%0 Journal Article %1 jackson_evaluation_1996 %A Jackson, L A %A Alexander, E R %A DeBolt, C A %A Swenson, P D %A Boase, J %A McDowell, M G %A Reeves, M W %A Wenger, J D %D 1996 %J The Pediatric Infectious Disease Journal %K Adolescent, Antibiotics, Antitubercular, Carrier Child, Disease Drug Factors, Female, Humans, Infections, Male, Meningococcal Microbial, Neisseria Oropharynx, Outbreaks, Resistance, Rifampin, Risk Schools, Serotyping State, meningitidis, %N 11 %P 992--8 %R 8933547 %T Evaluation of the use of mass chemoprophylaxis during a school outbreak of enzyme type 5 serogroup B meningococcal disease %V 15 %X BACKGROUND: A vaccine for prevention of serogroup B meningococcal disease is not available in the United States, and indications for the use of mass chemoprophylaxis for control of meningococcal outbreaks are not well-defined. In response to an outbreak of six cases of enzyme type 5 serogroup B meningococcal disease among students at a middle school, we implemented a program of mass rifampin prophylaxis and evaluated the effectiveness of this preventive measure. METHODS: Oropharyngeal cultures were obtained from 351 of the 900 students before prophylaxis; 196 participants were recultured 3 weeks later. Meningococcal isolates were subtyped and tested for rifampin susceptibility, and risk factors for disease or carriage among students were evaluated. RESULTS: No cases occurred after prophylaxis. Before prophylaxis 10\% (34 of 351) of students were meningococcal carriers and 3.4\% (12 of 351) carried the epidemic strain. After prophylaxis 2.5\% (5 of 196) were carriers and 1.0\% (2 of 196) carried the epidemic strain. Rifampin was 85\% effective in eradicating carriage, and the rate of acquisition of carriage during the 3-week period was low (0.5\%). Carriage persisted after prophylaxis in 4 students; 3 of these postprophylaxis isolates were rifampin-resistant. Rifampin resistance thus developed in 12\% (3 of 26) of preprophylaxis isolates. Disease/epidemic strain carriage was associated with enrollment in the school band and certain other classes. CONCLUSIONS: These findings suggests that mass chemoprophylaxis may be effective and should be considered for control of school serogroup B meningococcal outbreaks. This approach is less likely to be effective for control of outbreaks affecting larger, less well-defined populations and is associated with the rapid development of antibiotic resistance.

@article{jackson_evaluation_1996, abstract = {{BACKGROUND:} A vaccine for prevention of serogroup B meningococcal disease is not available in the United States, and indications for the use of mass chemoprophylaxis for control of meningococcal outbreaks are not well-defined. In response to an outbreak of six cases of enzyme type 5 serogroup B meningococcal disease among students at a middle school, we implemented a program of mass rifampin prophylaxis and evaluated the effectiveness of this preventive measure. {METHODS:} Oropharyngeal cultures were obtained from 351 of the 900 students before prophylaxis; 196 participants were recultured 3 weeks later. Meningococcal isolates were subtyped and tested for rifampin susceptibility, and risk factors for disease or carriage among students were evaluated. {RESULTS:} No cases occurred after prophylaxis. Before prophylaxis 10\% (34 of 351) of students were meningococcal carriers and 3.4\% (12 of 351) carried the epidemic strain. After prophylaxis 2.5\% (5 of 196) were carriers and 1.0\% (2 of 196) carried the epidemic strain. Rifampin was 85\% effective in eradicating carriage, and the rate of acquisition of carriage during the 3-week period was low (0.5\%). Carriage persisted after prophylaxis in 4 students; 3 of these postprophylaxis isolates were rifampin-resistant. Rifampin resistance thus developed in 12\% (3 of 26) of preprophylaxis isolates. Disease/epidemic strain carriage was associated with enrollment in the school band and certain other classes. {CONCLUSIONS:} These findings suggests that mass chemoprophylaxis may be effective and should be considered for control of school serogroup B meningococcal outbreaks. This approach is less likely to be effective for control of outbreaks affecting larger, less well-defined populations and is associated with the rapid development of antibiotic resistance.}, added-at = {2011-03-11T10:05:34.000+0100}, author = {Jackson, L A and Alexander, E R and {DeBolt}, C A and Swenson, P D and Boase, J and {McDowell}, M G and Reeves, M W and Wenger, J D}, biburl = {https://www.bibsonomy.org/bibtex/2ff3893dbf6990eb951cacf805f52fda2/jelias}, doi = {8933547}, interhash = {9ca19b885d016ff43e5b6744c08ad0f6}, intrahash = {ff3893dbf6990eb951cacf805f52fda2}, issn = {0891-3668}, journal = {The Pediatric Infectious Disease Journal}, keywords = {Adolescent, Antibiotics, Antitubercular, Carrier Child, Disease Drug Factors, Female, Humans, Infections, Male, Meningococcal Microbial, Neisseria Oropharynx, Outbreaks, Resistance, Rifampin, Risk Schools, Serotyping State, meningitidis,}, month = nov, note = {{PMID:} 8933547}, number = 11, pages = {992--8}, timestamp = {2011-03-11T10:06:51.000+0100}, title = {Evaluation of the use of mass chemoprophylaxis during a school outbreak of enzyme type 5 serogroup B meningococcal disease}, volume = 15, year = 1996 }