The natural history of meningococcal carriage and disease

Caroline Trotter, N. J. Gay, William Edmunds*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

87 Citations (Scopus)


The prevalence of Neisseria meningitidis carriage is highest in teenagers and lowest in young children. In contrast, invasive meningococcal disease is most common in young children with a smaller secondary peak in teenagers. Data on carriage and disease were analysed to quantify the risks of infection and disease by age and serogroup. The forces of infection for serogroups B, C, other meningococci and Neisseria lactamica were modelled together with the risk of disease given infection for serogroups B and C, using maximum likelihood to fit the models to the available data. The risk of meningococcal disease given infection declines steeply through childhood and is higher for serogroup C than for serogroup B. The secondary peak in disease in teenagers appears to be explained mostly by increased transmission although there is a suggestion that other factors may also contribute. These analyses provide important insights and may be used to guide further data collection and modelling studies.

Original languageEnglish
Pages (from-to)556-566
Number of pages11
JournalEpidemiology and Infection
Issue number3
Publication statusPublished - Jun 2006


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