From 1 January to 12 May 2013 (epidemiologic week 19), 9 249 suspected cases of meningitis, including 857 deaths, with a case fatality ratio of 9.3 percent, have been reported from 18 of the 19 African countries under enhanced surveillance1 for meningitis. The number of cases reported so far are the lowest recorded during the epidemic season in the last ten years2.
Outbreaks of the meningococcal disease have been confirmed in Guinea and South Sudan, where 404 suspected cases3 (38 deaths) and 196 suspected cases (13 deaths) have respectively been notified.
In Guinea a small outbreak at the sub-district level was reported in Siguiri district, predominantly due to Neisseria meningitidis serogroup W135 (Nm W135). Upon request from the Ministry of Health of Guinea, the International Coordinating Group (ICG)4 on Vaccine Provision for Epidemic Meningitis Control released 63 075 doses of ACW polysaccharide vaccines. A reactive vaccination campaign targeting the affected population was conducted by the Ministry of Health from 2-7 May 2013.
In South Sudan an outbreak of Neisseria meningitidis serogroup A (Nm A) was confirmed in Malakal county, in the Upper Nile state. The ICG released 198 770 doses of Meningococcal A conjugate vaccine to implement a reactive vaccination campaign from 15-24 May 2013, which was led by the Ministry of Health of South Sudan with the support of WHO and partners.
Additionally, outbreaks of meningitis were reported in Benin (1 district), Burkina Faso (1 district), and Nigeria (3 districts). These outbreaks were of short duration and the predominance of the Nm bacteria was not confirmed. The ministries of health of affected areas implemented a series of preventive and control measures which include reinforcement of surveillance, case management and sensitization of the population.
The decrease in the number of cases of meningitis reported during the period under review is thought to be due to the progressive introduction of the newly developed Meningococcal A conjugate vaccine in countries of the African Meningitis Belt since 2010.
The introduction of this first meningococcal vaccine available for preventive purposes in Africa has enabled the immunization of over 100 million people from 10 countries5 in the Meningitis Belt in the past three years (2010-2012).Pause to reflect for a moment about the quiet, enormous effort needed to immunize 100 million people in three years.