{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T19:50:54Z","timestamp":1785009054295,"version":"3.55.0"},"reference-count":50,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"unspecified","delay-in-days":90,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Teenagers have a higher risk of invasive meningococcal disease (IMD) than the general population. This cross-sectional study aimed to characterise strains of <jats:italic>Neisseria meningitidis<\/jats:italic> circulating among Norwegian teenagers and to assess risk factors for meningococcal carriage. Oropharyngeal swabs were collected from secondary-school students in southeastern Norway in 2018\u20132019. Meningococcal isolates were characterised using whole genome sequencing. Risk factors for meningococcal carriage were assessed from questionnaire data. Samples were obtained from 2296 12\u201324-year-olds (majority 13\u201319-year-olds). <jats:italic>N. meningitidis<\/jats:italic> was identified in 167 (7.3%) individuals. The highest carriage rate was found among 18-year-olds (16.4%). Most carriage isolates were capsule null (40.1%) or genogroup Y (33.5%). Clonal complexes cc23 (35.9%) and cc198 (32.3%) dominated and 38.9% of carriage strains were similar to invasive strains currently causing IMD in Norway. Use of Swedish snus (smokeless tobacco) (OR 1.56, 95% CI 1.07\u20132.27), kissing &gt;two persons\/month (OR 2.76, 95% CI 1.49\u20135.10) and partying &gt;10 times\/3months (OR 3.50, 95% CI 1.45\u20138.48) were associated with carriage, while age, cigarette smoking, sharing of drinking bottles and meningococcal vaccination were not. The high meningococcal carriage rate among 18-year-olds is probably due to risk-related behaviour. Use of Swedish snus is possibly a new risk factor for meningococcal carriage. Almost 40% of circulating carriage strains have invasive potential.<\/jats:p>","DOI":"10.1017\/s0950268820000734","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T02:11:37Z","timestamp":1585620697000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":25,"title":["Meningococcal carriage in Norwegian teenagers: strain characterisation and assessment of risk factors"],"prefix":"10.1017","volume":"148","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4437-4093","authenticated-orcid":false,"given":"S. V.","family":"Watle","sequence":"first","affiliation":[{"name":"Norwegian Institute of Public Health"},{"name":"Institute of Health and Society, University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Caugant","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health"},{"name":"Institute of Health and Society, University of Oslo"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Tunheim","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"Bekkevold","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Laake","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O. B.","family":"Brynildsrud","sequence":"additional","affiliation":[{"name":"Norwegian Institute of Public Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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The Council of the European Union. Council Recommendation of 30 November 2009 on smoke-free environments. Available at https:\/\/eur-lex.europa.eu\/legal-content\/EN\/ALL\/?uri=CELEX:32009H1205(01) (Accessed 16 December 2019)."},{"key":"S0950268820000734_ref50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2019.10.018"},{"key":"S0950268820000734_ref2","doi-asserted-by":"publisher","DOI":"10.1038\/s41579-019-0282-6"},{"key":"S0950268820000734_ref4","doi-asserted-by":"publisher","DOI":"10.3201\/eid1206.051297"},{"key":"S0950268820000734_ref22","volume-title":"Health Risks From Snus use (In Norwegian)","year":"2019"},{"key":"S0950268820000734_ref24","doi-asserted-by":"publisher","DOI":"10.1006\/taap.1995.1233"},{"key":"S0950268820000734_ref43","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2015.1051276"},{"key":"S0950268820000734_ref26","doi-asserted-by":"publisher","DOI":"10.1016\/j.micinf.2008.12.001"},{"key":"S0950268820000734_ref19","doi-asserted-by":"publisher","DOI":"10.3201\/eid2306.161768"},{"key":"S0950268820000734_ref32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2015.02.006"},{"key":"S0950268820000734_ref47","doi-asserted-by":"publisher","DOI":"10.1016\/j.vaccine.2007.04.038"},{"key":"S0950268820000734_ref33","first-page":"759","article-title":"Regulation of capsule in Neisseria meningitidis","volume":"42","author":"Tzeng","year":"2016","journal-title":"Critical Reviews in Microbiology"},{"key":"S0950268820000734_ref17","doi-asserted-by":"publisher","DOI":"10.1080\/21645515.2018.1450121"},{"key":"S0950268820000734_ref36","doi-asserted-by":"publisher","DOI":"10.3109\/00365548.2015.1010228"},{"key":"S0950268820000734_ref5","unstructured":"5. 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