Primary meningococcal conjunctivitis: Summary of evidence for the clinical and public health management of cases and close contacts

Sydel R. Parikh, Helen Campbell, Sema Mandal, Mary Ramsay, Shamez Ladhani*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Background: Neisseria meningitidis is a rare cause of acute bacterial conjunctivitis but can progress to invasive meningococcal disease (IMD) in the case and their close contacts. There is, however, a lack of consensus on the clinical and public health management of primary meningococcal conjunctivitis (PMC). Methods: We searched Ovid MEDLINE via PubMed, EMBASE and NHS evidence (up to June 2019) for all publications relating to meningococcal conjunctivitis to provide an evidence-base for developing guidelines for the management of PMC cases and their close contacts. Results: The review identified a 10–29% risk of IMD among PMC cases within two days of onset of eye infection (range: 3 h to 4 days). In one study, the risk of IMD in PMC cases treated with systemic antibiotics was 19 times lower than topical antibiotics alone (p = 0.001). IMD among close contacts of PMC cases is uncommon but potentially fatal. Whether meningococcal vaccination for PMC cases or close contacts provides any additional benefit is unclear. Conclusions: Systemic antibiotic treatment significantly reduces the risk of invasive disease in PMC cases, while antibiotic chemoprophylaxis for close contacts will reduce their risk of secondary IMD. These findings need to be highlighted in relevant clinical and public health guidelines.

Original languageEnglish
Pages (from-to)490-494
Number of pages5
JournalJournal of Infection
Issue number6
Publication statusPublished - Dec 2019

Bibliographical note

Funding Information:
We would like to thank colleagues in the Knowledge and Library Services at Public Health England for their assistance in acquiring articles pertinent to this work. We would also like to thank both the immunisation department and the meningococcal reference unit for their ongoing help and support in the national surveillance of invasive meningococcal disease.

Publisher Copyright:
© 2019


  • Chemoprophylaxis
  • Invasive meningococcal disease
  • Primary meningococcal conjunctivitis


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