Meningitis outbreaks As Africa enters the dry season

Apr 7 2004

As Africa enters the dry season, meningitis outbreaks have reported. The so-called 'meningitis belt' is a massive strip of Africa, travelling east to west, parallel to the Sahara desert and covering sub-Saharan countries from Senegal to Ethiopia.

In the past few weeks, several meningitis A cases have been detected in northern Ethiopia, in the Wellega and Gonder regions. In the Central African Republic (CAR), a meningitis A outbreak has also been reported in the Batangafo district, 400km north of the capital, Bangui. Other epidemic outbreaks have been reported in Burkina Faso, Ivory Coast, Niger and the Democratic Republic of Congo. In all these countries, MSF is fighting the disease by launching mass vaccination campaigns and providing appropriate treatment.

The Ethiopia outbreak

According to data gathered by MSF, so far 55 A-type meningitis cases have been reported and the epidemic threshold has been exceeded in two kebeles in the Ibnat district in South Gonder.

On March 18, a cargo plane, shipped by MSF and loaded with vaccines and medical supplies for the vaccination campaign, arrived. Teams have already vaccinated 8,000 people in a campaign that will last several weeks and up to 89,000 people will be vaccinated in an effort where the challenge is in correctly choosing the most affected areas and populations to be vaccinated in a vast region inhabited by over two million people.

A team composed of six MSF expatriates has been deployed in the South Gonder region – located on the shore of Tana Lake - to provide treatment for the emerging meningitis cases and organize a mass vaccination campaign in the 15 'kebeles' (municipal administrations) in the Ibnat district in South Gonder. Additional teams are working to vaccinate 60,000 people in the Wellega districts, also in the southern region.

Interventions are difficult in such a large, overpopulated country as Ethiopia where, in addition to the logistical issue of identifying outbreaks and reaching remote populations, authorities are implementing massive population resettlements.

The CAR outbreak

The CAR outbreak has been reported in Batangafo district, 400km north of Bangui, the capital. In this district, inhabited by 59,000 people, 42 suspected cases have been reported so far, of which 12 confirmed as A-type virus, reaching a 9.5% fatality rate.

The Emergency Unit has also sent a nurse and a logistician to the Central African Republic to support the team already present in the country. They will be vaccinating all the people over two years of age in Batangafo town and its surrounding areas. The vaccination campaign, which started on March 8th, will benefit 59,000 people living in Batangafo and neighbouring rural areas. By mid-March, 40,000 people had already been immunized. The campaign, launched in collaboration with the Ministry of Health, still goes on in the rural areas and includes measles vaccination as well.

Identification and prevention

A good epidemiological surveillance system is key for early detection of meningitis outbreaks. In addition, launching vaccination campaigns as well as treating the emerging cases are crucial to prevent these outbreaks from turning into full blast epidemics.