Prophylaxis of meningococcal meningitis

In Germany, the incidence of meningococcal disease is approximately 1/100.0 00 and has not risen during recent years. Transmission occurs by direct con tact with respiratory droplets, mostly from asymptomatic carriers and less frequently from patients with meningococal disease. The incubation period c an vary from 2-10 days but usually is 3-4 days. Incidence is highest in chi ldren and decreases with age. The mortality from meningococcal disease is a pproximately 10%. In case meningococcal meningitis is clinically suspected antibiotic treatment (in Germany with penicillin G or a cephalosporin) shou ld not be delayed. Patients must be isolated for at least 24 hours after th e institution of antibiotic therapy. For early detection of local outbreaks , public health authorities should be quickly informed of suspected cases. Persons in close contact should be treated with antimicrobial chemoprophyla xis. In addition to rifampin, ciprofloxacin or ceftriaxone can be used for chemoprophylaxis. For control of local outbreaks of serogroup C meningococc al disease, the meningococcal vaccine can be used.