Scholten R J, Bijlmer H A, Dankert J, Valkenburg H A
Vrije Universiteit, Instituut voor Extramuraal Geneeskundig Onderzoek, Amsterdam.
Ned Tijdschr Geneeskd. 1993 Jul 24;137(30):1505-8.
To assess the secondary attack rate (SAR) of meningococcal disease among the household contacts of primary patients and to describe the use of chemoprophylaxis in the Netherlands.
Descriptive, nation-wide survey.
Information was collected of patients with meningococcal disease, reported between April 1st, 1989 and April 30th, 1990, and their household contacts. A household contact suffering from meningococcal disease between 24 hours and 1 month after hospital admission of the primary patient, was considered to be a secondary case. Chemoprophylaxis was considered appropriate if rifampicin or minocycline had been prescribed to all household contacts within a maximum of one day after admission of the primary patient.
There were 5 secondary cases (SAR: 0.3%). Chemoprophylaxis was prescribed to 627 of 1130 household contacts (55%). Of those the prophylaxis was considered appropriate in 46%. 2 secondary cases were not given any prophylaxis, 2 received penicillin and 1 rifampicin. Of the primary patients, 6% were given prophylaxis during their hospital stay. All meningococci, isolated from pairs of secondary and primary patients, were rifampicin sensitive.
The SAR of meningococcal disease in the Netherlands is similar to that in other countries. Although prescription of chemoprophylaxis is not recommended by the government, it is prescribed to 55% of the household contacts, and in almost half of these instances it was considered to be appropriate. Chemoprophylaxis is rarely prescribed to primary patients. Recommendations concerning chemoprophylaxis in the Netherlands are in need of reappraisal. Based on the results from this study and the literature, the prescription of chemoprophylaxis to all household contacts of a patient with meningococcal disease, and to the index patient, is recommended.
评估原发性患者家庭接触者中脑膜炎球菌病的二代发病率（SAR），并描述荷兰化学预防法的使用情况。
描述性全国性调查。
收集1989年4月1日至1990年4月30日期间报告的脑膜炎球菌病患者及其家庭接触者的信息。原发性患者入院后24小时至1个月内患脑膜炎球菌病的家庭接触者被视为二代病例。如果在原发性患者入院后最多一天内已对所有家庭接触者开具利福平或米诺环素，则认为化学预防法是适当的。
有5例二代病例（SAR：0.3%）。1130名家庭接触者中有627人（55%）接受了化学预防法。其中，46%的预防措施被认为是适当的。2例二代病例未接受任何预防措施，2例接受了青霉素，1例接受了利福平。原发性患者中有6%在住院期间接受了预防措施。从二代和原发性患者对中分离出的所有脑膜炎球菌对利福平敏感。
荷兰脑膜炎球菌病的SAR与其他国家相似。尽管政府不建议开具化学预防法，但仍有55%的家庭接触者接受了该方法，且其中近一半被认为是适当的。原发性患者很少接受化学预防法。荷兰有关化学预防法的建议需要重新评估。基于本研究结果和文献，建议对脑膜炎球菌病患者的所有家庭接触者以及索引患者开具化学预防法。
