infectious diseases
Meningococcal Diseases
Prevention of Meningococcal Diseases
Close contacts of people with meningococcal disease are at increased risk of acquiring disease and should receive a prophylactic antibiotic. Options include Rifampin600 mg (for children ≥ 1 month, 10 mg/kg; for children<1 month, 5 mg/kg) orally every 12 hours for 4 doses Ceftriaxone250 mg (for children<15 years, 125 mg; for children ≥ 15 years, 250 mg) IM for 1 dose In adults, a fluoroquinolone (ciprofloxacinorlevofloxacin500 mg orofloxacin400 mg) orally for 1 dose; for children ≥ 1 month,ciprofloxacin20 mg/kg orally for 1 dose (maximum dose 500 mg) Azithromycinis not routinely recommended, but a recent study showed that a single 500-mg dose was equivalent torifampinfor chemoprophylaxis and so could be an alternative for patients with contraindications to recommended drugs. Ciprofloxacin-resistant meningococcal disease is rare but has been reported in several countries (Greece, England, Wales, Australia, Spain, Argentina, France, and India) and in 2 US states (North Dakota and Minnesota). When choosing an antibiotic for postexposure prophylaxis, clinicians should consider reports of localciprofloxacin-resistant meningococci. See Meningococcal Vaccine for more information, including There are several meningococcal vaccines: Three quadrivalent conjugate vaccines (MenACWY-D, MenACWY-CRM, and MenACWY-TT) that protect against 4 of the 6 common pathogenic serogroups of meningococcus (all but B and X) are available. type b vaccine (Hib-MenCY-TT) is approved for children 6 weeks through 18 months of age at increased risk of meningococcal disease; however, Hib-MenCY-TT is no longer available in the US ( Prevention reference ). A quadrivalent polysaccharide vaccine (MPSV4) for use in selected patients ≥ 56 years is no longer available in the US. Two monovalent vaccines that protect against serogroup B (MenB-4C and MenB-FHbp) are available. All children should receive a quadrivalent conjugate vaccine at age 11 or 12 years, with a booster dose at age 16 years (see also the Childhood Vaccination Schedules ). These vaccines are also recommended for adults who are at increased risk. MenB-4CorMenB-FHbpis recommended for people ≥ 10 years who are at increased risk of serogroup B meningococcal disease. 1.Mbaeyi SA, Bozio CH, Duffy J, et al: Meningococcal vaccination: Recommendations of the Advisory Committee on Immunization Practices, United States, 2020.MMWR Recomm Rep69(No. RR-9):1–41, 2020. doi: 10.15585/mmwr.rr6909a1 