Source: Centers for Disease Control
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What is meningococcal carriage?
You can have occasionally have meningococcal bacteria at the back of your nose and throat without any symptoms of illness. This is known as "carriage" or "carrying the bacteria," and the bacteria can come and go over time. At any given time, 5% to 10% of people may carry meningococcal bacteria in their nose and throat. Carrying the bacteria may also benefit the individual by providing some protection from disease.
Is meningococcal carriage considered dangerous?
Finding meningococcal bacteria in your nose and throat is not usually considered dangerous. When you carry meningococcal bacteria in the back of your nose and throat, it is rare for these bacteria to move and invade other parts of your body and make you sick. It is only considered dangerous if you have also recently been exposed (within the last 10 days) to a person with meningococcal disease (meningitis or blood infection). This is considered dangerous since it means the strain that the ill person spread to you is one that is more likely to cause disease. Some strains of meningococcal bacteria are stronger and more likely to make you sick than other weaker strains, which will just spend some time in your nose and throat and then go away.
A benefit to carriage of meningococcal bacteria is that it allows your immune system to develop protection against the carried strain. People who have been carriers for more than a week are at low risk for disease from the carried strain (even if it is a strain known to cause disease) because of the immunity they have developed.
How do you test someone for meningococcal carriage?
A swab, similar to a "Q-tip," is put in the throat (back of the mouth) for a few seconds, like when you get tested for strep throat. That swab is then analyzed in a lab to see if meningococcal bacteria are on it.
Why is a carriage evaluation being done along with vaccination at Providence College?
Some meningococcal vaccines have been shown to prevent carriage, or eliminate carriage if you already have the bacteria in your nose and throat. Since this serogroup B vaccine has not been previously used in an outbreak situation, we hope to learn whether this vaccine can also prevent carriage. This is an important opportunity to monitor the extent to which serogroup B vaccination had an impact on reducing the circulation of meningococcal bacteria among students at Providence College. The findings will be helpful for deciding when to use this vaccine in future outbreaks.
Who will be part of the carriage evaluation?
Students 18 years of age and older at Providence College who are in the group recommended to receive the serogroup B meningococcal vaccine are invited to participate in the carriage evaluation. This includes all undergraduates, graduate students who live in dormitories. Participation is voluntary. Even if students did not receive the vaccine, they can still participate in this throat swab survey.
Are there any risks to students who participate in the carriage evaluation?
Swabbing of the throat's surface is unlikely to cause any adverse reactions, but occasionally may cause a momentary feeling of choking or discomfort in some people.
Will there be other carriage evaluations on campus?
When students come to the vaccine clinic to receive their second dose of the serogroup B meningococcal vaccine (early April), students can participate in another throat swab survey while waiting the required 15-20 minutes following vaccination. A third swab survey will occur one month after the second vaccine dose (early May). You can expect an e-mail from Providence College administration letting you know about the second and third swabs.
What information will be collected from the students who participate in the carriage evaluation?
Personally identifying information including name, date of birth, residence hall, and phone number will be used to follow-up with participants. Participants will be given a short questionnaire to complete at the time of each swab to determine potential risk factors for carriage. The questionnaire will ask about recent antibiotic use, recent respiratory illness, basic demographics, smoke exposure, and social behaviors.
How will the information about the students be kept private?
Each participant will be assigned a unique identifier number. This unique identifier number will be used when individual data from the questionnaire and throat swab results are entered into a password-protected computerized database. The database will be maintained in a secure location at Providence College, Rhode Island Department of Health, and CDC. Only the Providence College and Rhode Island Department of Health will maintain a list of names and contact information that is linked to their corresponding unique identifier numbers. Any records that identify participants by name will be kept private to the extent permitted by law.
Will students be told their throat swab results?
Because providing preventive antibiotics is not recommended for meningococcal carriage, the carriage results will not automatically be provided to students. However, if a student would like to know their test results, they can email CDC. Results will be available about 1-2 months after each survey. More information on how the student can get their results will be available when they enroll in the evaluation.
It is possible that other species in the same family as the bacteria that causes meningococcal disease (the family name is called Neisseria) will be found in the swab specimen. If Neisseria gonorrheae (the bacteria that cause gonorrhea) are found, participants will automatically be notified in a confidential manner and offered information and treatment by the Rhode Island Department of Health following the current treatment guidelines.
Shouldn't a known meningococcal carrier take antibiotics just in case?
This is not recommended because of the low risk of disease associated with meningococcal carriage, the small but known risk of taking unnecessary antibiotics (such as antibiotic allergy and promoting antibiotic-resistant disease), and the theoretical risk of preventing beneficial natural immunity to the carried germ. Providence College Student Health Center intends to follow CDC and Rhode Island Department of Health recommendations regarding use of antibiotics in carriers. Please feel free to discuss these issues further with your doctor.