Meningococcal disease in Belgium. Secondary attack rate among household, day-care nursery and pre-elementary school contacts.

During a recrudescence of meningococcal disease mainly due to serogroup B, 1913 notified cases were investigated in Belgium from 1971 to 1976. From 1971 to 1973, 76 secondary cases were reported out of a total of 1455 cases (5.2 per cent); and from 1974 to 1976, nine secondary cases were reported of a total of 458 cases (2.0 per cent). Seventy per cent of the secondary cases occurred within seven days after the Index case. The 4.7 per cent fatality rate among secondary cases was lower than the 9.8 per cent fatality rate among primary cases. The estimated secondary attack rate was 685 per 100 000 among household contacts, 404 per 100 000 among day-care nursery contacts and 77 per 100 000 among pre-elementary school contacts. These attack rates were significantly higher (P less than 0.001) than the incidence rates in the corresponding age-groups in the general community, indicating the need for prophylaxis in these contacts.

Effect of spiramycin on the nasopharyngeal carriage of Neisseria meningitidis.

Nine doses of oral spiramycin were administered to 59 adult healthy nasopharyngeal carriers of meningococci: a 2-gram loading dose followed by 1 g every 12 h for 4 days. There was a reduction in carriage of 85 and 59%, respectively, on the 2nd and 12th post-treatment day. There was no difference in vitro sensitivity to spiramycin and erythromycin of the meningococci isolated before and after treatment. Spiramycin may be advocated as an effective and safe alternative drug for the chemoprophylaxis of secondary meningococcal disease when sulphonamide resistance is suspected.