American Board of Internal Medicine (ABIM) Certification Practice Exam

Individuals in close contact with a person infected with Neisseria meningitidis require antibiotic prophylaxis if:

1. They are vaccinated

2. They have prolonged exposure over a week

3. They have a history of upper respiratory infections

4. They have close contact for more than 8 hours

The correct answer is: They have close contact for more than 8 hours

Antibiotic prophylaxis for individuals in close contact with a person infected with Neisseria meningitidis is critical in preventing the spread of this serious bacterial infection, particularly meningococcal disease. The situation requiring prophylaxis typically involves those who have had close or prolonged exposure to the infected individual, which can include household contacts, intimate partners, or those sharing living spaces. The rationale behind the need for prophylaxis after close contact is based on the understanding of how Neisseria meningitidis is transmitted, primarily through respiratory droplets during activities such as coughing, sneezing, or intimate interactions. Prolonged contact, defined as being within close proximity (usually less than 3 feet) for an extended duration (more than 8 hours), significantly increases the risk of transmission and bacterial colonization. In this context, individuals who have had close contact for more than 8 hours are categorized as being at high risk for developing disease and therefore qualify for antibiotic prophylaxis. This measure serves to eliminate any potential carriers that may have become colonized but not yet exhibited symptoms, which is essential in controlling outbreaks. The other scenarios listed do not encompass the specific criteria that necessitate prophylactic treatment. Vaccination status, history of respiratory infections, or general exposure