Materiały źródłowe

• #1 Selection of Antibiotics as Prophylaxis for Close Contacts of Patients with Meningococcal Disease in Areas with Ciprofloxacin Resistance — United States, 2024 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7305a2.htm

  Meningococcal disease cases caused by ciprofloxacin-resistant strains of Neisseria meningitidis have increased in the United States. Use of ciprofloxacin for antibiotic prophylaxis in areas with ciprofloxacin resistance might result in prophylaxis failure. […] CDC provides implementation guidance for health departments for the preferential use of other recommended prophylaxis options (i.e., rifampin, ceftriaxone, or azithromycin) in place of ciprofloxacin when two or more ciprofloxacin-resistant meningococcal disease cases that account for 20% of all cases are reported in a local catchment area during a 12-month period. […] Monitoring for prophylaxis failures and antimicrobial resistance among meningococcal isolates is essential to support the need for additional updates to recommendations.

• #2 Meningococcal Disease | Infection Control | CDC

  https://www.cdc.gov/infection-control/hcp/healthcare-personnel-epidemiology-control/meningococcal-disease.html

  Administer antimicrobial prophylaxis to healthcare personnel, regardless of vaccination status, who have an exposure to N. meningitidis. […] Appropriately administering postexposure prophylaxis (PEP) to persons exposed to meningitidis; and excluding potentially infectious HCP from work. […] Chemoprophylaxis is administered as soon as possible after exposure, ideally less than 24 hours after identification of an index patient. […] Rifampin, ciprofloxacin, and ceftriaxone are 90%-95% effective in reducing nasopharyngeal carriage of N. meningitidis and are all acceptable antimicrobial agents for chemoprophylaxis. […] In the setting of a healthcare facility meningococcal disease outbreak, meningococcal vaccination or use of chemoprophylaxis in a wider group than exposed HCP may be considered in consultation with public health officials.

• #3 Antibiotics for preventing meningococcal infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6698485/

  Meningococcal disease is a contagious bacterial infection caused by Neisseria meningitidis (N meningitidis). Household contacts have the highest risk of contracting the disease during the first week of a case being detected. Prophylaxis is considered for close contacts of people with a meningococcal infection and populations with known high carriage rates. […] To study the effectiveness, adverse events and development of drug resistance of different antibiotics as prophylactic treatment regimens for meningococcal infection. […] Randomised controlled trials (RCTs) or quasiRCTs addressing the effectiveness of different antibiotics for: (a) prophylaxis against meningococcal disease; (b) eradication of N meningitidis. […] Using rifampin during an outbreak may lead to the circulation of resistant isolates. Use of ciprofloxacin, ceftriaxone or penicillin should be considered. All four agents were effective for up to two weeks followup, though more trials comparing the effectiveness of these agents for eradicating N. meningitidis would provide important insights.

• #4 Controlling Spread of Meningococcal Infection | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/meningococcal-infection/controlling-spread-meningococcal-infection

  B. Chemoprophylaxis is recommended for the following: […] If neither a third generation cephlosporin nor ciprofloxacin was given as treatment, patients with meningococcal invasive disease should receive antibiotic prophylaxis prior to discharge to ensure elimination of nasopharyngeal carriage. […] Because the rate of secondary disease for close contacts is highest immediately after onset of disease in the index patient, antimicrobial chemoprophylaxis should be administered as soon as possible (ideally 24 hours after identification of the index patient). Conversely, chemoprophylaxis administered 14 days after onset of illness in the index patient is probably of limited or no value. […] Chemoprophylaxis is indicated for persons who in the 7 days before onset of illness or until 24 hours after the case had begun an effective antibiotic had close contact with the case.

• #5 Controlling Spread of Meningococcal Infection | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/meningococcal-infection/controlling-spread-meningococcal-infection

  Contacts who have previously received meningococcal vaccination should still receive chemoprophylaxis. […] Contacts should receive chemoprophylaxis as soon as possible, preferably within 24 hours after the index case has been identified, though diminishing levels of benefit may still be realized even with delays of up to 2 weeks. […] Contacts of the case should be identified and referred to their healthcare provider for antibiotic prophylaxis. […] Any contact that develops symptoms suggestive of meningococcal disease within 3-4 weeks after exposure should be evaluated promptly by a physician. […] Recommendations for chemoprophylaxis are based on the assumption that persons of any age may be susceptible to meningococcal infections. […] To prevent additional cases: Refer close contacts to healthcare providers for appropriate chemoprophylaxis.

• #6 UMEM Educational Pearls – University of Maryland School of Medicine, Department of Emergency Medicine

  https://umem.org/educational_pearls/1394/

  Chemoprophylaxis should be given to those individuals who came into „close contact” with someone infected with meningitis due to meningococcal infection (i.e. Neisseria meningitidis). It should be given as early as possible following the exposure; when there is a high index of suspicion, do not wait for culture results to give prophylaxis. […] Chemoprophylaxis is generally not indicated when the etiology is Streptococcus pneumoniae, and should be reserved for young children who have not received a Haemophilus influenzae type b (Hib) vaccination and immunocompromised close contacts when the etiology is Hib. […] While the definition of a „close contact” remains somewhat ambiguous, it generally refers to individuals who have had prolonged (8 hours) contact while in close proximity (to the patient, or who have been directly exposed to the patient’s oral secretions between one week prior to the onset of the patient’s symptoms until 24 hours after initiation of appropriate antibiotic therapy. […] Standard regimens for antimicrobial prophylaxis include ciprofloxicin, ceftriaxone, and rifampin. Adults typically require a single oral dose of 500 mg of ciprofloxicin or 250 mg of intramuscular (IM) ceftriaxone, while individuals under age 15 may receive a single dose of 150 mg of IM ceftriaxone.

