Donors will be identified as satisfying the diagnostic criteria for Chronic Recurrent Multifocal Osteomyelitis through clinical consultations.

Adults going for tonsillectomy will be approached to donate their tonsils. Blood and sputum samples may also be collected at this time.

Meningitis and septicaemia (blood poisoning) caused by the bacterium Neisseria meningitidis (meningococcus) remain important causes of death and disability amongst children and younger adults in the UK and elsewhere. The bacteria can be carried on the mucous membranes in the back of the nose and mouth without causing any symptoms. This so-called carriage state is found in around 10% of the population of the UK at any one time. The bacteria are spread through person to person contact and only occasionally does this spread lead to the development of meningitis and septicaemia rather than carriage. The reasons behind this are not clearly understood. A vaccine against meningococcus group C (Men C), one of five groups of the bacteria that can cause disease, was introduced into the UK in 1999 and led to a sharp drop in the rates of meningitis and septicaemia. The vaccine also led to a decrease in the rates of carriage of the bacteria. This suggests that the vaccine not only generates immune protection preventing meningitis and septicaemia but also generates immunity in the back of the nose and mouth preventing carriage. The way the vaccine generates this “mucosal immunity” is not known and is the topic of our research. This study is the first part of a research programme and aims to identify the way the vaccine works in the blood.