Three cases in Minnesota and North Dakota are the first reported cases of ciprofloxacin-resistant meningococcal disease in North America.
Close contacts of an index case of meningococcal disease have a 500- to 800-fold higher risk for disease than the general population, and 1% to 3% of household contacts develop the disease if no prophylaxis is provided. Antibiotic prophylaxis can markedly decrease carriage rates and should be given to close contacts within the first 24 hours after the identification of an index case. Previously, CDC-recommended prophylaxis regimens included rifampin, ceftriaxone, and ciprofloxacin. However, three recent case reports of fluoroquinolone-resistant Neisseria meningitidis in North Dakota and Minnesota have led to a regional change in these recommendations.
The three cases involved a child who attended day care, an adult, and a college student. Me…