• #7 Meningitis Prophylaxis

  https://emed.ie/Infections/Prophylaxis/Prophylaxis_Meningitis.php

  Bacterial meningitis is a notifiable disease. Inform Public Health: +353 21 4927601. They will advise on chemoprophylaxis of contacts. […] Chemoprophylaxis is indicated only for those who had close prolonged contact with the case in the preceding seven days: […] Unless the index case has received ceftriaxone in hospital, chemoprophylaxis should also be given to the patient prior to discharge. […] Chemoprophylaxis is recommended only for healthcare workers whose mouth or nose is directly exposed to large particle droplets/secretions from the respiratory tract of a probable or confirmed case of meningococcal disease during the acute illness until the case has completed 24 hours of antibiotics. […] Chemoprophylaxis is rarely indicated in Hib infection; only when there are unvaccinated or incompletely vaccinated children or persons at increased risk (e.g. asplenia or complement deficiency) in the household. […] If Haemophilus influenzae type b, pneumococcal meningitis or Neisseria meningitidis Groups C, A, Y and W135, vaccination of contacts and index may be indicated. Please refer to Public Health for advice.

• #8 Meningococcal Meningitis Treatment & Management: Approach Considerations, Pharmacologic Care, Prophylaxis

  https://emedicine.medscape.com/article/1165557-treatment

  Chemoprophylaxis can be considered for people in close contact with patients in an endemic situation. […] Antimicrobials commonly used for chemoprophylaxis are rifampin, ciprofloxacin, ceftriaxone, minocycline, and spiramycin. […] Ceftriaxone may provide an effective alternative to rifampin for prophylaxis in people in close contact with patients with meningococcal meningitis. […] Oily chloramphenicol may be the drug of choice in areas with limited health facilities, because a single dose of the long-acting form has been shown to be effective.

• #9 Antibiotics for preventing meningococcal infections

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6698485/

  Prophylaxis is also considered in populations with known high carriage rates, such as military personnel. […] Rifampin (rifampicin) given orally twice daily for two days in a 10 mg/kg dose (600 mg maximum) remains the drug of choice for meningococcal prophylaxis of highrisk groups. […] Thus other systemic antibiotics that effectively eliminate nasopharyngeal carriage of N meningitidis, including ciprofloxacin and ceftriaxone, are also used as prophylactic agents. […] A systematic review comparing the effectiveness and adverse events of different antibiotics for preventing meningococcal infection should establish the best options for preventing further spread of this disease.

• #10 CDC issues new antibiotic prophylaxis guidelines for invasive meningococcal disease contacts | CIDRAP

  https://www.cidrap.umn.edu/antimicrobial-stewardship/cdc-issues-new-antibiotic-prophylaxis-guidelines-invasive-meningococcal

  With the number of invasive meningococcal disease cases caused by ciprofloxacin-resistant strains of Neisseria meningitidis rising, the Centers for Disease Control (CDC) yesterday published new guidelines for when other antibiotic prophylaxis (prevention) options should be considered for close contacts of patients. […] Under the new guidelines, the CDC recommends other antibiotics be considered if, over a rolling 12-month period, two or more invasive meningococcal disease cases caused by ciprofloxacin-resistant strains are reported in a local catchment area and 20% or more of the invasive meningococcal disease cases in that area are caused by ciprofloxacin-resistant strains. […] Other recommended options for prophylaxis include rifampin, ceftriaxone, and azithromycin. The CDC says local health departments have flexibility in guidance implementation. […] „Ongoing monitoring for antibiotic resistance of meningococcal isolates through surveillance and health care providers’ reporting of prophylaxis failures will guide future updates to prophylaxis considerations and recommendations,” the authors wrote.

• #11 Selection of Antibiotics as Prophylaxis for Close Contacts of Patients with Meningococcal Disease in Areas with Ciprofloxacin Resistance — United States, 2024 | MMWR

  https://www.cdc.gov/mmwr/volumes/73/wr/mm7305a2.htm

  Health departments should preferentially consider using antibiotics other than ciprofloxacin as prophylaxis for close contacts when both of the following criteria have been met in a local catchment area during a rolling 12-month period: 1) the reporting of two or more invasive meningococcal disease cases caused by ciprofloxacin-resistant strains, and 2) 20% of all reported invasive meningococcal disease cases are caused by ciprofloxacin-resistant strains. […] The primary anticipated public health benefit of this guidance is a reduced likelihood of ciprofloxacin prophylaxis failure. However, potential prophylaxis failures with alternative antibiotics might occur, and the potential for reduced adherence or slower administration of less convenient alternative prophylaxis options remains. […] CDC’s implementation guidance for choosing antibiotics for invasive meningococcal disease prophylaxis is based on observed increases in the number of cases of invasive meningococcal disease caused by ciprofloxacin-resistant strains since 2019 and concerns about potential prophylaxis failures in areas with ciprofloxacin resistance.

