Meningococcal disease in day care centers

Household contacts exposed to patients with meningococcal disease are at demonstrably higher risk of that disease than the general population. Less intimate and less prolonged contact such as that involving hospital personnel or school classmates is not clearly associated with increased risk. This may well be due to the fact that older children and adults commonly have protective antibodies. Preschoolers, on the other hand, are more often susceptible as shown by their higher age specific primary and secondary attack rates. When a child who attends a day care center nursery develops meningococcal disease the presumed exposure of numerous susceptibles is a theoretically dangerous situation. Although data with which to calculate the secondary attack rate among such contacts are not collected nationwide, recent experience and two earlier reports suggest that secondary cases do indeed occur.