Democratic Republic of the Congo declares meningitis outbreak

High case fatality ratio of 50% reported in Tshopo province;;261 cases, 129 deaths reported so far;
Democratic Republic of the Congo declares meningitis outbreak
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The Democratic Republic of the Congo has declared an outbreak of meningitis in the north-eastern Tshopo Provinc that has reported more than 261 cases and 129 deaths — a high case fatality ratio of 50 per cent — the World Health Organization (WHO) said.

Neisseria meningitis, a bacterial form of meningitis, has been detected in the tests carried out by Institut Pasteur, Paris.

Neisseria meningitidis infects only humans; there is no animal reservoir. The bacteria are transmitted from person-to-person through droplets of respiratory or throat secretions from carriers.

The worst affected is Banalia: More than 100 patients are receiving treatment at home and in health centres.

The DRC health ministry has deployed an initial emergency team to speed up control efforts. A crisis response committee has been set up in Banalia and in Kisangani, capital of Tshopo.

The WHO has deployed medical experts to support the DRC government’s efforts to scale up control measures, said Matshidiso Moeti, regional director for Africa, WHO.

The largest burden of meningococcal disease occurs in an area of sub-Saharan Africa known as the meningitis belt, which spans 26 countries and stretches from Senegal in the west to Ethiopia in the east.

Prevention

During the dry season (December to June), dust winds, cold nights and upper respiratory tract infections damage the nasopharyngeal mucosa, increasing the risk of meningococcal disease. Transmission of Neisseria meningitidis can be facilitated by overcrowded housing arrangements and gatherings.

In the African meningitis belt, Neisseria meningitidis serogroup A accounted for 80-85 per cent of meningitis epidemics before the introduction of a meningococcal A conjugate vaccine (MenACV) through mass preventive campaigns since 2010. Routine immunisation programmes have started since 2016.

More than 1.6 million people aged between 1 and 29 years were vaccinated in a massive campaign in 2016 in Tshopo.

As many as 24 out of 26 countries in the meningitis belt have conducted mass preventive campaigns targeting 1-29 years old population by April 2021. Several countries have introduced MenACV into their national routine immunisation schedules.

Among vaccinated populations, incidence of Neisseria meningitidis serogroup A (NmA) has declined by more than 99 per cent — no NmA case has been confirmed since 2018, said WHO.

Meningitis is a largely preventable disease through vaccination. In November 2020 ‘Defeating Meningitis by 2030’ global road map was approved by the World Health Assembly with three objectives:

  • End of bacterial meningitis epidemics
  • Reduction of cases of vaccine-preventable bacterial meningitis by 50 per cent and deaths by 70 per cent
  • Reduction of disability and improvement of quality of life after meningitis due to any cause

Continuing introduction into routine immunisation programmes and maintaining high coverage is critical to avoid NmA epidemics.

Cases of meningitis and outbreaks due to other serogroups (NmC, NmW and NmX) continue to strike.

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