The Telemark Meningococcal Project 1987-2007. Twenty years experience of preventing secondary cases of meningococcal disease by identification and erdication of the disease-causing strain of Neisseria meningitidis in close contacts of patients with primary meningococcal disease

Abstract

Once meningococcal disease occurs, the infection may spread leading to one or more secondary cases. The Telemark Meningococcal Project was initiated in 1987 to prevent secondary cases. By culture of throat samples from close contacts, meningococci were identified, and identity with the disease-causing strain from the patient was determined by DNA based typing techniques. Contacts carrying the disease-causing strain were given rifampicin to eradicate it. Following the introuction of the Project, no secondary cases has been seen in Telemark. We conclude that the Project may have prevented from 1-7 secondary cases and that it has gained from 12 to 99 quality adjusted life years (QALY). House-hold members and kissing contacts have the highest odds of carrying the disease-causing strain and should always be given chemoprophylaxis. The Project should be permanently implemented for the prevention of spread of meningococcal disease in Telemark