• ISSN: 0934-9723; 1435-4373
• DOI: 10.1007/BF01970955

A long-term study was conducted to determine the rate of re-emergence of throat carriage of meningococci in a semi-closed kibbutz community after the administration of chemoprophylaxis to all its members. Serotype B:4 was selected as marker organism since it was isolated from a fatal case and was the most frequently occurring strain (80%) among serogroup B isolates, which themselves comprised 54% of all meningococci. The carriage rate among Israeli residents (volunteer workers were analyzed separately) before treatment was 6.6% (49/748) overall, with 4.3% group B strains. Three weeks after treatment, in most cases with rifampicin (whereby three persistently positive persons were retreated with minocycline), no meningococci were recovered. Six months later, 1.9% of a population sample aged < or = 30 years were positive, while before treatment and one and three years later, 9.4%, 8.6% and 4.6% respectively were positive in this age group. Serotype B:4 comprised 81.3% of group B strains before prophylaxis, 5.3% after one year, and 28.6% after three years, thus possibly re-establishing itself as the single dominant serotype. The marked suppression of carriage after mass chemoprophylaxis appeared to last at least six months, with the meningococcal population being re-established within a year.