Published Date: 2009-03-13 15:00:54
Subject: PRO/EDR> Meningitis, bacterial - Africa (02): Nigeria, WHO meningitis region
Archive Number: 20090313.1038
MENINGITIS, BACTERIAL - AFRICA (02): NIGERIA, WHO MENINGITIS REGION
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[1] Nigeria
[2] Africa: WHO Meningitis Region
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[1]
Date: Thu 12 Mar 2009
Source: Agence France-Presse (AFP) [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5jnqZygqNJdnANb_ojvfZI38jb5vg>
A meningitis outbreak has killed 931 people [with a total of 13 516
cases affected] in 4 West African countries since January [2009],
with most deaths occurring in the continent's most populous nation
Nigeria, the United Nations said Wednesday [11 Mar 2009]. "Nigeria is
the most affected with 9086 cases and 562 deaths. Niger reports 2620
cases and 113 deaths. Burkina Faso reports 1756 cases and 250 deaths.
Mali reports 54 cases and 6 deaths."
UNICEF warned that the authorities in Nigeria, where public health
facilities are abysmal and poverty rampant despite its huge oil
riches, faced an uphill task in tackling the crisis. "In Nigeria,
case management and a mass vaccination campaign are underway. The
stock of vaccine may be insufficient regarding the epidemiological
trends, especially in the districts in the north," it warned.
Health authorities placed northern Nigeria on a state of high alert
in January [2009] following a meningitis outbreak in the town of
Zinder in neighbouring Niger. Nigeria's largest northern state of
Kano has been the worst hit thus far.
Meningitis causes inflammation of the lining of the brain and spinal
cord and has long wracked Africa, the world's poorest region.
According to UNICEF, it can spread through sneezing and coughing. The
disease mainly affects children and young adults aged 1-30, it said.
"The so-called African meningitis belt stretches from Mauritania in
the west to Ethiopia in the east and is home to about 350 million
people," UNICEF said. "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 biggest recorded outbreak of epidemic meningitis in Africa
occurred in 1996 with over 250 000 cases and 25 000 deaths. Even when
the disease is diagnosed early, 5 to 10 percent of patients die,
typically within one or 2 days of the onset of symptoms, according to
the World Health Organisation. Most victims suffer irreversible
neurological consequences.
The current WHO recommendation for outbreak control is to mass
vaccinate every district in an epidemic phase, as well as nearby
areas in alert phase. It estimates that a mass immunisation campaign
can avoid 70 percent of cases. Outbreak response also includes active
surveillance and case management and support to community awareness programmes.
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.
UNICEF said mass vaccination drives were currently underway in Niger
and Burkina Faso.
--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>
******
[2] Africa: WHO Meningitis Region
Date: Wed 11 Mar 2009
Source: WHO MDSC (Multidisease Surveillance Centre) Meningitis Weekly
Bulletin Week 08 2009 [edited]
<http://www.who.int/csr/disease/meningococcal/Bulletin%20Meningite%202009_S8.pdf>
Table 1: Epidemiological Situation Week 8 (16-22 Feb 2009)
Country / Case / Death / Lethality (percent) / District in alert /
District in epidemic / Complet (percent) / NmA / NmW135 / Other Nm /
Pneum / Hib
Benin / 11 / 0 / 0.0 / 0 / 0 / 98.7 / 0 / 0 / 0 / 3 / 0
Burkina Faso / 266 / 35 / 13.2 / 4 / 1 / 100.0
Cameroon / - / - / - / - / - / - / - / - / - / - / -
Central African Rep / - / - / - / - / - / - / - / - / - / - / -
Cote d'Ivoire / 7 / 0 / 0.0 / 0 / 0 / 86.0 / - / - / - / - / -
Ethiopia / - / - / - / - / - / - / - / - / - / - / -
Ghana / - / - / - / - / - / - / - / - / - / - / -
Guinea / - / - / - / - / - / - / - / - / - / - / -
Mali / - / - / - / - / - / - / - / - / - / - / -
Niger / 621 / 21 / 3.4 / 7 / / 6 / 100.0
Nigeria / 1817 105 / 5.8 / 29 / / 28 / 70.8 / 37 / 7 / 0 / 2 / 0
Congo DR** / - / - / - / - / - / - / - / - / - / - / -
Chad / 25 / 4 / 16.0 / 0 / 0 / 92.9 / - / - / - / - / -
Togo / 12 / 0 / 0.0 / 0 / 0 / 100.0 / - / - / - / - / -
Total / 2759 / 165 / 6.0 / 40 / 35 / 59.6 / 37 / 7 / 0 / 5 / 0
* identification by: PCR, latex, culture
** definition of alert/epidemic thresholds not applicable to this
country outside the meningitis belt.
