FROM: Red Book: 2003 Report of the Committee on Infectious Diseases. 26th ed. Elk Grove Village, IL:  American Academy of Pediatrics, 2003:  293-301.

• Report the case to Epidemiology & Assessment

Phone: (714) 834-8180
Fax: (714) 834-8196

• Respiratory isolation until 24 hours after start of antibacterial treatment
• If case will be returning to household or child care center with other children under age 4 years or other susceptible children (incompletely immunized* or immunocompromised), start CASE on rifampin (see dosage below) just before discharge from hospital to eliminate upper respiratory tract carriage of organism.  If the case has received treatment with ceftriaxone or cefotaxime, rifampin is NOT necessary.

*Complete immunization is defined as:

• at least 1 dose of conjugate vaccine at 15 months of age or older
• 2 doses between 12 and 14 months of age
• a 2- or 3- dose primary series when younger than 12 months with a booster dose at 12 months of age or older.

• Give rifampin to ALL household members in these situations:

a) Household with child under age 12 months if the child has not received the primary series

b) Household with at least 1 contact younger than 4 years of age who is unimmunized or incompletely immunized (defined above)

c) Household with an immunocompromised child (regardless of immunization status)

Prophylaxis should be initiated as soon as possible.  If household members are unable to fill prescriptions or you are unable to contact them, refer to Epidemiology & Assessment at (714) 834-8180.

• Inform household that any exposed child who develops a febrile illness should be evaluated by a physician as soon as possible.

Epidemiology & Assessment will handle any other situations, such as day care, household members who could not be contacted, or household members who could not fill prescriptions for chemoprophylaxis.

Infant less than 1 month old: 10 mg/kg once daily for 4 days

All others: 20 mg/kg once daily to maximum of 600 mg daily for 4 days

Not recommended for pregnant women or persons with liver disease. Instruct patients that rifampin can stain soft contact lenses, turn urine orange, and interfere with oral contraceptives during current cycle.