West Africa on alert for meningitis epidemic
up-to-date as of March 8th - week 10 into the epidemic
• A virulent meningitis outbreak affects four countries of West Africa. To date, a total of 22,955 cases and 1,374 deaths have been reported.
The epidemic strain A has been identified in Nigeria, Niger and Mali, whereas in Burkina Faso, it is the streptococcus pneumoniae.
Active surveillance is overseen by national government, with the support of WHO. UNICEF procures vaccines and antibiotics for case management and prevention. On the ground NGOs like MSF and others play a key role in case management and mass vaccination campaign.
Symptoms include stiff neck, high fever, headaches, vomiting and sometimes seizures. Even when the disease is diagnosed early and adequate therapy instituted, 5% to 10% of patients die, typically within 24-48 hours of onset of symptoms, according to WHO. Most victims suffer irreversible neurological consequences.
Epidemic strains A, C and W135 are now the main serogroups observed in Africa.
Outbreaks occur every year between December and May. The dry season, with strong dusty winds and cold nights make people more prone to respiratory infections and facilitates the spread of bacteria.
The largest recorded outbreak of epidemic meningitis was recorded in Africa in 1996, with over 250,000 cases and 25,000 deaths registered.
Preparedness and response
The current WHO recommendation for outbreak control is to mass vaccinate every district that is in an epidemic phase, as well as those contiguous districts that are in alert phase. It is estimated that a mass immunization campaign, promptly implemented, can avoid 70 per cent of cases.
Once the disease is contracted, it can be treated in its early stages with antibiotics. WHO recommends oily chloramphenicol as the drug of choice in areas with limited health facilities.
A preventive vaccine is available against the serogroups A, C and W135. However quantities available worldwide are limited.
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