Respiratory viruses do not trigger meningococcal disease in children Kathryn A. Dunlop a, *, Peter V. Coyle c , Paul Jackson b , Christopher C. Patterson e , Michael D. Shields d a Paediatrics, Antrim Hospital, 45 Bush Road, Antrim BT41 2RL, Northern Ireland, UK b Royal Belfast Hospital for Sick Children, 112 Falls Road, Belfast BT12 6BE, Northern Ireland, UK c Department of Clinical Virology, Royal Group of Hospitals, Grosvenor Road, Belfast BT12 6BB, Northern Ireland, UK d Department of Child Health, Queen’s University of Belfast, The Institute of Clinical Science, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK e Department of Epidemiology and Public Health, Queen’s University Belfast, Mulhouse Building, Royal Victoria Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK Accepted 6 September 2006 Available online 17 October 2006 KEYWORDS Respiratory viruses; Meningococcal disease; Children Summary Objectives: To determine whether the nasopharyngitis prodrome of meningococ- cal disease is caused by the disease itself or respiratory viral coinfection. Methods: Case control study of children with suspected meningococcal disease. Nasal swabs and a respiratory history were obtained from suspected cases and matched controls. Molecular testing for 12 respiratory viruses was used. Results: 104 suspected cases and controls were recruited. Detection rates for respiratory viruses were 27% (28/104) for suspected cases and 29% (30/104) for controls. Rhinoviruses (43/58, 74%) and adenoviruses (14/58, 24%) occurred most frequently with 3 coinfections. 39 (38%) suspected cases were confirmed as meningococcal disease with a detection rate for respiratory viruses of 26% (10/39). No significant difference was found in the respiratory viral detection rate between this group and their controls, Odds ratio Z 1.0 (95% CI 0.3 to 3.3). Prodromal respiratory symptoms were significantly more likely for suspected cases (77/104, 74%) than controls (55/104, 53%), Odds ratio 2.8 (95% CI 1.4 to 6.0), but were equally common in confirmed (28/39, 72%) and unconfirmed cases (49/65, 75%), Odds ratio 0.8 (95% CI 0.3 to 2.3). Conclusions: This study found no evidence that respiratory viral infections contribute to the pro- drome of meningococcal disease. Rhinovirus and adenovirus detection by nasal swab is common in well and unwell children. ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. * Corresponding author. Tel.: þ44 0 28 9442 4869; fax: þ44 0 28 9442 4294. E-mail address: k.dunlop@doctors.org.uk (K.A. Dunlop). 0163-4453/$30 ª 2006 The British Infection Society. Published by Elsevier Ltd. All rights reserved. doi:10.1016/j.jinf.2006.09.003 www.elsevierhealth.com/journals/jinf Journal of Infection (2007) 54, 454e458