Guidelines for the Early Clinical and Public Health Management of ...

Guidelines for the Early Clinical and Public Health Management of Bacterial Meningitis (including Meningococcal Disease)
Chemoprophylaxis of contacts of invasive meningococcal disease
• There is evidence that microbiological clearance of meningococci follows administration of appropriate
antibiotics.
• The decision to provide chemoprophylaxis is based on a risk assessment following the notification of each
case.
• Three antibiotics (rifampicin, ciprofloxacin, ceftriaxone) are currently recommended in Ireland for
chemoprophylaxis of meningococcal disease; each agent has advantages and disadvantages and is the
preferred agent in specific circumstances.
• Rifampicin is the antibiotic of choice for chemoprophylaxis for young children.
• Ciprofloxacin is the preferred chemoprophylactic agent for women taking an oral contraceptive as rifampicin
can affect the efficacy of oral contraceptives and is also an alternative chemoprophylactic agent for
individuals who wear soft contact lenses as rifampicin can discolour the contact lens.
• Ceftriaxone is the preferred chemoprophylactic agent for pregnant women.
Infection Control Measures
• N. meningitidis is transmitted from person-to-person by aerosols, droplets or direct contact with respiratory
secretions from a person carrying the organism.
• Suspect/confirmed cases should ideally be placed in a single room for the first 24 hours following initiation
of treatment.
• After 24 hours of appropriate antibiotic treatment individuals with meningococcal disease are considered to
be no longer infectious.
• HCWs should wear surgical masks when in close contact with an infectious patient for the first 24 hours
after initiation of treatment.
• Pre-exposure vaccination may be considered for HCWs at increased risk of exposure (e.g. laboratory workers
handling specimens (see Chapter 10 for more detail).
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