Prophylactic measures to be taken before visiting areas where meningococcal infection may be a problem

Abstract

Summary Meningococcal infections used to be a menace all over the world before the development of effective antibacterial drugs and vaccines. Today, the risk of infection is varying from 0.3 to over 500 cases per 100 000 inhabitants, highest in sub-Saharan Africa, where outbreaks of cerebrospinal meningitis occur with a periodicity of 8 to 10 years. In other regions, epidemics take place with greater intervals. In spite of the enormous amount of information on meningococcal infections, our knowledge about the epidemiology of the disease is not good enough to predict the place and time of the coming epidemics which are usually caused by serogroup A meningococci. In view of the severity of diseases caused by meningococci and the relatively high case fatality, it is advised that tourists and other travellers visiting places where meningococcal infections are known to be a risk factor be immunized with conjugated vaccines of serogroup A and C. Should effective group B vaccine be available, it should be also used for preventing disease. Besides vaccination, other general hygienic measures for preventing meningococcal infections should be recommended in places where an overcrowding effect is inevitable : dwellings, schools, camps, barracks and public transport. The quality of air is an important factor to prevent the spread of infection. Direct personnal contacts with the persons having the symptoms of respiratory infections should be avoided or reduced to a minimum, with all necessary protection of healthy persons. Measures for collective and individual protection of people against meningococcal infections were reviewed by a group of experts who attended the WHO Meeting on the Assessment and Further Development of the WHO Programmes on Streptococcal Diseases and Meningococcal Infections, Geneva, 10–13 October 1988 (WHO/MNM/STREP/CSM/89.2). The recommendations of the meeting stand actual up to now.