• #12 NY officials tell providers to stop using ciprofloxacin to prevent bacterial meningitis | CIDRAP

  https://www.cidrap.umn.edu/antimicrobial-stewardship/ny-officials-tell-providers-stop-using-ciprofloxacin-prevent-bacterial

  The New York State Department of Health (NYSDH) is telling healthcare providers to discontinue the use of ciprofloxacin in people who’ve had contact with patients diagnosed as having bacterial meningitis. […] Ciprofloxacin is among the antibiotics that have been recommended for post-exposure prophylaxis (PEP) to prevent illness in contacts of people with invasive meningococcal disease, a rare but severe infection caused by Neisseria meningitidis. […] „Providers should instead use rifampin or ceftriaxone, as they remain a first-line treatment option,” State Health Commissioner James McDonald, MD, MPH. said in a press release. „Importantly, the treatment recommendations have not changed it’s vital to begin antibiotic treatment promptly when invasive meningococcal disease is suspected.” […] The NYSDH said azithromycin may also be used as an alternative option for PEP.

• #13 CDC MMWR: Updated Guidance on Meningococcal Disease Prophylaxis – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/news/cdc-updates-meningococcal-disease-prophylaxis-guidance/

  Alternative prophylactic antibiotics should be preferentially considered for close contacts of individuals diagnosed with ciprofloxacin-resistant meningococcal disease. […] The Centers for Disease Control and Prevention (CDC) recommends the use of rifampin, ceftriaxone, or azithromycin over ciprofloxacin for prophylaxis against meningococcal disease in communities where ciprofloxacin resistance may result in prophylaxis failure, according to updated guidance published in Morbidity and Mortality Weekly Report (MMWR). […] Therefore, the CDC issued updated guidance on meningococcal disease prophylaxis for implementation across health departments. […] For close contacts of individuals with invasive meningococcal disease, the CDC recommends the preferential use of alternative prophylactic agents be considered if the following criteria are met within a 12-month period:

• #14 CDC MMWR: Updated Guidance on Meningococcal Disease Prophylaxis – Infectious Disease Advisor

  https://www.infectiousdiseaseadvisor.com/news/cdc-updates-meningococcal-disease-prophylaxis-guidance/

  Ongoing monitoring for antibiotic resistance of meningococcal isolates through surveillance and health care providers reporting of prophylaxis failures will guide future updates to prophylaxis considerations and recommendations. […] The CDC noted that, Although no instances of prophylaxis failure associated with ciprofloxacin resistance in the United States have been reported to date, use of ciprofloxacin as prophylaxis in areas with ciprofloxacin resistance might increase the likelihood of failure. […] Alternative first-line antibiotics for prophylaxis against meningococcal disease include oral rifampin (4 doses within 48 hours) and ceftriaxone (single injection). […] This updated prophylaxis guidance should be maintained until a full 24 months pass without report of any diagnoses of invasive meningococcal disease caused by ciprofloxacin resistance. […] According to the CDC, Ongoing monitoring for antibiotic resistance of meningococcal isolates through surveillance and health care providers reporting of prophylaxis failures will guide future updates to prophylaxis considerations and recommendations.

• #15 Contact prophylaxis for invasive meningococcal or Hib disease

  https://www.rch.org.au/clinicalguide/guideline_index/Meningococcal_prophylaxis/

  Prophylaxis for invasive meningococcal or Hib disease […] Antimicrobial recommendations may vary according to local antimicrobial susceptibility patterns; please refer to local guidelines […] Prophylaxis must be given early to both the index case and contacts, especially for N. meningitidis disease, because of the rapidity with which secondary cases may develop […] Rifampicin interferes with the metabolism of several medications, including the oral contraceptive pill (alternative contraception should be instituted), anticonvulsants, warfarin and chloramphenicol […] Rifampicin is preferred in infants, although ciprofloxacin is safe and effective […] Ceftriaxone is preferred in pregnancy […] Rifampicin colours body fluids red, for example urine, saliva, tears (soft contact lenses may be damaged), sweat.

• #16 Prophylaxis – Primary Care Notebook

  https://primarycarenotebook.com/pages/infectious-disease/meningitis/prophylaxis

  Preventative measures for bacterial meningitis include: […] prophylactic antibiotics, for example, rifampicin for Haemophilus infections and N. meningitidis. This is recommended for close, usually household, contacts of patients with meningococcal infection, but only for families and other close contacts with children under 4 years of age in the case of Haemophilus infection. […] It is also recommended that there is prophylaxis for patients themselves. […] drugs recommended for use in preventing secondary cases of meningococcal disease include rifampicin, ciprofloxacin, and ceftriaxone. […] ciprofloxacin is recommended when large numbers of contacts (aged 2 years or above) need prophylaxis. Ciprofloxacin has a number of advantages over rifampicin. […] It can also interact with other drugs but a single dose is unlikely to have a significant effect. […] Manufacturers do not recommend using ciprofloxacin in children or growing adolescents unless benefits of treatment are considered to outweigh risks.

