Meningococcal meningitis is a highly contagious bacterial form of meningitis - a serious inflammation of the meninges, the thin lining that surrounds the brain and spinal cord.
In the last 20 years, according to the World Health Organization (WHO), close to one million suspected cases of meningitis have been reported and 100,000 people have died.
The vast majority of meningitis cases and deaths occur in Africa. During the dry season (December to June), epidemics regularly hit countries in the African ‘meningitis belt’, a region that stretches across the continent from Senegal to Ethiopia.
Even when the disease is diagnosed early and adequate treatment is started, five to ten (10) per cent of patients typically die within 24 to 48 hours after the onset of symptoms. Left untreated, up to 50 per cent of cases may result in death.
What causes meningitis?
Meningococcal meningitis is highly contagious. Six strains of the bacterium Neisseria meningitidis (A, B, C, W135, X and Y) are known to cause meningitis. People can be carriers without showing symptoms and transmit the bacteria when they cough or sneeze. Overcrowding and cramped living conditions increase the risk of spreading the disease.
Symptoms of meningitis
Signs and symptoms include sudden and intense headaches, fever, nausea, vomiting, photophobia (a low tolerance to light) and stiffness of the neck. Although anyone of any age can become infected with meningitis, babies and children are particularly susceptible.
Diagnosing meningitis in the settings in which we work is often difficult - and needs to be done quickly. A painful lumbar puncture is needed for the examination of spinal fluid, and sometimes the bacteria can be seen under a microscope. The diagnosis is confirmed by culturing bacteria from spinal fluid or blood. Further tests determine how effective certain antibiotics will be for the patient.
Ceftriaxone is the first line treatment for bacterial meningitis. Patients older than two (2) months are treated during five (5) days and children less than two (2) months need a seven (7) day treatment. There are also alternative antibiotics treatments (ampicillin, penicillin).
A new vaccine against this strain provides protection for at least ten (10) years and even prevents healthy carriers from transmitting the infection. Large preventive vaccination campaigns have now been carried out in Benin, Burkina Faso, Cameroon, Chad, Ghana, Mali, Niger, Nigeria, Senegal and Sudan and have resulted in a decrease in the number of new cases. The vaccination campaigns have helped to stop the cycle of deadly meningococcal A epidemics in the region, but smaller-scale outbreaks caused by other strains continue to be recorded. An epidemic in Niger in 2015, which was an extension of an epidemic in neighbouring Nigeria, was the first large meningococcal C epidemic ever recorded in the country.
However, timely mass vaccinations are the most effective means of limiting the spread of epidemics. The WHO has estimated that mass immunizations have managed to prevent up to 70 per cent of expected cases in individual meningitis outbreaks in Africa.
MSF vaccinated 326,100 people against meningitis in response to outbreaks in 2015.