- Prophylaxis recommended for:

• household contacts, including those living in the same household and individuals who share sleeping arrangements
• close contacts:
  • child care facility or nursery school contacts
  • individuals in contact with index case’s nasopharyngeal secretions (i.e. kissing on the mouth; sharing cigarettes, drinking bottles, or musical instruments) within 7 days prior to the onset of symptoms and up to 24 hours after index case starts appropriate antibiotic treatment.
• medical personnel who have had contact with nasopharyngeal secretions (without barrier protection such as a mask) of the case such as during mouth-to-mouth resuscitation, intubation, or nasotracheal suctioning before antibiotics begun
• index case if not treated with cefotaxime/ceftriaxone
• airline contacts:
  • those individuals sitting on either side of the index case (but not across the aisle) or other passengers or flight staff who have had direct contact with the respiratory secretions of the index case, and
  • the diagnosis of invasive disease occurred no more than 48 hours after air travel, and
  • the flight occurred within the previous 10 days, and
  • the total time spent aboard the aircraft was at least eight hours, including ground time.

NB: Prophylaxis should be offered to persons who had contact with the case in the 7 days preceding the onset of illness or hospitalization of the index case. Prophylaxis can be considered for up to 10 days after last contact with an untreated case regardless of immunization status.

Prophylaxis started > 10 days after the most recent exposure to a case is of limited or no benefit.

Eligible contacts should also be offered meningococcal vaccine (vaccine chosen is dependent on serogroup causing disease in index case, and age of recipient).

Recommended Prophylaxis

Antibiotic	Children	Adults
First line Rifampin or	< 1 month 5mg/kg PO bid x 2 days ≥ 1 month (<60kg) 10mg/kg PO bid x 2 days (max 600mg)	(and children > 60kg) 600mg PO bid x 2 days
Alternative Ceftriaxone or	< 12 years 125mg IM single dose ≥ 12 years 250mg IM single dose	250mg IM single dose
Ciprofloxacin	≥ 9 years 500 mg PO single dose	500mg PO single dose