MENINGOCOCCAL DISEASE PREVENTION AND CONTROL STRATEGIES FOR PRACTICE-BASED PHYSICIANS

Localized outbreaks of meningococcal disease in the United States and Canada continue to cause serious alarm within communities as a result of the fulminating pattern of the disease, high mortality rate, and hi gh incidence among adolescents. The increasing number of outbreaks sin ce 1991 has raised questions about the management and prevention of fu rther cases during an outbreak. The purpose of this statement is to gu ide primary-care physicians in their role in infection control and pre vention of both sporadic cases and outbreaks of invasive meningococcal disease. This statement provides information on the epidemiology of m eningococcal disease, including definitions of sporadic, secondary, an d coprimary cases, clusters of cases, and outbreaks. Data are presente d on identification of cases, disease risk of contacts, and agents for chemoprophylaxis, and recommendations are given for: (I) risk assessm ent of contacts, (2) administration of chemoprophylaxis, (3) appropria te use of meningococcal. vaccine, (4) appropriate use of the microbiol ogy laboratory, (5) the necessity for timely and appropriate reporting of invasive meningococcal disease to local public health authorities, and (6) information on counseling and public education that may be he lpful during an outbreak to minimize public anxiety. An additional sec tion, ''Information for Sharing,'' which uses a question-and-answer fo rmat and which may be helpful to parents and community and health care workers during an outbreak, is also provided.