Letter

Carriage of meningococci in contacts of patients with meningococcal disease

BMJ 1999; 318 doi: 10.1136/bmj.318.7184.665 (Published 6 March 1999)
Cite this as: BMJ 1999;318:665

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“Kissing contacts” need to be defined

  1. Andrew Hayward, Lecturer in public health medicine (Andrew.Hayward@nottingham.ac.uk)
  1. Medical School, University of Nottingham, Nottingham NG7 2UH
  2. Department of Epidemiology and Public Health, Medical School, University of Newcastle, Newcastle upon Tyne NE1 7RU
  3. Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, NL-3720 BA Bilthoven, Netherlands
  4. Telelab, Telemark Biomedical Centre, Gulset, N-3705 Skien, Norway
  5. Department of Medical Microbiology, University of Troms⊘, N-9037 Troms⊘, Norway

    EDITOR—In their study Kristiansen et al show high carriage rates of pathogenic strains of Neisseria menigitidis in household and kissing contacts of patients with invasive meningococcal disease.1 While it is easy to define a household contact it may be more difficult to define a kissing contact. There are many types of kiss, ranging from a “peck on the cheek” to much more! In some cultures kissing is as common as shaking hands. In such situations widespread chemoprophylaxis to “kissing contacts” may not be appropriate. It would be valuable to know whether Kristiansen et al placed any restrictions on who was defined as a kissing contact.

    References

    1. ↵
      1. Kristiansen BE,
      2. Tveten Y,
      3. Jenkins A
      . Which contacts of patients with meningococcal disease carry the pathogenic strain of Neisseria meningitidis? A population based study. BMJ 1998; 317: 621–625. (5 September.)
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    Chemoprophylaxic strategy needs to be determined

    1. Peter Dutton, Fourth year medical student,
    2. Robert Winterton, Fourth year medical student (R.I.S.Winterton@ncl.ac.uk),
    3. Ewan Wright, Fourth year medical student,
    4. Han San Aw Yeang, Fourth year medical student
    1. Medical School, University of Nottingham, Nottingham NG7 2UH
    2. Department of Epidemiology and Public Health, Medical School, University of Newcastle, Newcastle upon Tyne NE1 7RU
    3. Department of Infectious Diseases Epidemiology, National Institute of Public Health and the Environment, NL-3720 BA Bilthoven, Netherlands
    4. Telelab, Telemark Biomedical Centre, Gulset, N-3705 Skien, Norway
    5. Department of Medical Microbiology, University of Troms⊘, N-9037 Troms⊘, Norway

      EDITOR—The study by Kristiansen et al addresses important questions about the use of chemoprophylaxis in contacts of patients with meningococcal disease.1 We believe, however, that the data presented do not fully support the conclusions. Kristiansen et al found high rates of meningococcal carriers among class 1contacts (12.4%) and advocated the use of chemoprophylaxis in this group, on the basis of their assumption that carrying the pathogenic strain increases the likelihood of contracting the disease. One concern is that this group accounts for only 18 of 42 contacts who …

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