Prophylaxis for contacts of patients with meningococcal or Haemophilus influenzae type b disease.

The diagnosis of meningitis often causes profound fear and occasionally overt hysteria in family members and acquaintances of affected patients. Recent studies have indicated that in cases of meningitis caused by either Neisseria meningitidis or Haemophilus influenzae type b this fear, at least in part, is justified. Close contacts of patients with either illness are at considerably increased risk of contracting the disease. Consequently physicians are called upon to decide what preventive measures, if any, must be taken. Because prospective controlled studies in nonepidemic periods are difficult to perform, the role of prophylaxis is not entirely clear. Recommendations of experts in the field have been contradictory. This review will attempt to summarize current understanding of secondary spread of these diseases and the role of prophylaxis in their prevention.