meningococcal chemoprophylaxis

introduction

contacts of patients with invasive meningococcal disease should be considered for contact tracing and chemoproprophylaxis.
in addition, there are vaccines but these do not cover all subtypes

those who frequently ate, slept or stayed at the patient's home during the 7 days before the onset of symptoms, in particular, young children and their child caregivers or nursery-school contacts
those who sat beside the patient on an airplane flight of 8 hours or longer
those who had direct exposure to the patient through kissing, sharing utensils, drinking from same containers, etc
those who may have performed mouth-to-mouth resuscitation
doctors and nurses closely involved in intubation or other procedures involving patient's saliva or nasal secretions
patients who only received benzyl penicillin as this does not eradicate nasal carriage

ceftriaxone 250 mg (child: 125 mg) IM, as a single dose (preferred option during pregnancy)
OR
ciprofloxacin (adult and child 12 years or more) 500 mg orally, as a single dose (preferred option for women taking oral contraceptives)
OR
rifampicin 600 mg (neonate: 5 mg/kg; child: 10 mg/kg up to 600 mg) orally, 12-hourly for 2 days (preferred option for children).
- rifampicin is associated with multiple drug interactions, including the combined oral contraceptive pill (OCP), and is contraindicated in pregnancy, alcoholism and severe liver disease.
- it will also stain contact lenses and cause the urine to go orange