Public health management of sporadic cases of invasive meningococcal disease and their contacts

Neisseria meningitidis is a common commensal bacterium of the human pharyngeal mucosa. This organism can cause severe invasive meningococcal disease (IMD) usually presenting as meningitis, septicaemia or both. Unfortunately, public health management of sporadic IMD varies widely in Europe and this can be partly attributed to uncertainty surrounding the effectiveness of preventive measures. The purpose of this document is to provide evidence-based guidance for good practice in public health management of sporadic cases of meningococcal disease and their contacts. It has the additional aim of assisting countries across Europe in making decisions about appropriate measures to control and prevent meningococcal disease at national and sub-national levels. This guidance document should assist European countries in reviewing their own policies on public health management and microbiological diagnosis of meningococcal disease. While the results presented here do not include guidance for management of exposed healthcare workers nor of community outbreaks, it will cover the following relevant areas: • Laboratory tests to confirm the diagnosis of IMD. • Use of antibiotics at discharge from hospital. • Chemoprophylaxis for close contacts considering different settings. • Choice of antibiotic for chemoprophylaxis for different groups (adults, children, pregnant women). • Use of meningococcal vaccine in addition to chemoprophylaxis. In addition to the quality of scientific evidence, the conclusions take into account potential benefit and harm, values, burdens and costs.