On the other hand, antibiotic chemoprophylaxis was implemented in the pre-vaccine era in sub-Saharan Africa  and is commonly used among household contacts of cases during outbreaks in western countries [10, 13], but it is not recommended as part of the usual response to meningitis outbreaks in sub-Saharan Africa . This recommendation has been made based on expert opinion that implementing prophylaxis would divert efforts from case management and reactive vaccination campaigns. Nonetheless, data from the 2015 epidemic in Niger suggested that attack rates for household contacts were approximately 20 times higher than that of the general community, suggesting that this group could be an important target for prevention activities . On the other hand, in the same epidemic, 86% of households reported only one case, which could mean that the public health impact of targeting only household contacts could be limited. A recent meta-analysis of four small studies showed a substantial reduction in subsequent cases of meningitis in households receiving chemoprophylaxis . Three antibiotic regimens have been considered as a prophylaxis in other settings: single-dose oral ciprofloxacin, single-dose injectable ceftriaxone, and a 2-day, four-dose course of oral rifampicin. The logistical problems inherent with using an injectable drug like ceftriaxone on a large scale and the unavailability of rifampicin as a single drug in countries with a high prevalence of tuberculosis make ciprofloxacin the best choice for potential prophylactic use in meningococcal meningitis outbreaks in Africa.