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Disease: Bacterial meningitis

Although several different bacterial genera can cause meningitis, Neisseria meningitidis, a NON-MOTILE, ENCAPSULATED, GRAM-NEGATIVE DIPLOCOCCUS, is one of the most important because of its potential to cause epidemics. The WHO estimates that there have been an estimated 700,000 cases of epidemic meningococcal disease (EMD) in the past 10 years, of which about 70,000 individuals have died worldwide, but primarly in Africa.

October 9, 2007 - The meningitis season from December 2006 to May 2007 in Africa’s meningitis belt saw an estimated 53,000 cases of meningitis, with an estimated 4,000 deaths. This was the highest number of cases and deaths since the 2001 meningitis season. To fight last season’s epidemic, the World Health Organization (WHO) and its partners amassed 7 million doses of vaccine to protect 400 million people across the 21 countries of the so called “meningitis belt,” an area that extends from Senegal to Ethiopia with an estimated total population of 300 million. This stretch of land is home to some of the world’s poorest and most war-scarred places, including Sudan and Nigeria.

These 21 countries are at risk because they are prone to exteremly dusty winds during the winter dry season (from December to May), which along with usually cold nights decreases the immunity of the pharynx. The meningitis bacteria are most easily transmitted through close contact, especially through sneezing, coughing, sharing eating utensils, or kissing. Throughout much of the meningitis belt, people often live in crowded family quarters and sometimes travel to large markets, making transmission of the disease easier.

During the 2007 season in Burkina Faso, meningitis infected more than 20,000 people, disabling 2,000 and killing more than 1,300. Across Africa, more than 1,600 died from the disease.

To prevent such a crises from occurring again in 2008, the World Health Organization (WHO) convened an urgent donor’s meeting to ask donors to pledge $13.8 million, enough to buy 12 million doses of vaccine.

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Geneva, 20 December 2007 - The International Federation of Red Cross and Red Crescent Societies launched a prevention campaign and surveillance in 14 countries of the meningitis belt to get ready for possibly one of the worst meningitis epidemics in a decade. In fact, it could be worse than the one that hit Africa in 1996 when there were 250,000 cases of the disease and 25,000 people died in Sudan alone.

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February 1, 2008 - Amid warnings of a major meningitis outbreak in Africa, epidemic levels of the bacterial infection broke out in parts of Burkina Faso. The vaccination campaign did not reach all the districts facing the outbreak. More than 774 cases were reported.

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February 12, 2008 - Aid agencies and the authorities in the Central African Republic (CAR) joined forces to vaccinate hundreds of thousands of people at risk of meningitis in the northwest of the country. Meningitis was spreading across three northwestern districts and threatening up to one million people.

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February 13, 2008 - Epidemic levels of meningitis reached two additional districts in Burkina Faso that were just 20 km from the Ivory Coast border, making it likely the epidemic in Burkina Faso is being boosted by infected people entering from neighboring countries. It is estimated that 5 million people are now at risk across 20 health districts in Burkina Faso.

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February 26, 2008 - Other than the major outbreak in Burkina Faso, surveillance indicates that the meningitis belt so far is actually experiencing lower levels of meningitis cases, compared with same period last year. There have been 2312 cases and 324 deaths, which actually is 14% lower than the corresponding time from 2007.

-Dr. Pommerville-

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