Meningococcal bacteria are spread via droplets from the upper respiratory tract. The droplets can be spread by coughing, a runny nose, or direct contact with oral secretions, such as by sharing a toothbrush. Interestingly, some people are colonized with these bacteria, which means that they carry the bacteria in their respiratory tracts but do not become ill. Unfortunately, they are still able to spread the disease to others.
Knowing about these methods of transmission is helpful in determining who should receive preventative antibiotics if they are exposed to someone with serious meningococcal disease. The general rule is that the closer you have been to an infected person, the higher your risk of developing the disease and the more likely you should take the antibiotics. Thus, household contacts, plus nursery-school or day-care contacts, should receive the protective antibiotics. In addition, anyone with direct contact with a person’s oral secretions, such as someone who kissed or shared a spoon or fork with an infected person, should also receive the antibiotics. If the infection is caused by a subtype that is part of one of the available vaccines (see the following questions), then exposed individuals should consider receiving the vaccine along with the antibiotics.
In general, meningococcal disease is a random, sporadic event. Only two to three thousand cases occur in the United States every year. Thus, unless your child is exposed to someone with a significant illness, it is a relatively rare disease. However, because it is so dramatic and can strike healthy individuals, it is a fearsome infection for many parents.