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Meningitis Prophylaxis in Children
While H1N1 and garden-variety influenza have been taking the spotlight lately, we can't forget about other disease processes. Meningitis is still a severe, life-threatening/altering process which occurs in various social groups (e.g. military cadets, college students).
However, with more of our parents working out of the home, child care is more often the norm, and as such, you may find yourself dealing with cases of children who have been in proximity to another child or caregiver diagnosed with meningitis. What do you do?
The causative agent will often dictate your choice of management.
Neisseria meningitidis - nursery/child care contacts should receive chemoprophylaxis and the Menactra vaccine (if they have not already received it) within 7 days of onset; casual school or work contacts do NOT require prophylaxis
Streptococcus pneumoniae - no chemoprophylaxis or vaccination required (unless series was not continued)
Haemophilus influenzae - if only one case reported, no intervention; if 2 or more cases within a 60-day period, Hib vaccination and chemoprophylaxis with rifampin for BOTH children and caregivers (especially if the center cares for young children who have not completed their Hib series)
References
Pediatrics in Review, July 2009: "Infections in Child-Care Facilities and Schools"