Six different strains of Neisseria meningitidis in a case with meningococcal sepsis and five contact persons in a boys' home

Background: It is routine practice to provide chemoprophylaxis for close co ntacts of a patient infected with meningococci. Patients: When a 17-year-old boy living in a boys' home was admitted to the hospital with septic shock caused by Neisseria meningitidis, we immediatel y identified contact persons in the boys' home. Results: 104 contact persons were identified and screened for oropharyngeal colonization. 77 persons received chemoprophylaxis, N. meningitidis was is olated from the index case and from five of 104 throat swabs of the contact persons (three home dwellers, one staff member, one visitor),The overall c arrier rate was 4.8%. All isolates showed different patterns when analyzed by pulsed-field gel electrophoresis, which was in accordance with results o f serotyping by the German National Reference Center for Meningococci. Conclusion: In this non-epidemic situation, contacts between the index case , home mates, home personnel, and visitors were not close enough for effect ive transmission of meningococci, since no strain was found twice. This sup ports recommendations for the use of chemoprophylaxis in persons with intim ate contact to the index patient.