- Administer Rifampin (<18 yrs) or Cipro (adults) to close contacts of index case. Drugs clear pathogen among those exposed within 24-48 hrs

- Vaccinate individuals in an open/closed community when they are at a higher risk (high risk defined as the occurrence of > 10 cases/100,000 population in an open/closed community within a period of less than 3 months) than the common risk in the community (defined as < 1 case/100,000 pop). The vaccine stimulates immune response in vaccinees within 10 days and thereby prevents spread of infection. The vaccine does not provide immediate protection for close contacts exposed to an index case. Outbreaks based on the indication of 10 cases/100,000 in < 3 months, same setting are rare compared to the occurrence of single cases.

- Effective prevention depends on timely reporting of index case. Report to HD within 24 hours when signs and symptoms are suggestive of meningococcal infection. Do not wait for laboratory confirmation. Timely reporting allows HD staff to initiate the identification of close contacts to be prophylaxed.

- Prophylaxis is initiated for all close contacts who have been exposed to the index case within a window period of 10 days prior to the treatment of the index case (index case no longer infectious). With timely reporting within 24 hours the window period starts from date of treatment of index case. However, when the occurrence of an index case is known with a delay of several days after the disease has become manifest, the window period to prophylax exposed close contacts becomes very narrow or non-existent. If an index case is reported 10 days or more after onset of signs and symptoms, then there is not point is starting chemoprophylaxis of close contacts, since those exposed and susceptible would have developed disease.