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Many people are nasopharyngeal carriers of Neisseria meningitidis but few develop invasive disease. Factors associated with invasion include viral infection, dry dusty air, and passive smoking. Bacterial factors related to invasiveness in the nasopharynx include adhesion factors, IgA protease production, ciliary inhibiting factors, the polysaccharide capsule, and surface antigens which may vary in expression or structure. …