Mathematical modelling of infection and disease due to Neisseria meningitidis and Neisseria lactamica.

BACKGROUND Invasive meningococcal disease, due to Neisseria meningitidis, is an important cause of morbidity and mortality in young children and adolescents. Nasopharyngeal carriage of meningococci (MC), is most prevalent in young adults whereas carriage of Neisseria lactamica (LC), a related non-pathogenic organism, is most prevalent in young children. The objective of this study was to use modelling techniques to test hypotheses on the processes that govern the incidence of meningococcal disease (MD). METHODS Deterministic compartmental models were fitted to age structured data sets of MC, LC and MD. RESULTS The model most consistent with the available data sets is one where LC inhibits MC, an inhibition that lasts for a mean of 4.7 years. The hypothesis that LC also acts as a natural immunogen against MD was consistent with this model. The second peak of MD observed among adolescents could be due to the peak in the acquisition of MC in this age group. CONCLUSIONS The role of LC as a natural immunogen against asymptomatic and symptomatic meningococcal infection was consistent with available field data. If the introduction of novel meningococcal vaccines into a population changes the prevalence of MC or LC, this could have a substantial impact on the effectiveness of immunization programmes. This paper demonstrates the potential utility of modelling to estimate these effects.

[1]  S. Larsen,et al.  Pharyngeal carriage of Neisseria meningitidis and Neisseria lactamica in households with infants within areas with high and low incidences of meningococcal disease , 1991, Epidemiology and Infection.

[2]  B T Grenfell,et al.  The estimation of age-related rates of infection from case notifications and serological data , 1985, Journal of Hygiene.

[3]  P. Sheehe,et al.  Meningococcal carriage in a population of "normal" families. , 1971, The Journal of infectious diseases.

[4]  M. Ramsay,et al.  Changing patterns of case ascertainment and trends in meningococcal disease in England and Wales. , 1997, Communicable disease report. CDR review.

[5]  D. Caugant,et al.  Intercontinental spread of a genetically distinctive complex of clones of Neisseria meningitidis causing epidemic disease. , 1986, Proceedings of the National Academy of Sciences of the United States of America.

[6]  C. Broome.  The carrier state: Neisseria meningitidis. , 1986, The Journal of antimicrobial chemotherapy.

[7]  H. Ward,et al.  Immunological investigations of meningococcal disease. III. Brevity of group C acquisition prior to disease occurrence. , 1977, Scandinavian journal of infectious diseases.

[8]  J. Dowling,et al.  Pharyngeal pneumococcal acquisitions in "normal" families: a longitudinal study. , 1971, The Journal of infectious diseases.

[9]  N. Lightfoot,et al.  Carriage of Neisseria meningitidis: investigations in a military establishment , 1988, Epidemiology and Infection.

[10]  J. Stuart,et al.  AN OUTBREAK OF MENINGOCOCCAL DISEASE IN GLOUCESTERSHIRE , 1986, The Lancet.

[11]  M. Maiden,et al.  Antigenic diversity of meningococcal outer membrane protein PorA has implications for epidemiological analysis and vaccine design , 1996, Clinical and diagnostic laboratory immunology.

[12]  M. Artenstein,et al.  HUMAN IMMUNITY TO THE MENINGOCOCCUS I. THE ROLE OF HUMORAL ANTIBODIES , 1969 .

[13]  A. J. Hall.  Infectious diseases of humans: R. M. Anderson & R. M. May. Oxford etc.: Oxford University Press, 1991. viii + 757 pp. Price £50. ISBN 0-19-854599-1 , 1992 .

[14]  M. Artenstein,et al.  Human immunity to the meningococcus. II. Development of natural immunity. , 1969 .

[15]  B. Greenwood,et al.  The epidemiology of infections due to Neisseria meningitidis and Neisseria lactamica in a northern Nigerian community. , 1982, The Journal of infectious diseases.

[16]  Surgeon-Commander S.F. Dudlev.  The carrier problem , 1922 .

[17]  P. Magnus,et al.  Asymptomatic carriage of Neisseria meningitidis in a randomly sampled population , 1994, Journal of clinical microbiology.

[18]  J. Saunders.  Population Genetics of bacteria. , 1994 .

[19]  L Watier,et al.  Meningococcal disease and influenza-like syndrome: a new approach to an old question. , 1992, The Journal of infectious diseases.

[20]  P. Musgrove,et al.  A critical review of 'a critical review': the methodology of the 1993 World Development Report, 'Investing in Health'. , 2000, Health policy and planning.

