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Lecturer in general practice Division of Common Practice, The Health-related College, Queen’s Medical Centre, Nottingham NG7 2UH1 Correction. BMJ 2000; 320:1436 (28 Could.)approaches would be necessary to confirm regardless of whether the rapid rise in carriage in the start of term is the result of a true rise in acquisition, irrespective of whether differential acquisition of virulent and non-virulent strains happens, or irrespective of whether alternative explanations account for the findings.Anna Gilmore senior registrar in public wellness medicine London College of Hygiene and Tropical Medicine, London WC1E 7HT anna.gilmore@lshtm.ac.uk James Stuart consultant epidemiologist Communicable Illness Surveillance Centre (South West), Public Health Laboratory, Gloucester1 Neal KR, Nguyen-Van-Tam JS, Jeffrey N, Slack RCB, Madeley RJ, Ait-Tahar K et al. Changing carriage price of Neisseria meningitidis among university students for the duration of the very first week of term: cross sectional study. BMJ 2000;320:846-9. (25 March.) 2 Gilmore A, Jones G, Barker M, Soltanpoor N, Stuart JM. Meningococcal illness in the University of Southampton: outbreak investigation. Epidemiol Infect 1999;123:185-92. 3 Imrey PB, Jackson LA, Ludwinski PH, England AC III, Fella GA, Fox BC, et al. Meningococcal carriage, alcohol consumption and campus bar patronage within a serogroup C meningocccal illness outbreak. J Clin Microbiol 1995: 33:3133-7. 4 Cartwright KAC, Stuart JM, Jones DM, Noah ND. The Stonehouse survey: nasopharyngeal carriage of meningocci and Neisseria lactamica. Epidemiol Infect 1987;99:591-601. 5 Caugant DA, Hoiby EA, Magnus P, Scheel O, Hoel T, Bjune G, et al. Asymptomatic carriage of Neisseria meningitidis within a randomly sampled population. J Clin Microbiol 1994; 32:323-30.Carriage rate of Neisseria meningitidis amongst university studentsFurther information are needed Editor–The paper by Neal et al documenting danger Title Loaded From File variables for acquisition of Neisseria meningitidis among university students aids further our understanding with the aetiology of outbreaks of meningococcal illness at universities.1 Numerous outbreaks have now been linked to bars and nightclubs.two 3 By displaying that social elements like attendance at bars influence acquisition, the study aids substantiate evidence that social behaviour is very important in determining outbreak occurrence. Nonetheless, the threefold rise in carriage prices inside the initial 4 days of term is unexpected. The initial carriage rate (six.9 ), as Neal et al acknowledge, is surprisingly low. In 16-24 year olds, carriage rates in each outbreak and non-outbreak circumstances are often 20 or higher.four five The sudden enhance, inside a cross sectional study, to rates that could be regular for this age group suggests possible confounding. Carriage has been clearly documented to vary with age and sex,two 4 5 but no comparison of your age and sex of your four groups is presented, nor are these variables integrated within the regression analysis that examines threat factors for carriage. The study shows that virulent C2a strains are acquired extra quickly over the term than other strains. Rapid acquisition of illness causing strains was also suggested in the outbreaks at Cardiff and Southampton universities, exactly where low carriage prices of serogroup C outbreak organisms were documented in addition to pretty close clustering of your instances in time.two If a speedy improve in carriage does take place at the get started of term, and particularly if virulent C2a strains are transmitted preferentially because the study suggests, one would anticipate the rise in carriage to b.