Prevention of meningitis in a day-care center: management of an outbreak of Haemophilus influenzae type b.

The care of infants and toddlers in nursery school and day-care centers in increasingly large numbers over the past decade poses special problems with respect to communicable disease control. This age group is particularly susceptible to those infectious agents (bacterial, viral, and parasitic) spread by close personal contact. This study describes an outbreak of Haemophilus influenzae type b meningitis in a large nursery school in Westchester County, New York. Organized efforts to control the outbreak through recommendation of rifampin prophylaxis were undertaken and evaluated. Compliance following the first case of meningitis was unacceptably low (45% of children and 33% of staff). Following the second case, however, compliance rose to 90% among child attendees and 79% among staff. Recommended procedures for implementation of control measures are described.