N meningitidis exposure

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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.


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;