Occupational transmission of meningococcal disease

This week's MMWR has a report on transmission of meningococcal disease from an infected patient to a police officer who responded to the patient's home and a respiratory therapist who cared for the patient in the Emergency Department. Neither of the secondary cases were offered postexposure prophylaxis. CDC recommends prophylaxis for HCWs with direct exposure to the patient's oral secretions (e.g., performacne of endotracheal intubation). In this case the police officer was not evaluated for prophylaxis because of a delay in contact tracing. However, the MMWR report admits that if the CDC recommendations were followed the police officer may have not been offerred prophylaxis. What's surprising is that CDC didn't revise the recommendation. Given the severity of meningococcal disease I think we need to be more flexible than CDC's recommendation. We offer prophylaxis to any unprotected HCW within 3 feet of the patient.