• #17 Treatment and Prevention of Community-Acquired Bacterial Meningitis

  https://www.uspharmacist.com/article/treatment-and-prevention-of-communityacquired-bacterial-meningitis

  Preventive measures include the use of vaccines that target Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae, as well as the use of chemoprophylaxis in selected situations. […] Antimicrobial chemoprophylaxis is indicated in certain situations to prevent the spread of infection from those with meningitis caused by N meningitidis or H influenzae. […] Chemoprophylaxis against meningococcal infection is indicated for a close contact, defined as prolonged contact ( 8 hours) in close proximity ( 3 feet), or anyone who has been directly exposed to the patients oral secretions in the 7 days before the onset of the infected patients symptoms. […] Chemoprophylaxis against H influenzae type b is recommended for all household contacts in households with individuals younger than age 4 years who are not fully vaccinated; for any immunocompromised household contacts who are younger than age 18 years (regardless of their vaccination status); and for all attendees and providers in child-care settings when two or more cases of invasive infection have occurred within 60 days and there are children who attend the facility who have not received the complete vaccine series.

• #18 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  For meningitis due to H. influenzae type b, chemoprophylaxis is rifampin 20 mg/kg orally once a day (maximum: 600 mg/day) for 4 days. There is no consensus on whether children 2 years require prophylaxis for exposure at day care. […] Chemoprophylaxis usually is not needed for contacts of patients with other types of bacterial meningitis.

• #19

  https://www.who.int/news-room/fact-sheets/detail/meningitis

  Vaccines offer the best protection against common types of bacterial meningitis. […] Vaccines can prevent meningitis caused by: meningococcus, pneumococcus, Haemophilus influenzae type b (Hib). […] Maternal Group B streptococcus vaccines to prevent invasive GBS disease in infants are in the final stages of clinical development. […] Post-exposure prophylaxis with antibiotics is given to close contacts of individuals with meningococcal disease to eradicate asymptomatic meningococcal carriage in the nose and decrease the risk of transmission. […] Identifying mothers whose babies are at risk of getting Group B streptococcal (GBS) disease is recommended in many countries. Mothers at risk of transmitted GBS to their babies are offered intravenous penicillin during labour to prevent their babies developing GBS infection.

• #20 Prevention of Meningococcal Disease | AAFP

  https://www.aafp.org/pubs/afp/issues/2005/1115/p2049.html

  Invasive disease caused by Neisseria meningitidis has an average annual incidence of one case per 100,000 in the United States. Antibiotic chemoprophylaxis with rifampin, ciprofloxacin, or ceftriaxone is required for household and other close contacts. […] The U.S. Food and Drug Administration recently approved a meningococcal conjugate vaccine containing serogroups A, C, Y, and W-135. The Advisory Committee on Immunization Practices recommends that this vaccine be given to 11- and 12-year-old adolescents, to adolescents entering high school, and to college freshmen living in dormitories. […] Close contacts of patients with invasive meningococcal disease should receive antimicrobial chemoprophylaxis, regardless of whether the disease is sporadic or occurs in an outbreak setting. […] Approximately 70 to 80 percent of the serogroups most likely to cause meningococcal disease in adolescents and young adults are potentially preventable by the tetravalent meningococcal vaccine. […] It is recommended that MCV4 be given at the 11- to 12-year-old preadolescent visit, to adolescents entering high school, and to college freshman living in dormitories.

• #21 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  Vaccination and chemoprophylaxis are 2 means of preventing meningitis. […] Vaccination against H influenzae type B (Hib) is strongly recommended in susceptible individuals (though there is no standard recommendation for H influenzae vaccination in adults). Vaccination against S pneumoniae also is strongly encouraged for susceptible individuals, including people older than 65 years and individuals with chronic cardiopulmonary illnesses. It is not known whether the adult use of conjugate pneumococcal vaccine decreases the incidence of S pneumoniae meningitis. […] Several meningococcal vaccines are available in the United States: Meningococcal groups A, B, C, W, and Y (Penbraya), Meningococcal conjugate or MenACWY vaccine (Menactra, Menveo, MenQuadfi), Meningococcal group B vaccine (Bexsero, Trumenba).

• #22 Meningitis Treatment & Management: Approach Considerations, Treatment of Subacute Meningitis, Treatment of Bacterial Meningitis

  https://emedicine.medscape.com/article/232915-treatment

  Vaccinations against encapsulated bacterial organisms (eg, S pneumoniae and N meningitidis) are encouraged for people with functional or structural asplenia. Vaccinations should always be administered expeditiously to individuals who undergo splenectomy. […] Vaccination with quadrivalent meningococcal polysaccharide vaccine should be offered to all high-risk populations, including those who have underlying immune deficiencies, those who travel to hyperendemic areas and epidemic areas, and those who do laboratory work that involves routine exposure to N meningitidis. College students who live in dormitories or residence halls are at modest risk; they should be informed about the risk and offered vaccination. […] For meningococcal meningitis, chemoprophylaxis consists of one of the following: Rifampin 600 mg (for children 1 month, 10 mg/kg; for children 1 month, 5 mg/kg) orally every 12 hours for 4 doses, Ceftriaxone 250 mg (for children 15 years, 125 mg) IM for 1 dose, For adults, a fluoroquinolone (ciprofloxacin or levofloxacin 500 mg or ofloxacin 400 mg) orally for 1 dose.

