@article{3182533,
    title = "Characterization of meningococcal carriage isolates from Greece by whole
genome sequencing: Implications for 4CMenB vaccine implementation",
    author = "Kesanopoulos, Konstantinos and Bratcher, Holly B. and Hong, Eva and and Xirogianni, Athanasia and Papandreou, Anastasia and Taha, Muhamed-Kheir and and Maiden, Martin C. J. and Tzanakaki, Georgina",
    journal = "PLOS ONE",
    year = "2018",
    volume = "13",
    number = "12",
    publisher = "Public Library of Science",
    doi = "10.1371/journal.pone.0209919",
    abstract = "Herd protection, resulting from the interruption of transmission and
asymptomatic carriage, is an important element of the effectiveness of
vaccines against the meningococcus. Whilst this has been well
established for conjugate polysaccharide vaccines directed against the
meningococcal capsule, two uncertainties surround the potential herd
protection provided by the novel protein-based vaccines that are used in
place of serogroup B (MenB) polysaccharide vaccines (i) the strain
coverage of such vaccines against carried meningococci, which are highly
diverse; and (ii) the generation of a protective immune response in the
mucosa. These considerations are essential for realistic estimates of
cost-effectiveness of new MenB vaccines. Here the first of these
questions is addressed by the whole genome sequence (WGS) analysis of
meningococci isolated from healthy military recruits and university
students in Greece. The study included a total of 71 MenB isolates
obtained from 1420 oropharyngeal single swab samples collected from
military recruits and university students on voluntary basis, aged 18-26
years. In addition to WGS analysis to identify genetic lineage and
vaccine antigen genes, including the Bexsero Antigen Sequence Type
(BAST), the isolates were examined with the serological Meningococcal
antigen Typing System (MATS) assay. Comparison of these data
demonstrated that the carried meningococcal population was highly
diverse with 38% of the carriage isolates showed expression of antigens
matching those included in the 4CMenB vaccine. Our data may suggest a
limited potential herd immunity to be expected and be driven by an
impact on a subset of carriage isolates."
}