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15 November 2007

Volume 45, Number 10
Clinical Infectious Diseases 2007;45:1327–1334
© 2007 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2007/4510-0012$15.00
DOI: 10.1086/522190
MAJOR ARTICLE

Lack of Association between Group B Meningococcal Disease and Autoimmune Disease

Michael Howitz,1

Tyra Grove Krause,1

Jacob Brunbjerg Simonsen,2

Steen Hoffmann,3

Morten Frisch,2

Nete Munk Nielsen,2

John Robbins,4

Rachel Schneerson,4

Kåre Mølbak,1 and

Mark A. Miller5

Departments of 1Epidemiology, 2Epidemiology Research, and 3Bacteriology, Mycology and Parasitology, Statens Serum Institut, Copenhagen, Denmark; and 4Laboratory of Developmental and Molecular Immunity, National Institute of Child Health and Human Development, and 5Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, Maryland

Background.The capsular polysaccharide of group B meningococci (GBM) is structurally identical to a polysaccharide found on neural cell adhesion molecules in humans. This structural identity has raised concern that a vaccine based on the GBM capsular polysaccharide might induce autoimmune disease in vaccinated persons. Because systemic infection with GBM induces serum antibody in adults, we investigated whether persons with a history of GBM disease are at increased risk of developing autoimmune diseases.

Methods.The entire Danish population constituted our study cohort of 7,467,001 individuals, who were observed for autoimmune diseases from 1977 through 2004. At‐risk years were counted as the number of uninfected years prior to the first recorded diagnosis of meningococcal disease but changed to person‐years at risk at the diagnosis of GBM disease (2984 subjects) or group C meningococcal disease (914 patients). Ratios of incidence rates of autoimmune disease served as measures of the relative risk.

Results.Persons with a history of GBM disease experienced a total of 37,290 person‐years at risk, ranging from 11 days to 31 years at risk after the onset of GBM disease, during which 49 cases of autoimmune disease occurred. Persons with GBM disease had no increased risk of autoimmune diseases, either compared with persons with a history of group C meningococcal disease (incidence rate ratio, 0.9; 95% confidence interval, 0.5–1.4) or compared with persons without a history of meningococcal disease (incidence rate ratio, 1.1; 95% confidence interval, 0.8–1.5).

Conclusions.Our findings suggest that invasive disease caused by GBM is not associated with autoimmune diseases in humans for up to 31 years after meningococcal disease and should lessen concerns regarding the development of a capsular‐based GBM vaccine.

Received 13 March 2007; accepted 6 July 2007; electronically published 4 October 2007.

Reprints or correspondence: Dr. Michael Howitz, Artillerivej 5, DK‐2300 Copenhagen S, Denmark ().

Cited by

M. J. GOLDACRE, C. J. WOTTON, D. G. R. YEATES. (2009) Cancer and immune-mediated disease in people who have had meningococcal disease: record-linkage studies. Epidemiology and Infection 137:05, 681
Online publication date: 1-Jun-2009.
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M. HOWITZ, L. LAMBERTSEN, J. B. SIMONSEN, J. J. CHRISTENSEN, K. MØLBAK. (2009) Morbidity, mortality and spatial distribution of meningococcal disease, 1974–2007. Epidemiology and Infection 1
Online publication date: 30-Apr-2009.
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Michael F. Howitz, Jacob Simonsen, Tyra Grove Krause, John B. Robbins, Rachel Schneerson, Kåre Mølbak, Mark A. Miller. (2009) Risk of Adverse Birth Outcome After Group B Meningococcal Disease. The Pediatric Infectious Disease Journal 28:3, 199-203
Online publication date: 1-Apr-2009.
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