• #23 Meningococcal Disease – NFID

  https://www.nfid.org/infectious-disease/meningococcal/

  Keeping up to date with recommended vaccines is the best way to protect against meningococcal disease. Three types of meningococcal vaccines are available in the US (MenACWY, MenB, MenABCWY). […] CDC recommends routine MenACWY for: All preteens at age 11-12 years, All teens at age 16 years (booster dose), Children and adults at increased risk for meningococcal disease. […] CDC recommends routine MenB vaccine: Individuals age 10 years and older at increased risk for meningococcal disease. […] CDC recommends the new combination MenABCWY vaccination as an option for: Individuals age 10 years and older who need MenACWY and MenB at the same visit. […] CDC recommends meningococcal vaccines for adults if they are at increased risk. This includes: Certain medical conditions (talk to your healthcare professional for the appropriate schedule), International travelers to areas where meningococcal disease is endemic, Scientists (and others) whose jobs involve working with meningococcal bacteria, College students, Military personnel, Increased risk due to a meningococcal disease outbreak.

• #24 Treatment and Prevention of Community-Acquired Bacterial Meningitis

  https://www.uspharmacist.com/article/treatment-and-prevention-of-communityacquired-bacterial-meningitis

  There are vaccines that target selected bacterial etiologies of bacterial meningitis: H influenzae, S pneumoniae, and N meningitidis. […] The CDC Advisory Committee on Immunization Practices (ACIP) recommends H influenzae type b (Hib) vaccination as part of routine childhood immunizations and in those with anatomical or functional asplenia (including sickle cell disease) who have not previously received the vaccine. […] Two vaccines are currently marketed for the prevention of pneumococcal disease: the pneumococcal 13-valent conjugate vaccine (PCV13 or Prevnar 13) and the 23-valent pneumococcal polysaccharide vaccine (PPSV23 or Pneumovax 23). […] A quadrivalent conjugate (MenACWY) vaccine is recommended by the ACIP as routine vaccination for adolescents aged 11 or 12 years and older (with a booster dose at age 16 years) and for those aged 2 months and older who are at increased risk for meningococcal disease. […] In addition, ACIP recommends routine use of a serogroup B meningococcal (MenB) vaccine series among persons aged 10 years and older who are at increased risk for serogroup B meningococcal disease.

• #25 Pharmacotherapy Update | Prevention of Meningococcal Disease

  https://www.clevelandclinicmeded.com/medicalpubs/pharmacy/julyaug2005/default.htm

  While chemoprophylaxis is an efficacious and immediate measure for post-exposure prophylaxis and for prevention of meningococcal disease caused by N. meningitidis serotype B, immunoprophylaxis is more appropriate for reducing future risk of contracting meningococcal disease. Two vaccines for prevention of meningococcal disease are currently available in the United States. Both of these vaccines are approved for active immunization against invasive meningococcal disease caused by N. meningitidis serotypes A, C, Y and W-135. However, these vaccines differ in composition, route of administration, target patient populations, and use in combination with other vaccines. […] Recommendations for Meningococcal Vaccination: With the recent approval of Menactra, ACIP recommends routine vaccination of individuals 11-12 years of age at the pre-adolescent healthcare visit using Menactra. For adolescents not previously vaccinated with Menactra, ACIP recommends vaccination prior to high school entry. Routine vaccination using Menactra in all adolescents starting at 11 years of age is the goal by 2008. Routine vaccination against meningococcal disease is also recommended for individuals at higher risk of acquiring the disease (e.g., freshmen living in dormitories or individuals with functional or anatomical asplenia).

• #26 Challenges of Unpredictability: Meningitis Prevention Takes Everyone’s Continuous Vigilance – Interview with A Key Opinion Leader – European Medical Journal

  https://www.emjreviews.com/microbiology-infectious-diseases/article/challenges-of-unpredictability-meningitis-prevention-takes-everyones-continuous-vigilance-interview-with-a-key-opinion-leader-s100124/

  Martinn-Torres indicated: Any new case of meningococcal meningitis globally could be considered a public health failure because this disease is vaccine-preventable; however, widespread implementation of available vaccines is lacking. […] Martinn-Torres emphasised that the development of first-generation pentavalent vaccines that combine existing vaccines has been an important step forward in meningococcal meningitis prevention. […] Widespread implementation of meningococcal meningitis vaccination covering all epidemiologically important serogroups is needed to prevent meningococcal meningitis disease as a whole. […] Martinn-Torres recommended that healthcare professionals should be continuously proactive and committed to existing meningococcal meningitis immunisation programmes in their countries to achieve optimal vaccine uptake while expanding these programmes to include more at-risk age groups. […] Finally, Martinn-Torres would like to see improved surveillance in countries where it is not established, the possibility for personalised immunisation based on host genetic and other risk factors, and stronger public health infrastructure to ensure that meningitis is eliminated globally.

• #27 Meningitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508

  Stay healthy. Keep your immune system strong by getting enough rest, exercising regularly, and eating a good diet with fresh fruits, vegetables and whole grains. […] Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and nose. Even better, cough or sneeze into your shoulder. […] If you’re pregnant, watch what you eat. Reduce your risk of a listeria infection by cooking meat, including hot dogs and lunch meats, to 165 degrees Fahrenheit (74 degrees Celsius). Eat only cheeses made from milk that has been pasteurized to kill germs. Check labels to be sure cheeses are made with pasteurized milk. […] Vaccinations can help prevent some forms of bacterial meningitis. Vaccinations include: Haemophilus influenzae type b vaccine. This vaccine is called Hib for short. The U.S. Centers for Disease Control and Prevention, also called the CDC, suggest this vaccine for children starting at about 2 months of age. The vaccine also is for some adults. This includes adults who have sickle cell disease or AIDS and those who don’t have a spleen.

