Treatment and prevention of meningococcal disease

Meningococcal meningitis responds well to treatment and, even when this is given in unsatisfactory surroundings, recovery rates of 90-95% can be expected. A few patients are left with permanent disabilities, such as deafness, but most make a complete recovery. Mild cases of acute meningococcaemia are sometimes encountered. In Africa such patients are seen most frequently at the end of an epidemic, but in general the outlook for patients with this condition is poor. Patients who have hypotension or impairment of consciousness often die, even when they receive optimum treatment. Meningococcal disease can be prevented by chemoprophylaxis, vaccination or a combination of both. Great care is needed in deciding upon the control strategy which should be adopted in any particular set of circumstances. Studies on the cost effectiveness of different approaches to the prevention of meningococcal disease in developing countries are needed urgently.