How to do it? Practical guidance on organising mass antibiotic prophylaxis for a large school after a cluster of meningococcal disease

After a second meningitis case occurred in a school, we undertook mass prophylaxis of 2095 pupils and staff of three institutions on the site. This incident, early in the life of the new primary care organisations, presented several challenges and provided opportunities to learn about successful co-management of future major incidents. This paper aims to identify and address problems in planning such prophylaxis, with particular reference to the new NHS arrangements. It also provides a practical checklist, with commentary on potential issues based on our local experience. This may help other health protection units facing similar incidents, and contribute to the development of more general guidance.