• #28

  https://www.nhs.uk/conditions/meningitis/

  A number of vaccinations are available that offer some protection against meningitis. […] Vaccinations offer some protection against certain causes of meningitis. […] These include the: MenB vaccine offered to babies aged 8 weeks, followed by a second dose at 16 weeks and a booster at 1 year […] 6-in-1 vaccine offered to babies at 8, 12 and 16 weeks of age […] pneumococcal vaccine 2 doses offered to babies at 12 weeks and 1 year, and a single dose offered to adults aged 65 or over […] Hib/MenC vaccine offered to babies at 1 year of age […] MMR vaccine offered to babies at 1 year and a second dose at 3 years and 4 months […] MenACWY vaccine offered to teenagers, sixth formers and „fresher” students going to university for the first time.

• #29 Meningitis – Wikipedia

  https://en.wikipedia.org/wiki/Meningitis

  Since the 1980s, many countries have included immunization against Haemophilus influenzae type B in their routine childhood vaccination schemes. This has practically eliminated this pathogen as a cause of meningitis in young children in those countries. […] Meningococcus vaccines exist against groups A, B, C, W135 and Y. […] In Africa, until recently, the approach for prevention and control of meningococcal epidemics was based on early detection of the disease and emergency reactive mass vaccination of the population at risk with bivalent A/C or trivalent A/C/W135 polysaccharide vaccines.

• #30 Prophylaxis for household contacts – Meningitis Outbreak Response in Sub-Saharan Africa – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK274185/

  However, the group did not find any new information to suggest that, during epidemics, chemoprophylaxis for household contacts of cases would offer any additional benefit to the community in situations where case management and vaccination programmes are being implemented. […] Vaccination is not recommended for household contacts. […] During epidemics, household contacts would be included in any community immunization programme. However, it would be advisable to consider vaccinating household or other close contacts (e.g. in schools or barracks) during an outbreak due to a vaccine preventable serogroup, if mass vaccination is not undertaken or in advance of a vaccination campaign. […] The administration of prophylaxis to household contacts implies a need to confirm a case of meningococcal meningitis promptly. […] Although the previous guideline recommended chemoprophylaxis for household contacts of a person with meningococcal disease, in the experience of the Guideline Development Group, this is not yet a part of routine medical practice in meningitis belt countries.

• #31 Meningococcal Meningitis Treatment & Management: Approach Considerations, Pharmacologic Care, Prophylaxis

  https://emedicine.medscape.com/article/1165557-treatment

  Person-to-person transmission can be interrupted by chemoprophylaxis, which eradicates the asymptomatic nasopharyngeal carrier state. […] Deterrence and prevention of meningococcal meningitis can be achieved by either immunoprophylaxis or chemoprophylaxis. Rifampin, quinolones, and ceftriaxone are the antimicrobials that are used to eradicate meningococci from the nasopharynx. […] Vaccination is used for close contacts of patients with meningococcal disease due to A, C, Y, or W135 serogroups, to prevent secondary cases. […] The „Routine Vaccination” and „Special Situations” sections have been updated to incorporate the new Bexsero vaccination schedule. […] Mass immunization of selected communities, using polyvalent A and C polysaccharide vaccine, is a useful control measure. […] Vaccines against meningococcus A, C, W, and Y are available.

• #32

  https://www.who.int/activities/preventing-and-controlling-meningitis-outbreaks

  Prevention of meningococcal cases and outbreaks, through vaccination, is the best control strategy. […] The availability of an affordable conjugate vaccine against serogroup A, since 2010, has allowed the rollout of mass preventive campaigns in epidemic-prone areas of the meningitis Belt, dramatically reducing cases and outbreaks due to this serogroup. […] Until wide-spread preventive vaccination with appropriate vaccines is enabled, control of meningococcal epidemics in the belt relies mainly on efficient surveillance for prompt outbreak detection and confirmation of the outbreak-causing pathogens, and rapid mass reactive vaccination. […] The new roadmap to defeat meningitis by 2030 calls for the elimination of meningitis epidemics by 2030, as one of its visionary goals. Through this roadmap, WHO and partners will support countries to achieve this goal, by enabling the development, enhanced access and coverage of affordable vaccines, effective prophylactic strategies and targeted interventions.

• #33 Meningitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508

  Seek medical care right away if you think that you or someone in your family has meningitis. For meningitis caused by bacteria, early treatment can prevent serious complications. […] Talk with your healthcare professional if you’ve been near someone with meningitis. That may be a family member or someone you live or work with. You may need to take medicines to prevent getting an infection. […] These steps can help prevent meningitis: Wash your hands. Careful hand-washing helps prevent the spread of germs. Teach children to wash their hands often. Teach them to wash hands before eating and after using the toilet, spending time in a crowded public place, or petting animals. Show them how to wash and rinse their hands well. […] Practice good hygiene. Don’t share drinks, foods, straws, eating utensils, lip balms or toothbrushes with anyone. Teach children and teens to avoid sharing these items too.

• #34 Meningitis: Prevention, Symptoms & Treatment

  https://www.webmd.com/brain/meningitis-12-frequently-asked-questions

  Is it possible to prevent meningitis? There are four vaccines available to prevent bacterial meningitis. If not previously vaccinated, teens entering high school or entering college (and who will be living in a dormitory) should be vaccinated. […] The doctor may suggest other steps to prevent meningitis: Antibiotics, if you’ve come into close contact with someone who has had some kinds of bacterial meningitis […] Good hygiene, such as regular hand washing […] Not sharing food, drinks, or utensils.

