28 September 2000
There are two approaches taken by MSF to the prevention of meningitis outbreaks:
vaccination of a population at the beginning of any threatened epidemic. See the article on Managing an epidemic. advocacy on behalf of better living conditions for refugees, who may be at especial risk to outbreaks because of crowding. We recommend that the minimum area of a refugee camp should be 30 square metres per person, with a minimum dwelling space of 3.5 square metres per person. If these conditions are met then rapid contagion is far less likely.
An example - epidemic of meningitis in Nigeria Nigeria is a large country in West Africa, with a population of some 110 million. The northern part falls within the meningitis belt, and in early 1996 there was an outbreak of meningococcal disease there that threatened the 50 million inhabitants of the 17 northern states. It was the first time that MSF had been called upon to intervene against meningitis in so densely populated a region.
The epidemic lasted approximately four months. The MSF project covered three states, Bauchi, Katsina and Kano. It had the twin objectives of firstly treating meningitis patients rapidly and effectively to prevent death and disability, and secondly cutting off the epidemic before it spread to other parts of the country. At the height of the epidemic MSF had some 50 expatriate field volunteers in country working in collaboration with thousands of Nigerian health workers.
To ensure that a maximum number of people across this huge geographical area had access to treatment and immunisation, MSF set up special meningitis centres. A major priority was to strengthen the local cold chain for the storage and transport of the number of vaccines that were needed. Some three million persons were immunised. Almost 46,000 cases of meningitis were recorded in the three states where MSF was active. Almost 5,000 deaths occurred, many of them in isolated villages.
To complicate this already overwhelming situation, there were concomitant outbreaks of both cholera and measles that were also taken in hand by the teams.
After the end of the epidemic MSF retained a presence in Nigeria to help strengthen epidemiological surveillance