The management of contacts following a case of nosocomial meningococcaemia in a children's ward

Abstract

This report describes the response to a very rare instance of meningococcal disease in a child hospitalised for an unrelated condition. The circumstances of the case meant that there were large numbers of staff, patients, family members and visitors who were possible contacts. Staff from two public health units in the vicinity of the hospital were called in to assist in the coordination of the assessment of the exposure status of contacts, the provision of chemoprophylaxis and counselling of contacts. The response team was compelled to make a broad interpretation of the guidelines for prophylaxis of contacts because of the uncertainty about when the case may have acquired the infection and the many opportunities for possible transfer of the infecting organism to contacts. A total of 107 people were assessed, with 68 receiving some form of prophylaxis. A number of interesting problems arose during the conduct of the response. There were no more cases of meningococcal disease amongst identified contacts or their contacts.