N meningitidis exposure
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
- mouth-to-mouth resuscitation
- Passengers sitting next to the patient on 8+ hour flights.
Options for chemoprophylaxis for exposed contacts include
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;