infectious diseases
Meningococcal Diseases
Key Points
Over 90% of meningococcal infections involve meningitis or meningococcemia. An asymptomatic nasopharyngeal carrier state is common; transmission usually occurs via direct contact with respiratory secretions from a carrier. In the US, most cases are sporadic, typically in children<2 years of age, but outbreaks can occur, primarily in semiclosed communities (eg, military recruit camps, dormitories, day care centers) and often involve patients aged 16 to 23 years. Treat withceftriaxoneor penicillin; adddexamethasonefor patients with meningitis. Give close contacts a prophylactic antibiotic. Vaccinate all children starting at age 11 or 12 years, and selectively vaccinate high-risk younger children and other high-risk people. 