Vaccine is available in Latin America

EDITOR—I read with interest the editorial by Pollard and Begg.1 For eight years, a vaccine for serogroup meningococcus B has been available in Latin America. This vaccine is produced in Cuba, and, although it may not be perfect, it has shown immunogenicity. The statement that there is no vaccine is incorrect. I would like to know whether Pollard and Begg are aware of this but think it is not a recommended vaccine, or if they are not aware of it.

Prophylaxis is not necessary

EDITOR—Traditionally, Monday mornings are depressing times for medical microbiologists. Until now, this has largely been a result of the handful of new cases of methicillin resistant Staphylococcus aureus discovered over the preceding weekend. In November, however, my usual gloom was turned to despair by a flurry of telephone calls from colleagues in various states of panic demanding prophylaxis for meningococcal disease. I am a consultant microbiologist and infection control doctor, and it has taken me a long time to convince healthcare workers at my trust that antimeningococcal prophylaxis is not necessary for healthcare workers, including ambulance crews, after nursing a patient with meningococcal disease. The only exception to this rule is after mouth to mouth resuscitation.

Pollard and Begg in their editorial are advising that antibiotics should be offered to healthcare workers with direct exposure to potentially infected secretions, despite their own assertions that few published reports exist of healthcare workers or laboratory staff developing invasive meningococcal disease.1 This advice seems to be based on a single case of a paediatrician in France, who developed meningococcaemia after intubating a child with meningococcal disease.2 I do not know whether or not a causal link was proved in this case. Such advice is contrary to national guidance.3

Furthermore, the risks of antibiotic chemoprophylaxis are not adequately covered in …