During the first 11 weeks of 2009 (January 1- March 15),
a total of 24 868 suspected cases, including 1 513
deaths (1), have been reported to WHO by countries of
the meningitis belt. More than 85% of the cases have
occurred in one epidemic foci, encompassing Northern
Nigeria and Niger (see below) and are characterized by
the predominance of Neisseria meningitidis (Nm)
serogroup A.
Niger
The Ministry of Health of Niger has reported 4 513
suspected cases of meningococcal disease including 169
deaths (case-fatality rate of 3.7%) from January 1 to
March 15 2009. So far 20 of Niger's 42 districts have
crossed the alert or the epidemic threshold. In the last
week alone, 1 071 suspected cases including 30 deaths
(case-fatality rate of 2.8%) have been reported, with 10
districts crossing the epidemic threshold, and 10 the
alert threshold.
Cerebrospinal fluid specimens tested by PCR and/or
culture positive have confirmed the large predominance
of Neisseria meningitidis serogroup A.
Nigeria
The Ministry of Health of Nigeria has reported 17 462
suspected cases of meningococcal disease, including 960
deaths, (case-fatality-rate of 5.5% from January 1 to
March 15). In the last week alone, 4 164 suspected cases
with 171 deaths were reported, with 66 Local Government
Area's (LGAs) having crossed the epidemic threshold
while 30 had crossed the alert threshold.. Cases are
originating from 16 Northern states, with states of the
North East (Bauchi, Gombe and Yobe) being the most
affected this week. As in preceding weeks, Katsina and
Jigawa are seriously affected as well.
Cerebrospinal fluid specimens have tested positive
for Neisseria meningitidis serogroup A by latex test
and/or culture. Mass vaccination has been implemented by
the Federal Ministry of the Health, with the support of
Médecins sans Frontières, UNICEF and WHO. Although
vaccination strategy across the states varies, WHO has
made recommendations to standardize vaccine strategy and
the rational use of vaccine.
WHO support
WHO is supporting the Nigerian Federal and National
Ministry of Health to strengthen disease surveillance,
laboratory diagnosis, case management and in defining
adapted vaccination strategies. Technical experts from
WHO have been supporting the Federal Ministry of Health
in Nigeria since mid February 2009.
The International Coordinating Group on Vaccine
Provision for Epidemic Meningitis Control (ICG) have
released 2.3 million doses of polysaccharide vaccines to
Nigeria and 1.9 million doses of vaccine to Niger. (ICG
partners include WHO, International Federation of Red
Cross and Red Crescent Societies, United Nations
Children Fund, Médecins sans Frontières). The stockpile
of the ICG for this epidemic season was set at 12.97
million doses. The emergency stockpile has been
established with the support of Global Alliance for
Vaccines and Immunization (GAVI) and EU Humanitarian Aid
Office (ECHO). (1) Data for week 11 for Burkina Faso,
Niger and Nigeria only. However other countries are
reporting less than 50 cases a week so far.
(1) Data for week 11 for Burkina Faso, Niger and
Nigeria only. However other countries are reporting less
than 50 cases a week so far.