Meningococcal Postexposure Prophylaxis

Postexposure prophylaxis is the provision of medication to prevent disease in persons who are not protected against a particular disease by vaccination but who have been exposed to it.

Indications (areas of application)

• Persons in close contact with a diseased person with invasive meningococcal infection (all serogroups), ie:
  • All household contact members,
  • Persons in contact with a patient’s oropharyngeal secretions,
  • Contact persons in children’s facilities with children under 6 years of age (if good group separation, only the affected group),
  • Persons with close contacts in communal facilities with household-like character (boarding schools, dormitories as well as barracks).

Implementation

• In persons who were in close contact with ill persons in the 7 days before their onset of illness:
  • Chemoprophylaxis (should be given as soon as possible after diagnosis in the index patient, but is useful up to 10 days after last exposure):
    • Rifampicin
      • Neonates: 2 x 5 mg/kg bw p.o.in 2 ED p. o. for 2 days.
      • Infants, children and adolescents up to 60 kg: 2 x 10 mg/kg bw (max ED 600 mg) p. o. for 2 days.
      • Adolescents and adults over 60 kg: 2 x 600 mg p. o. for 2 days.

      Eradication rate: 72-90% or

    • Ciprofloxacin
      • 18 years and older: 1 x 500 mg p. o.

      Eradication rate: 90-95 %ggf.

    • Ceftriaxone
      • From 2 to 12 years: 1 x 125 mg i. m.
      • From 12 years: 1 x 250 mg i. m. in an ED Eradication rate: 97%.
  • In pregnant women, the administration of rifampicin and gyrase inhibitors is contraindicated! These receive for prophylaxis if necessary ceftriaxone (1 x 250 mg i.m.).
• The index patient with invasive meningococcal infection should also receive rifampicin after completion of therapy unless treated intravenously with a 3rd generation cephalosporin. Postexposure vaccination:
  • For serogroup C: Vaccination with a conjugate vaccine; starting at 2 months of age as indicated in the technical information.
  • For serogroup A, W, Y: vaccination with 4-valent conjugate vaccine (ACWY); if approved for the age group.
  • For serogroup B: vaccination with meningococcal B vaccine according to the indications of the professional information, if approved for age group.