Published Date: 2008-02-25 03:00:16
Subject: PRO/EDR> Meningitis, meningococcal - Africa: meningitis belt
Archive Number: 20080225.0756

MENINGITIS, MENINGOCOCCAL - AFRICA: MENINGITIS BELT
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Date: Fri 22 Feb 2008
Source: WHO Epidemic and Pandemic Alert and Response (EPR) [edited]
<http://www.who.int/csr/don/2008_02_22a/en/index.html>


The WHO Multi-Disease Surveillance Centre in Ouagadougou (MDSC - Burkina
Faso) is monitoring the meningitis situation in the African meningitis belt
throughout the epidemic season and, in particular, in 13 countries under
enhanced seasonal surveillance: Benin, Burkina Faso, Cameroon, the Central
African Republic, Chad, Cote d'Ivoire, the Democratic Republic of the
Congo, Ethiopia, Ghana, Mali, Niger, Nigeria and Togo.

Preliminary reports from these countries are of a total of 2312 cases (324
deaths) occurring between 1 Jan and 10 Feb 2008. These figures are 29 per
cent lower than those reported in the same 6 week period in 2007 (3274
cases, 413 deaths) indicating lower levels of meningitis activity so far in
2008.

Among countries reporting cases to the MDSC, Burkina Faso, the Central
African Republic and the Democratic Republic of the Congo have been
reporting outbreaks since the beginning of the season. Other countries
reporting meningitis activity without reaching the epidemic threshold at
district level include Benin, Cote d'Ivoire, Ethiopia, Ghana, Mali, Niger,
Nigeria and Togo. Cameroon and Chad have not reported any cases. Burkina
Faso is the most affected country with a total of 1422 cases, including 204
deaths (case fatality ratio [CFR] 14.3 per cent) reported from 1 Jan to 10
Feb 2008. These cases represent more than 61 per cent of all cases reported
to MDSC in 2008 (against 64 per cent for the same period in 2007).

_Neisseria meningitidis_ [seogroup] A (Nm A) was identified as the
causative agent in Mangodara and Sapouy districts. Vaccination was carried
out in these districts as well as in Gaoua, targeting the 2 to 29 year old
population. A cross border assessment is being carried out on the situation
in Ivory Coast in the area neighboring Mangodara district. Although the
epidemiological trend in Burkina Faso is similar to the one observed last
year [2007], the 1st 6 weeks of 2007 saw more cases reported in total as
well as more districts reaching the epidemic threshold (8 as against 2 in
2008).

The Ministry of Health in the Central African Republic is launching
reactive mass vaccination campaigns in some of the communes that have
reached the epidemic threshold in the northern prefecture of Nana-Gribizi.
A total of 45 cases, including 5 deaths (CFR 11.1 per cent) had been
reported by the end of week 6, and Nm A has been identified as the
responsible pathogen. International partners including WHO and the
International Coordination Group (ICG) are providing support for the
vaccination campaigns.

In the Democratic Republic of the Congo, a situation assessment is being
carried out in Aru district (that neighbours Arua district in Uganda),
where 167 cases, including 17 deaths (CFR 10.2 per cent) were reported
during the period from 1 Jan to 10 Feb 2008. The most affected areas
include Laybo, Ariwara and Aungba health zones. The Aru district also
experienced an outbreak in early 2007.

In southern Sudan, a situation assessment is being carried out in areas
where suspected cases were reported, including in Awerial, Bor, Jur River
and Torit Counties. Uganda experienced an outbreak in Arua district, West
Nile region, with a total of 380 cases, including 17 deaths (CFR 4.5 per
cent) reported from 13 Dec 2007 to 28 Jan 2008. A sharp decline in the
weekly case count was observed following a mass vaccination campaign that
was implemented in week 4. No suspected cases have been reported from other
countries within the meningitis belt, namely Eritrea, Guinea, the Gambia,
Kenya, Mauritania and Senegal.

So far in 2008, the ICG has provided 40 000 vaccine doses, injection
material and safety disposal boxes for vaccination campaigns in the Central
African Republic. The current ICG stockpile, available for outbreak
response in this meningitis season stands at 7 million doses of bivalent
polysaccharide A/C vaccine and 3.3 million doses of trivalent
polysaccharide vaccine A/C/W135.

For more information on submitting requests for vaccines through the ICG
and regional meningitis surveillance, see links below.
- International Coordinating Group (ICG) on Vaccine Provision for Epidemic
Meningitis Control
<http://www.who.int/csr/disease/meningococcal/icg/en/index.html>
- Epidemiological information
<http://www.who.int/csr/disease/meningococcal/epidemiological/en/index/html>.

--
communicated by:
ProMED-mail <promed@promedmail.org>

[This is a nice up to date summary from WHO concerning the ongoing
meningococcal meningitis outbreak in the African bacterial meningitis belt.
See prior ProMED-mail posts listed below for more information. A map of the
African bacterial meningitis belt can be found at
<http://www.medic8.com/images/map4-9.gif>. - Mod.ML]

See Also

Meningitis, meningococcal - Central African Republic: RFI 20080212.0567
Meningitis, meninges - Africa: W. Africa, Congo DR 20080125.0309
2007
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Meningitis, meningococcal - Italy (Veneto) 20071222.4120
Meningitis, meningococcal - Uganda (Arua) 20071207.3954
Meningitis - Namibia (North): RFI 20070906.2942
2000
---
Meningitis - Namibia (North) 20001214.2182

..................ml/msp/sh


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