Saturday, March 28, 2009

Meningitis epidemic strikes

More than 200 people have died of meningitis in the past week alone in Niger and Nigeria, according to the World Health Organization.

Before we look at the current situation let's take the time to ensure we know the basics:

What is Meningitis?

Meningitis is an infection of the fluid of a person's spinal cord and the fluid that surrounds the brain. People sometimes refer to it as spinal meningitis. Meningitis is usually caused by a viral or bacterial infection. Knowing whether meningitis is caused by a virus or bacterium is important because the severity of illness and the treatment differ. Viral meningitis is generally less severe and resolves without specific treatment, while bacterial meningitis can be quite severe and may result in brain damage, hearing loss, or learning disability. For bacterial meningitis, it is also important to know which type of bacteria is causing the meningitis because antibiotics can prevent some types from spreading and infecting other people. Before the 1990s, Haemophilus influenzae type b (Hib) was the leading cause of bacterial meningitis, but new vaccines being given to all children as part of their routine immunizations have reduced the occurrence of invasive disease due to H. influenzae. Today, Streptococcus pneumoniae and Neisseria meningitidis are the leading causes of bacterial meningitis.
Source: CDC

What are the signs and symptoms of meningitis?

High fever, headache, and stiff neck are common symptoms of meningitis in anyone over the age of 2 years. These symptoms can develop over several hours, or they may take 1 to 2 days. Other symptoms may include nausea, vomiting, discomfort looking into bright lights, confusion, and sleepiness. In newborns and small infants, the classic symptoms of fever, headache, and neck stiffness may be absent or difficult to detect, and the infant may only appear slow or inactive, or be irritable, have vomiting, or be feeding poorly. As the disease progresses, patients of any age may have seizures.
Source: CDC

How is meningitis diagnosed?

Early diagnosis and treatment are very important. If symptoms occur, the patient should see a doctor immediately. The diagnosis is usually made by growing bacteria from a sample of spinal fluid. The spinal fluid is obtained by performing a spinal tap, in which a needle is inserted into an area in the lower back where fluid in the spinal canal is readily accessible. Identification of the type of bacteria responsible is important for selection of correct antibiotics.

Can meningitis be treated?

Bacterial meningitis can be treated with a number of effective antibiotics. It is important, however, that treatment be started early in the course of the disease. Appropriate antibiotic treatment of most common types of bacterial meningitis should reduce the risk of dying from meningitis to below 15%, although the risk is higher among the elderly.

Is meningitis contagious?

Yes, some forms of bacterial meningitis are contagious. The bacteria are spread through the exchange of respiratory and throat secretions (i.e., coughing, kissing). Fortunately, none of the bacteria that cause meningitis are as contagious as things like the common cold or the flu, and they are not spread by casual contact or by simply breathing the air where a person with meningitis has been.

However, sometimes the bacteria that cause meningitis have spread to other people who have had close or prolonged contact with a patient with meningitis caused by Neisseria meningitidis (also called meningococcal meningitis) or Hib. People in the same household or day-care center, or anyone with direct contact with a patient's oral secretions (such as a boyfriend or girlfriend) would be considered at increased risk of acquiring the infection. People who qualify as close contacts of a person with meningitis caused by N. meningitidis should receive antibiotics to prevent them from getting the disease. Antibiotics for contacts of a person with Hib meningitis disease are no longer recommended if all contacts 4 years of age or younger are fully vaccinated against Hib disease

Source: CDC

Let's return to the current situation:

LAGOS, Nigeria (CNN) -- More than 200 people have died of meningitis in the past week alone in Niger and Nigeria, according to the World Health Organization.

The disease is an epidemic in 76 areas of the two countries, the health agency reported Wednesday.

A spokesman for W.H.O. in Nigeria, Dr. Olaokun Soyinka, said Saturday that the outbreak is bigger than usual and stretches across the African meningitis belt from east- to west-sub-Saharan Africa.

The outbreak began around the start of the year, Soyinka told CNN. It usually peaks in the dry season because of dust, winds and cold nights, before dipping around May when the rains come, he said.

A shortage of vaccines means officials are relying on "effective prevention," in which they watch for outbreaks and then vaccinate people in the epicenter and surrounding areas, Soyinka told CNN.

There have been nearly 25,000 suspected cases and more than 1,500 deaths in the meningitis belt in the first 11 weeks of the year, W.H.O. reported. More than 85 percent of those cases happened in northern Nigeria and Niger.

Nigeria's Ministry of Health has reported 17,462 suspected cases of meningococcal disease, including 960 deaths, the world health agency said. In the past week, it reported 4,164 suspected cases with 171 deaths.

Sixty-six local government areas in Nigeria have crossed the epidemic threshold. Epidemic thresholds are a way the W.H.O. confirms the emergence of an epidemic so it can step up vaccinations and other management measures.

Niger's Ministry of Health has reported 4,513 suspected cases of meningococcal disease, including 169 deaths, since the start of the year. In the past week, 1,071 suspected cases and 30 deaths have been reported, the W.H.O. said.

Ten of Niger's 42 districts have crossed the epidemic threshold.

By comparison, other countries are reporting fewer than 50 cases a week.

Meningitis is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. Several different bacteria can cause meningitis but Neisseria meningitidis -- which is to blame for this outbreak -- is one of the most significant because of its potential to cause epidemics.

Health authorities have released 2.3 million doses of vaccine to Nigeria and 1.9 million doses to Niger, the W.H.O. said.

Here is the link to the original story: Nigeria

Here are additional reports about this story:

Meningitis Outbreak Grips Sub-Saharan Africa

The World Health Organization says Sub-Saharan Africa is in the grips of a meningitis outbreak. It says the two West African countries of Niger and Nigeria are the most heavily affected.

The World Health Organization reports nearly 25,000 suspected cases of meningitis, including more than 1,500 deaths, have been reported during the first 11 weeks of this year. WHO says 85 percent of the cases and deaths have occurred in Northern Nigeria and Niger.

Meningitis death toll reaches 960 in Nigeria; 17,000 people infected

GENEVA — The death toll from a severe outbreak of meningitis in Nigeria has risen to 960.

The World Health Organization says some 17,000 people have been infected with the disease since Jan. 1.

WHO spokeswoman Fadela Chaib says it is the first time there have been so many cases in northern Nigeria, an area she describes as being outside the usual African "meningitis belt."

Chaib says a total of 17,462 cases of meningitis have been reported in the three-month outbreak in Africa's most populous country and that the WHO and other agencies are helping to vaccinate people against the disease.

Meningitis kills more than 1100 West Africans: WHO

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