Invasive meningococcal disease: secondary spread in a day-care center.

We have reported the epidemiologic investigation and subsequent control measures precipitated by the occurrence of two temporally related cases of invasive meningococcal disease in a single day-care center classroom. A review of the literature indicates that day-care center contacts of patients with invasive meningococcal disease are at increased risk for secondary spread of infection. Our experience emphasizes the importance of reporting cases to the local health department, implementing rifampin prophylaxis for appropriate contacts, and considering immunization in select circumstances. Rifampin is indicated for all cases of meningococcal disease as well.