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Even vaccinated contacts should receive post exposure chemoprophylaxis for N meningitidis.

Incubation period is 1-10 days with most occurring within 5 days. Prophylaxis is indicated for:

• Household contacts especially those under 2.
• People frequently sleeping in the same dwelling in the week before illness.
• Preschool contacts in the week prior to illness.
• Those exposed to oral secretions within seven days
  • sharing utensils/toothbrush
  • kissing
  • intubation
  • mouth-to-mouth resuscitation
• Passengers sitting next to the patient on 8+ hour flights.

Options for chemoprophylaxis for exposed contacts include

• Rifampin
• Ciprofloxicin
• Ceftriaxone

This is in contrast to treatment for suspected N meningitidis meningitis which is treated with a regimen that includes a third generation cephalosporin.

Keep an eye out for emerging resistence to ciprofloxicin and beta-lactamase production. When the diagnosis is confirmed penicillin and ampicillin are options for treatment if susceptable.

References:

American Academy of Pediatrics. Meningococcal Infections. In: Kimberlin DW, Brady MT, Jackson MA, Long SS, eds. Red Book: 2018 Report of the Committee on Infectious Diseases. American Academy of Pediatrics; 2018;