The chronologic association of acute respiratory disease and meningococcal infection was examined in army recruits by weekly surveys of 17 basic training platoons. Nine platoons had received live, attenuated adenovirus vaccine, type 4, orally; the other eight platoons were given placebo. Severe viral respiratory disease was reduced significantly in the vaccinated group compared to the control platoons, yet meningococcal carrier rates were almost identical. Carrier rates increased progressively in both groups from initial rates of 33% to levels over 80% in the sixth week of basic training. The majority of meningococcal acquisitions occurred prior to or in the absence of viral proliferation in the upper-respiratory tract. No case of meningococcal meningitis occurred in the more than 950 individuals studied. These results suggest that viral respiratory disease is not a significant factor in meningococcal dissemination in recruits and is unlikely to be the cause of invasion following acquisition of the meningococcus in the nasopharynx.
Artenstein MS, Rust JH, Lamson TH, Buescher EL. Acute Respiratory Disease and Meningococcal Infection in Army Recruits. JAMA. 1967;201(13):1004–1008. doi:10.1001/jama.1967.03130130030008
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