Routine immunization against
Meningococcal meningitis due to Neisseria meningitidis is not
generally recommended following disasters because of its lack of efficacy
in young children and its short duration of protection. However, in areas
such as Africa's "meningitis belt" where epidemic Meningococcal
meningitis is known to occur, surveillance for meningitis using a standard
case definition should be part of any post-emergency surveillance system.
An incidence rate of meningitis exceeding 15/100,000/week in for example
the African meningitis belt for a period of
two consecutive weeks has been shown to be predictive of an outbreak in an
open populations >100,000. In refugee camps where the population is
unknown or is usually less than 100,000, a rough indicator of an outbreak
is a doubling of the baseline number of meningitis cases from one week to
the next over a period of three weeks. Even one case in a camp situation
should alert officials to monitor new cases with extreme care, and mass
immunization of a camp may be appropriate with only two cases having
occurred if it appears the disease is being transmitted within the camp
population. Immunization against types A or C should be done if the
following criteria are met:
- The presence of Neisseria
meningitidis type A or C is confirmed by the laboratory. Note:
type B does not usually cause large outbreaks.
- Surveillance data indicate that
persons older than 1 year of age (for type A) or 2 years of age (for
type C) are affected.
The age groups to immunize depend on the
age groups affected, although the immunization of children and young
adults between 1 to 25 years of age will usually protect most of the
population at risk. Priority should be given to the areas or populations
with the highest incidence rates.
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