Comparative long-term adverse effects elicited by invasive group B and C meningococcal infections

Research output: Contribution to journalArticle


BACKGROUND: Given the identity between Neisseria meningitidis serogroup B (MenB) capsular polysaccharide (polysialic acid; PSA) and PSA found on neural cell adhesion molecules, it has been proposed that infection with MenB or vaccination with PSA may be associated with subsequent autoimmune or neurological disease.

METHODS: We conducted 2 studies. The first was a retrospective nationwide study of invasive meningococcal disease (IMD) in Iceland (with 541 subjects) during the period 1975-2004, and we cross referenced this cohort with databases with respect to subsequent diagnosis of autoimmune disorders. A follow-up study involving 120 survivors of IMD was performed. The study included 70 patients with a history of MenB and 50 patients with N. meningitidis serogroup C (MenC) infection, who served as control subjects. Participants answered standardized questionnaires (Beck's Depression Inventory [BDI] II, Depression Anxiety Stress Scales [DASS], and Patient Health Questionnaire [PHQ]), and serum levels of immunoglobulin (Ig) G against MenB and MenC capsular polysaccharides were measured.

RESULTS: The nationwide cohort had 9166 patient-years of follow up. No evidence of increased autoimmunity was found to be associated with MenB, compared with MenC. In the follow-up study, patients were evaluated 16.6 years after the infection, representing 2022 patient-years of observation. Comparable rates of most complications were recorded, but MenC infections were associated with arthritis (P = .008) and migraine headaches (P = .01) more frequently than were MenB infections. No difference was observed with respect to scores on BDI-II, DASS, or PHQ. IgG anti-MenB and anti-MenC capsular polysaccharide levels were not related to patient complaints.

CONCLUSIONS: This study does not support the hypothesis that MenB infection may predispose to autoimmunity. MenC infections are associated with a higher prevalence of arthritis and migraine headaches. No evidence of antibody-associated pathology was detected at long-term follow-up.


  • Magnus Gottfredsson
  • Ingi K Reynisson
  • Ragnar F Ingvarsson
  • Hafrun Kristjansdottir
  • Martina V Nardini
  • Jon F Sigurdsson
  • Rachel Schneerson
  • John B Robbins
  • Mark A Miller
External organisations
  • National University Hospital of Iceland
  • National Institutes of Health, United States
  • University of Iceland
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Rheumatology and Autoimmunity


  • Adolescent, Adult, Antibodies, Bacterial, Arthritis, Autoimmune Diseases, Child, Child, Preschool, Female, Follow-Up Studies, Humans, Iceland, Immunoglobulin G, Male, Meningitis, Meningococcal, Middle Aged, Migraine Disorders, Nervous System Diseases, Retrospective Studies, Surveys and Questionnaires, Young Adult, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Original languageEnglish
Pages (from-to)e117-24
JournalClinical Infectious Diseases
Issue number9
Publication statusPublished - 2011 Nov
Publication categoryResearch
Externally publishedYes