Six different strains of Neisseria meningitidis in a case with meningococcal sepsis and five contact persons in a boys' home.

BACKGROUND

It is routine practice to provide chemoprophylaxis for close contacts of a patient infected with meningococci.

PATIENTS: When a 17-year-old boy living in a boys' home was admitted to the hospital with septic shock caused by Neisseria meningitidis, we immediately identified contact persons in the boys' home.

RESULTS

104 contact persons were identified and screened for oropharyngeal colonization. 77 persons received chemoprophylaxis. N. meningitidis was isolated from the index case and from five of 104 throat swabs of the contact persons (three home dwellers, one staff member, one visitor). The overall carrier rate was 4.8%. All isolates showed different patterns when analyzed by pulsed-field gel electrophoresis, which was in accordance with results of serotyping by the German National Reference Center for Meningococci.

CONCLUSION

In this non-epidemic situation, contacts between the index case, home mates, home personnel, and visitors were not close enough for effective transmission of meningococci, since no strain was found twice. This supports recommendations for the use of chemoprophylaxis in persons with intimate contact to the index patient.