• #35 Meningitis – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/meningitis/symptoms-causes/syc-20350508

  Stay healthy. Keep your immune system strong by getting enough rest, exercising regularly, and eating a good diet with fresh fruits, vegetables and whole grains. […] Cover your mouth. When you need to cough or sneeze, be sure to cover your mouth and nose. Even better, cough or sneeze into your shoulder. […] If you’re pregnant, watch what you eat. Reduce your risk of a listeria infection by cooking meat, including hot dogs and lunch meats, to 165 degrees Fahrenheit (74 degrees Celsius). Eat only cheeses made from milk that has been pasteurized to kill germs. Check labels to be sure cheeses are made with pasteurized milk. […] Vaccinations can help prevent some forms of bacterial meningitis. Vaccinations include: Haemophilus influenzae type b vaccine. This vaccine is called Hib for short. The U.S. Centers for Disease Control and Prevention, also called the CDC, suggest this vaccine for children starting at about 2 months of age. The vaccine also is for some adults. This includes adults who have sickle cell disease or AIDS and those who don’t have a spleen.

• #36 Prevention – Meningitis Centre

  https://meningitis.com.au/about-the-disease/prevention/

  DO NOT share drink bottles or drinking glasses. […] DO NOT share food. […] Cover your mouth and nose when sneezing. […] Wash your hands regularly, especially after going to the bathroom or changing a nappy. […] Avoid deep kissing socially. […] DO NOT share lipsticks. […] The best way to prevent Meningitis, Meningococcal, and Pneumococcal is through vaccination. However, its important to remember that not all strains are covered by vaccinations so, make sure you know the signs and symptoms AND IF YOU SUSPECT MENINGITIS, MENINGOCOCCAL OR PNEUMOCOCCAL SEEK URGENT MEDICAL ATTENTION. […] The best way to prevent bacterial meningitis is through vaccination. Not all strains are covered by vaccinations. So, make sure you know the signs and symptoms. […] Meningitis-preventing vaccines have proven to be extremely safe. Because they are composed of purified polysaccharide and protein, there is no possibility of contracting meningitis or any other infection from these vaccines. […] Safe, effective vaccines are now available for many common types of meningitis and new vaccines are in development all the time.

• #37 Meningococcal Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22442-meningococcal-disease

  You can help to prevent meningococcal disease by doing the following: […] Get vaccinated […] If you take complement inhibitors, your healthcare provider may suggest you also take antibiotics while you take these drugs. […] Some healthcare providers might suggest you be treated with preventive antibiotics if you live with or are in close contact with someone with meningococcal disease. […] In general, you should stay away from sick people whenever you can. You should wash your hands thoroughly and avoid touching your eyes, nose or mouth with unclean hands. […] Getting vaccinated is an important part of prevention.

• #38 Meningococcal | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/meningococcal

  Meningococcal disease is any illness caused by Neisseria meningitidis bacteria. These illnesses are often severe and deadly. They include infections of the lining of the brain and spinal cord (meningitis) and bloodstream infections (septicemia). Infants, teens and young adults (ages 16 through 23 years old), and adults 65 years and older have the highest rates of meningococcal disease in the United States. […] The best way to prevent meningococcal disease is to keep up with recommended meningococcal vaccines. It is important to maintain healthy habits such as getting plenty of rest and avoid having close contact with people who are sick with a meningococcal infection. […] To prevent yourself from getting sick by being in contact with someone with meningococcal infection, you should avoid: Kissing a sick person. Being in close contact of an infected persons coughs. Being in close proximity for an extended period of time. Sharing items that touch the mouth:

• #39 Meningococcal | Washington State Department of Health

  https://doh.wa.gov/you-and-your-family/immunization/diseases-and-vaccines/meningococcal

  The Center for Disease Control and Prevention recommends meningococcal vaccination for all preteens and teens. Other children and adults should get these vaccines in certain situations. […] Those at higher risk should talk to their doctor or health care provider for more details about if and when they can get vaccinated. […] Meningococcal disease is very serious and can be deadly in a matter of hours. Additionally, the disease can be difficult to diagnose because it shares symptoms with other illnesses. […] Rates of all types of meningococcal disease have decreased in the United States thanks to the use of vaccination. However, the United States still experiences meningococcal outbreaks. Rates of meningococcal disease increased in 2023 due to an increase in serogroup Y meningococcal disease in the United States. This recent trend stresses how important it is to be up to date on meningococcal vaccination, and this includes booster doses every 3 to 5 years depending on age, health condition, and lifestyle (travel, living situations, etc.).

• #40 Meningococcal disease awareness and prevention | UIC today

  https://today.uic.edu/meningococcal-disease-awareness-and-prevention/

  College freshmen should get vaccinated before entering college, or after starting college if they weren’t previously vaccinated. […] Your primary care provider can best help you make sure you have received your meningococcal vaccinations and recommend appropriate boosters in accordance with the CDC’s Advisory Committee on Immunization Practices. […] UIC students can receive a meningitis vaccine at Student Health Services as part of their regular medical visit or through a nurse visit once the student is established with the Family Medicine Center. […] Most private insurance plans will cover medically necessary vaccines, including meningitis vaccines.

