Editorials

Secondary prevention of meningococcal disease

BMJ 1996; 312 doi: https://doi.org/10.1136/bmj.312.7031.591 (Published 09 March 1996) Cite this as: BMJ 1996;312:591
  1. Bjorn-Erik Kristiansen,
  2. Arne-Birger Knapskog
  1. Consultant microbiologist County medical officer of health Telemark Biomedical Centre, PO Box 1868, N-3700 Skien, Norway

    High risk contacts should be given chemoprophylaxis and preventive treatment with penicillin

    Meningococcal disease puts huge pressure on local health officials. General practitioners must of course ensure that the correct diagnosis is made and that initial treatment is given, but referring the patient to hospital is not the end of the job. Meningococcal disease brings anxiety to the affected population, which may itself become a health problem. Doctors are expected to stop the disease spreading, to provide prophylaxis to those at risk of developing the disease, and to calm people's fears. Several weapons are at hand: chemoprophylaxis, protective chemotherapy, vaccination, and information.

    In Britain, as well as in many other countries, chemoprophylaxis (in the form of rifampicin) is given to close contacts of the patient (household members, kissing contacts, and friends who have stayed in the patient's home for hours during the past week) to eradicate meningococci. Typically, 15% of contacts carry meningococci in their throat, but only 3-4% carry the pathogenic strain.1 Too liberal use of chemoprophylaxis may lead to bacterial resistance. It may also impair the body's ability to develop antibodies against meningococci, which may be formed in response …

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