Effectiveness of vaccinating household contacts in addition to chemoprophylaxis after a case of meningococcal disease: a systematic review

• Published in: Epidemiology and infection Vol. 136; no. 11; pp. 1441 - 1447
• Main Authors: HOEK, M. R., CHRISTENSEN, H., HELLENBRAND, W., STEFANOFF, P., HOWITZ, M., STUART, J. M.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.11.2008
• Subjects: Anti-Bacterial Agents - therapeutic use; Bacterial diseases; Bacterial diseases of the nervous system. Bacterial myositis; Biological and medical sciences; Chemoprevention; Cogeneration; Disease incidence rates; Disease outbreaks; Disease risk; Disease Transmission, Infectious - prevention & control; Epidemiology; Family Characteristics; Family Health; Fatalities; Households; Human bacterial diseases; Humans; Infectious diseases; Literature reviews; Medical sciences; Meningococcal Infections - prevention & control; Meningococcal Vaccines - administration & dosage; Meningococcal Vaccines - immunology; Meta-analysis; Observational studies; Prevention and actions; Preventive medicine; Public health. Hygiene; Public health. Hygiene-occupational medicine; Review; Review Article; Sensitivity analysis; Specific populations (family, woman, child, elderly...); Vaccination; Vaccines; Infection; Human; Prevention; Chemoprophylaxis; Microbiology; Taxonomy; Vaccination; Bacteriosis; Review; Epidemiology; Meningococcal disease
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268808000770

We performed a systematic review to estimate the effectiveness of vaccination, in addition to chemoprophylaxis, in preventing meningococcal disease among household contacts. Medline, EMBASE, EMGM, and EUIBIS were used for data collection. Studies reporting on at least 100 primary cases and on subsequent cases in household settings with follow-up of more than 2 weeks after onset of disease in the primary case were reviewed. A meta-analysis was used to calculate the average attack rate in household contacts given chemoprophylaxis 14–365 days after onset of disease in the primary case. In total, 652 studies were identified, five studies and one unpublished report met the inclusion criteria. The weighted average attack rate was 1·1/1000 household contacts (95% CI 0·7–1·7). This review supports vaccination of household contacts in addition to chemoprophylaxis to reduce the risk of meningococcal disease among household contacts of a case caused by a vaccine-preventable serogroup.