1: Pertinent points
Epidemiology
-
Incidence of meningococcal disease, and frequency of clusters and
outbreaks, has increased in Australia over the past decade.
-
Meningococcal disease affects mainly children under five years of
age and adolescents.
Patient management-
Empirical antibiotic therapy should be given immediately to any
patient with suspected meningococcal disease, before referral to
hospital, particularly in the presence of actual or incipient shock.
-
A blood sample for culture should be collected before the first dose
of an antibiotic whenever possible, unless this would delay
antibiotic administration.
-
Antibiotic therapy in hospital should not be delayed while awaiting
results of diagnostic or other tests (e.g., computed tomography).
Prevention
- Rifampicin should be given to eradicate nasopharyngeal carriage of
Neisseria meningitidis, if the patient was treated with an
antibiotic other than ceftriaxone or ciprofloxacin.
-
Chemoprophylaxis with rifampicin, ceftriaxone or ciprofloxacin
should be offered to close contacts of a patient as soon as possible.
-
Public health units should respond urgently to control outbreaks.
-
The polysaccharide vaccine against N. meningitidis
serogroups A and C is highly effective for controlling outbreaks
caused by these serogroups.
-
An effective vaccine against N. meningitidis serogroup B is
not yet widely available.
Back to article - Register to be notified of new articles by e-mail - Current contents list - ©MJA 1997
<URL: http://www.mja.com.au/>
© 1997 Medical Journal of Australia.
