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Which contacts of patients with meningococcal disease carry the pathogenic strain of Neisseria meningitidis? A population based study

BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7159.621 (Published 05 September 1998) Cite this as: BMJ 1998;317:621
  1. BjOslash;rn-Erik Kristiansen, professorb,
  2. Yngvar Tveten, consultanta,
  3. Andrew Jenkins, researchera
  1. aA/S Telelab, Telemark Biomedical Centre, PO Box 1868 Gulset, N-3705 Skien, Norway,
  2. bDepartment of Medical Microbiology, University of Troms⊘, 9037 Troms⊘, Norway
  1. Correspondence to: Dr Kristiansen bjorneri@online.no
  • Accepted 5 September 1998

Abstract

Objectives: To determine the prevalence of the pathogenic strain of Neisseria meningitidis in contacts of patients with meningococcal disease, and to determine which contact groups are likely to be carriers and warrant chemoprophylaxis.

Design: Population based study.

Setting: Norwegian county of Telemark.

Subjects: 1535 primary contacts of 48 patients with meningococcal disease, and 78 secondary contacts.

Interventions: Carriers of the pathogenic strain were treated with rifampicin. All household members and kissing contacts under 15 years of age were treated with oral penicillin. Contacts were taught to recognise the symptoms of meningococcal disease.

Results: In 27 of 48 cases investigated, contacts carrying the pathogenicstrain of N meningitidis were found. A total of 42 such contacts were identified.Contacts were stratified into three classes according to the assumed closeness of contactwith patients. In class 1 (household members and kissing contacts) the prevalence of the pathogenic strain was 12.4% (95% confidence interval 5.5% to 19.3%). In classes 2 and 3 the prevalence was 1.9% (0.9% to 3.4%) and 1.6% (0.14% to 3.1%).

Conclusions: There is a high rate of carriage of the pathogenic strain of N meningitidis in patients' household members and kissing contacts, and this supports the practice of giving chemoprophylaxis to these contacts. The prevalence of carriage among other contacts is 2-3 times that found in the general population (0.7%); the benefits of chemoprophylaxis to these contacts may be marginal.

Footnotes

  • Accepted 5 September 1998
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