Comments
--------
Burkina Faso:
- district in alert: Toma, Titao, and Ziniare
- district in epidemic: Solenzo
Niger:
- district in alert: Gaya, Loga, Guidan-Roumdji, Magaria, Mirriah,
Keita, and Zinder
- district in epidemic: Bilma, Dogon-Doutchi, illela, Matameye
Madarounfa, and Tessaoua
Nigeria: 28 LGAs [local government areas] in epidemic and 29 LGAs in
alert (see details on page 3 of the original at the source URL). The
7 cases of NmW135 have been isolated in Adamawa State where no LGA
reached alert or epidemic threshold as of week 8 [16-22 Feb 2009]
Table 2. Synthesis of the Epidemiological Situation 2009 (reported weeks 1-8)
Country / Case / Death / Lethality (percent) / District in alert /
District in epidemic / Reported weeks / In districts (percent) / In
weeks (percent)
Benin / 109 / 15 / 13.8 / 1 / 0 / 01-08 / 98.7 / 100.0
Burkina Faso / 1514 / 213 / 14.1 / 7 / 3 / 01-08 / 100.0 / 100.0
Cameroon / - / - / - / - / - / - / - / -
Central African Rep / 41 / 17 / 41.5 / 1 / 0 / 01-07 / 100.0 / 100.0
Cote d'Ivoire / 120 / 27 / 22.5 / 0 / 0 / 01-08 / 90.0 / 90.0
Ethiopia / 32 / 6 / 18.8 / 0 / 0 / 01-07 / -
Ghana / 61 / 13 / 21.3 / 0 / 0 / 01-06 / - / -
Guinea / - / - / - / - / - / - / - / -
Mali / 31 / 2 / 6.5 / 0 / 0 / 01-04 / 100.0 / 100.0
Niger / 1897 / 84 / 4.4 / 6 / 7 / 01-08 / 100.0 / 100.0
Nigeria / 5323 / 333 / 6.3 / 37 / 52 / 01-08 / 70.8 / 99.9
Congo DR **/ - / - / - / - / - / - / - / -
Chad / 259 / 33 / 12.7 / 2 / 0 / 01-08 / 108.9 / 95.9
Togo / 105 / 16 / 15.2 / 1 0 / 01-08 / 100.0 / 99.3
Total / 9492 / 759 / 8.0 / 55 / 62 / 01-08 / 65.0 / 99.5
** definition of alert/epidemic thresholds not applicable to this
country outside the meningitis belt
Comments
--------
The epidemic trend is on the rise in Nigeria and Niger. The ascending
trend of the epidemic curve is still above those of 2007 and 2008. As
opposed to 2008 where the epidemic was located in northern West of
Nigeria, the epidemic of 2009 is mainly located in the Northern
Central region with eastward extension. The case fatality rates are
however low in the 2 countries. If in Niger the vaccine is still
available, in Nigeria, the 1st supplies of vaccines have just arrived
this week 8 [16-22 Feb 2009]. WHO missions are on the ground in
Nigeria to support local authorities.
--
Communicated by:
Dr Mandy Kader Konde
Director
WHO-Multidisease Surveillance Center (MDSC)
WHO-Meningitis Vaccine Project (MVP) Focal Point
1473 Avenue Naba Zombre, 01 BP 549 Ouagadougou 01
Burkina Faso
<kondek@oncho.afro.who.int>
[ProMED-mail thanks Dr Kader Konde of the WHO Multidisease
Surveillance Centre (MDSC) in Ouagadougou (Burkina Faso) for alerting
ProMED to the latest WHO data on bacterial meningitis in countries
under enhanced surveillance of meningitis in the WHO Africa Region.
The meningococcal meningitis epidemic in Nigeria and Niger continues
to expand, but the 1st supplies of meningococcal vaccines have just
arrived in Nigeria in week 8 (16-22 Feb) of 2009. The serogroups
covered by the meningococcal vaccine are not specified in the reports
above; in Nigeria, both serogroup A and W135 are involved.
Table 1 above is a summary of the reports on cerebrospinal meningitis
received by country for week 8 of 2009. Table 2 above is a summary of
the reports received on meningitis activity by country for weeks 1-8 of 2009.
The HealthMap/ProMED-mail interactive map of Nigeria is available at
<http://healthmap.org/promed/en?v=9.6,6.1,6>.
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 - Nigeria (02): WHO 20090305.0916Meningitis, meningococcal - Nigeria: WHO 20090220.0709
Meningitis, bacterial - Africa: WHO meningitis region, 2008 20090124.0310
Meningitis, meningococcal - Uganda (02): (MSI) 20090120.0249
Meningitis, meningococcal - Uganda: (ARU, HOI) 20090115.0170
2008
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Meningitis, meningococcal - Burkina Faso (02): vaccinated areas 20080412.1334
Meningitis, meningococcal - Burkina Faso 20080314.1017
Meningitis, meningococcal - Africa: meningitis belt 20080225.0756
Meningitis, meningococcal - Central African Republic: RFI 20080212.0567
Meningitis, meninges - Africa: W. Africa, Congo DR 20080125.0309
2007
----
Meningitis, meningococcal - Italy (Veneto) 20071222.4120
Meningitis, meningococcal - Uganda (Arua) 20071207.3954
Meningitis - Namibia (North): RFI 20070906.2942
2000
----
Meningitis - Namibia (North) 20001214.2182
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