A new strain of meningococcal meningitis serogroup C emerged in North-West Nigeria in 2013. Between 2013 and 2017, the strain has expanded to Niger and to Northern States of Nigeria causing more than 2500 deaths. Meningitis epidemics could affect 34 million people in the next two years and 10 million doses of vaccines would be needed in addition to the stock available in the international emergency stockpile in order to provide a sufficient response. Urgent action is needed to minimize the impact of such a devastating scenario.
Introductory-level online course on meningitis
This interactive online course on meningitis is part of a comprehensive pandemic and epidemic-prone disease course package, which offers the most relevant scientific, technical and operational knowledge on managing infectious hazards through video lectures, presentations and self-tests. The module on meningitis focuses on the bacteria Neisseria meningitidis, as it can cause large-scale epidemics, and takes an hour to complete.
Meningitis is an inflammation of the meninges, the membranes covering the brain and spinal cord. It can be caused by a variety of organisms that include bacteria, fungi or viruses. It is a serious condition that can be life threatening.
Meningococcal meningitis is an acute form of bacterial meningitis caused by Neisseria meningitidis. Meningococcal meningitis is of particular importance as it has the potential to cause large epidemics.
Polysaccharide vaccines are used during a response to outbreaks, mainly in Africa:
• They are either bivalent (serogroups A and C), trivalent (A, C and W), or tetravalent (A, C, Y and W)
• They are not effective before 2 years of age
• They offer a 3 year protection but do not induce herd immunity.
Conjugate vaccines are used in prevention (into routine immunization schedules and preventive campaigns) and outbreak response:
• They confer longer-lasting immunity (5 years and more), prevent carriage and induce herd immunity.
• They can be used as soon as of one year of age
•Available vaccines include:
Tetravalent (serogroups A, C, Y, W)
Protein based vaccine, against N. meningitidis B. It has been introduced into the routine immunization schedule (one country as of 2017) and used in outbreak response.
- International Coordinating Group (ICG) on vaccine provision for meningitis
- The Meningitis Vaccine Project - frequently asked questions
- Prioritization tool for Meningitis A Conjugate Vaccine Introduction
Antibiotic prophylaxis for close contacts, when given promptly, decreases the risk of transmission.
• Outside the African meningitis belt, chemoprophylaxis is recommended for close contacts within the household.
• In the African meningitis belt, chemoprophylaxis for close contacts is recommended in non-epidemic situations.
Ciprofloxacin antibiotic is the antibiotic of choice, and ceftriaxone an alternative.
Geographical distribution and risk
Focus on the African meningitis belt
Risk of Nm C epidemics in Africa
Continuing risk of meningitis due to Neisseria meningitidis serogroup C in Africa: revised recommendations from a WHO expert consultation
Pneumococcal meningitis outbreaks in sub-Saharan Africa
- Laboratory methods for the diagnosis of meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae
Managing meningitis epidemics in Africa