• #41 Challenges of Unpredictability: Meningitis Prevention Takes Everyone’s Continuous Vigilance – Interview with A Key Opinion Leader – European Medical Journal

  https://www.emjreviews.com/microbiology-infectious-diseases/article/challenges-of-unpredictability-meningitis-prevention-takes-everyones-continuous-vigilance-interview-with-a-key-opinion-leader-s100124/

  Meningitis is largely preventable through vaccination, but progress in the fight against this unpredictable disease is behind other vaccine-preventable diseases. […] Hence, vaccination programmes against IMD are critical to optimise immunisation rates and support the prevention of meningitis. […] Meningitis prevention is critical. […] The WHO, in collaboration with global partners and experts, has developed a roadmap with goals to eliminate bacterial meningitis epidemics, reduce cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%, and decrease disability and improve quality of life after meningitis of any cause by 2030. […] Martinn-Torres highlighted that vaccination of adolescents, one of the main carriers, prevents colonisation and spread of N. meningitidis, and helps control disease in all age groups.

• #42 Meningitis Prevention Policy Hub — American Society for Meningitis Prevention

  https://meningitisprevention.org/policy

  Meningococcal meningitis is fast-moving, deadly, and preventable but only if the right policies are in place at every level. […] I strongly urge the ACIP to reprioritize their assessment of meningococcal vaccine recommendations to ensure that more adolescents and young adults are protected from this deadly disease. […] State health policies should ensure strong and clear meningococcal vaccination requirements to protect adolescents and young adults. […] Students on college campuses are at increased risk for meningococcal meningitis, especially Meningitis B, and policies must evolve to ensure comprehensive, consistent protection across all institutions.

• #43 Meningococcal Meningitis Prevention Can Be Complicated. Here’s What You Need to Know

  https://www.nahnnet.org/index.php?option=com_jevents&task=icalrepeat.detail&evid=18&Itemid=115&year=2024&month=09&day=23&title=meningococcal-meningitis-prevention-can-be-complicated-heres-what-you-need-to-know&uid=c128bd8fe33ccbf309c695e0662ec5b4

  Meningococcal meningitis prevention landscape is evolving rapidly with the introduction of the new pentavalent meningitis vaccine, covering all five serogroups (A, B, C, W, and Y) and the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) set to revisit vaccine recommendations early next year. […] This presentation will emphasize the critical need for comprehensive protection against meningococcal meningitis in clinical practice and the integral role nurses play in ensuring the health of the communities they serve. […] The webinar will conclude with practical strategies and resources that nurses can implement to improve meningitis vaccination rates among their patients.

• #44 Prevention and control – Medical Surgical

  https://www.naxlex.com/nursing/study-guides/prevention-and-control-1695390503

  – The prevention and control of meningitis are based on reducing the exposure to the causative agents, enhancing the immunity of the population, and managing the outbreaks of the disease. […] […] – Some of the prevention and control measures for meningitis include: […] […] – Avoiding close contact with people who have meningitis or respiratory infections, such as by not sharing utensils, cups, or personal items. […] […] – Practicing good hygiene habits, such as by washing hands frequently, covering mouth and nose when coughing or sneezing, and disposing of tissues properly. […] […] – Getting vaccinated against certain types of meningitis, such as meningococcal, pneumococcal, Hib, or mumps vaccines. The vaccination schedule depends on the age group and risk factors of the individual. […]

• #45 Bacterial meningitis primary prevention – wikidoc

  https://www.wikidoc.org/index.php/Bacterial_meningitis_primary_prevention

  Primary preventive measures which may help prevention of bacterial meningitis may include vaccination against meningococcal, pneumococcal and hemophilus influenza infection. […] Other preventive measures may include antibiotic chemoprophylaxis for patients exposed to Neisseria meningitides and Hemophilus influenza type b. […] Primary preventive measures to prevent bacterial meningitis include the following. […] Other preventive measures which may help preventing meningitis may include: […] Chemoprophylaxis required for suspected cases of meningococcal and hemophilus infection.

• #46 Meningitis – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/meningitis/

  Prevention is through vaccination against common causes of meningitis, and chemoprophylaxis for exposed contacts. […] Follow recommended ACIP immunization schedules, particularly for: […] Meningococcal vaccine […] Pneumococcal vaccine […] Haemophilus influenzae type b vaccine. […] Provide postexposure chemoprophylaxis for close contacts. […] Administer chemoprophylaxis as soon as possible, preferably within 24 hours of symptom onset in the index patient. […] Provide postexposure chemoprophylaxis for close contacts if indicated. […] During community outbreaks of N. meningitidis: Vaccinate against the circulating serotype.

• #47 Pharmacotherapy Update | Prevention of Meningococcal Disease

  https://www.clevelandclinicmeded.com/medicalpubs/pharmacy/julyaug2005/default.htm

  Chemoprophylaxis is the primary method to prevent transmission of meningococcal disease from infected individuals to close contacts. Close contacts are defined as household members, child-care center contacts, and anyone exposed to the patients oral secretions. The attack rate for these close contacts is estimated to be 4 cases/1,000 persons exposed, which is more than 500 times that of the general population. Since the risk of contracting secondary disease is greatest immediately after onset of symptoms in the index case, chemoprophylaxis should be given within 24 hours after identification of the index case. Administration of chemoprophylaxis is probably of limited value if 14 or more days have elapsed after onset of symptoms in the index case. The CDC recommended antibiotics and dosing regimens for chemoprophylaxis are listed in Table 3.

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