Chemoprophylaxis is used to prevent transmission and development of invasive meningococcal and Hib infection in susceptible individuals who are close contacts of the index case. Fifty per cent of the increased risk of meningococcal infection in household contacts occurs within Z days of the presentation of the index case. Half of this occurs in the first 48 h. Therefore decisions regarding institution of chemoprophylaxis should not be delayed by waiting for microbiological confirmation.

Fear and anxiety within the family, school, or community frequently follows the occurrence of a case of meningococcal disease. Close collaboration between physicians caring for the affected patient and those responsible for community and public health advice is always essential. Rifampin (rifampicin) should be administered to all household contacts as soon as possible after the index case has been diagnosed. Ciprofloxacin or ceftriaxone are alternative, although less widely used, prophylactic agents.

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