When someone at home, in a class or in a dormitory has meningococcal disease, their close contacts may already be infected with the bacteria. Taking preventive antibiotics early helps stop the disease from developing and breaks the chain of transmission. The content below follows the book Prevention of meningococcal disease in Vietnam (Vietnam Association of Preventive Medicine), Lesson 6, which cites the Ministry of Health guidance on surveillance, prevention and control of meningococcal disease (Decision 3897/QĐ-BYT of 12/10/2012).

Who is a close contact

Someone who was near the patient during the period from 7 days before the patient's illness began until 24 hours after the patient started specific antibiotic treatment, including:

People living in the same household.
People living or working in the same room.
People who directly cared for the patient.
People with intimate contact, for example contact with saliva through kissing.
Children in the same nursery, group or class.

Source: Prevention of meningococcal disease in Vietnam (Vietnam Association of Preventive Medicine), Lesson 6, section 2.2.3.1, p. 175.

What to do

The health authority lists the close contacts and monitors their health for 10 days from the last contact.
Contacts monitor themselves. If they develop a fever or suspicious signs, they should tell a health worker straight away.
Limit contact with the patient and with other people.
Take preventive antibiotics as soon as possible, ideally within 24 hours of the case being confirmed. Antibiotic susceptibility results should guide the choice. If they are not yet available, choose one of the three medicines below.

Source: Prevention of meningococcal disease in Vietnam (Vietnam Association of Preventive Medicine), Lesson 6, section 2.2.3.2, pp. 175–176.

The three antibiotics and their doses

Ciprofloxacin:

Adults and children over 12: a single oral dose of 500 mg.
Not for children under 12, pregnant women or breastfeeding women.

Rifampicin, by mouth twice a day for 2 days:

Adults and children over 12: 600 mg per dose.
Children aged 1–12: 10 mg/kg per dose.
Infants under 12 months: 5 mg/kg per dose.
Not for people with jaundice, people previously allergic to rifampicin, pregnant women or breastfeeding women.

Azithromycin, a single oral dose:

Adults: 500 mg.
Children: 10 mg/kg.
Can be used by pregnant and breastfeeding women.

These medicines must be prescribed by a health worker. Do not buy and take antibiotics yourself without advice. In outbreaks, wider use of antibiotics follows the guidance of the Institutes of Hygiene and Epidemiology and the Pasteur Institutes.

Source: Prevention of meningococcal disease in Vietnam (Vietnam Association of Preventive Medicine), Lesson 6, section 2.2.3.2, pp. 176–177.

After taking the medicine

Preventive antibiotics only work in the short term and do not replace vaccination. After the exposure, ask your doctor about meningococcal vaccination. The book lists people who have been in contact with a patient during an outbreak as a group that needs vaccination. During the 10 days of monitoring, if you develop a high fever, headache, vomiting, a stiff neck or a purpuric rash, go to hospital immediately.

Source: Prevention of meningococcal disease in Vietnam (Vietnam Association of Preventive Medicine), Lesson 6, sections 2.2.1 and 3, pp. 174, 177.