[21]  William H. Press,et al.  Book-Review - Numerical Recipes in Pascal - the Art of Scientific Computing , 1989 .

[22]  A. Ades,et al.  Modeling age- and time-specific incidence from seroprevalence:toxoplasmosis. , 1993, American journal of epidemiology.

[23]  M. Hassan-King,et al.  Meningococcal carriage, meningococcal disease and vaccination. , 1988, The Journal of infection.

[24]  J. Kim,et al.  Meningococcal molecular mimicry and the search for an ideal vaccine. , 1991, Transactions of the Royal Society of Tropical Medicine and Hygiene.

[25]  Aycock Wl,et al.  MENINGOCOCCUS CARRIER RATES AND MENINGITIS INCIDENCE , 1950 .

[26]  William H. Press,et al.  Numerical Recipes: FORTRAN , 1988 .

[27]  G. Garnett,et al.  Mathematical models of Haemophilus influenzae type b , 1998, Epidemiology and Infection.

[28]  B. Gray,et al.  Epidemiologic studies of Streptococcus pneumoniae in infants: acquisition, carriage, and infection during the first 24 months of life. , 1980, The Journal of infectious diseases.

[29]  P. Lambden,et al.  Sequence analysis and relationships between meningococcal class 3 serotype proteins and other porins from pathogenic and non-pathogenic Neisseria species. , 1992, FEMS microbiology letters.

[30]  J. Mueller,et al.  MENINGOCOCCUS CARRIER RATES AND MENINGITIS INCIDENCE , 1950, Bacteriological reviews.

[31]  Michael J. Crawley,et al.  GLIM for Ecologists , 1994 .

[32]  G. Rake.  STUDIES ON MENINGOCOCCUS INFECTION , 1934, The Journal of experimental medicine.

[33]  C. Hennekens,et al.  Seroepidemiology and chemoprophylaxis disease due to sulfonamide-resistant Neisseria meningitidis in a civillian population. , 1974, The Journal of infectious diseases.

[34]  I. Goldschneider,et al.  Carriage of Neisseria meningitidis and Neisseria lactamica in infants and children. , 1978, The Journal of infectious diseases.

[35]  S. Long,et al.  Widespread silent transmission of pertussis in families: antibody correlates of infection and symptomatology. , 1990, The Journal of infectious diseases.

[36]  H. Valkenburg,et al.  Meningococcal disease in The Netherlands, 1958-1990: a steady increase in the incidence since 1982 partially caused by new serotypes and subtypes of Neisseria meningitidis. , 1993, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[37]  K. Cartwright,et al.  The Stonehouse survey: nasopharyngeal carriage of meningococci and Neisseria lactamica , 1987, Epidemiology and Infection.

[38]  C. Farrington.  Modelling forces of infection for measles, mumps and rubella. , 1990, Statistics in medicine.

[39]  P. Mäkelä,et al.  Vaccination with Haemophilus influenzae type b meningococcal protein conjugate vaccine reduces oropharyngeal carriage of Haemophilus influenzae type b among American Indian children , 1993, The Pediatric infectious disease journal.

[40]  D. Crook,et al.  The impact of conjugate vaccine on carriage of Haemophilus influenzae type b. , 1995, The Journal of infectious diseases.

[41]  P. De Wals,et al.  Methods for estimating the duration of bacterial carriage. , 1985, International journal of epidemiology.

[42]  W. Press,et al.  Numerical Recipes in Fortran: The Art of Scientific Computing.@@@Numerical Recipes in C: The Art of Scientific Computing. , 1994 .

[43]  R. Mallard,et al.  Age incidence of meningococcal infection England and Wales, 1984-1991. , 1993, The Journal of infection.

[44]  B. Perkins,et al.  Control and prevention of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP). , 1997, MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports.

[45]  M. Achtman,et al.  The porA gene in serogroup A meningococci: evolutionary stability and mechanism of genetic variation , 1994, Molecular microbiology.

[46]  R. Pinner,et al.  Meningococcal Disease in the United States—1986 , 1991 .

[47]  A Bouckaert,et al.  Longitudinal study of asymptomatic meningococcal carriage in two Belgian populations of schoolchildren. , 1983, The Journal of infection.

[48]  J. Griffiss,et al.  Neisseria lactamica and Neisseria meningitidis share lipooligosaccharide epitopes but lack common capsular and class 1, 2, and 3 protein epitopes , 1989, Infection and immunity.