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Weekly Epidemiological Monitor ISSN 2224-4220 Volume 11; Issue No Weekly Epidemiological Monitor ISSN 2224-4220 Volume 11; Issue no. 12; 25 March 2018 Current major event Meningococcal A conjugate vaccine introduction in countries of African Meningitis Belt (2010-2017) Epidemic management in the African Meningitis Belt The meningococcal meningitis cases are reported across the world. Nevertheless, large, frequent epidemics affect an exten- sive region of sub-Saharan Africa known as the “Meningitis Belt” which comprises of 26 countries from Senegal in the west to Ethiopia in the east. Editorial note The pathogen responsible for epidemic of bacterial meningitis is Neisseria meningiti- dis (N.m). There are 13 serogroups of this Meningitis cases and deaths in Sudan pathogen identified till now and four of and its neighboring countries, 2017 Update on outbreaks in the them are recognized to be the main cause Eastern Mediterranean Region of epidemics (A, B, C and W). The ma- Suspected cases* Deaths jority of the meningitis cases and out- Country MERS in Saudi Arabia; cholera in Somalia; breaks occur during the epidemic season, Season Year Season Year cholera in Yemen; dengue in Sudan. however the exact timing of the season Sudan 51 80 1 1 varies (occurring earlier in the East and Current public health events of South later in the West). 46 67 3 3 Sudan international concern o Ethiopia [cumulative N of cases (deaths), CFR %] After 2010, a meningococcal A conjugate 902 1875 13 24 vaccine (MACV) was gradually intro- Central Avian influenza: 2006-2017 African 697 846 73 88 duced in the epidemic prone areas in Egypt (A/H5N1) [359 (122), 34%] countries of this belt through preventive Republic Chad mass vaccination campaigns. This has 209 308 19 20 Egypt (A/H9N2) [4 (0)] dramatically reduced N.m. A cases and Uganda 130 228 30 30 Avian influenza A (H7N9): 2013-2017 brought a hope of elimination of N.m. A Kenya China [1,565 (612), 39.1%] epidemics in these areas. 146 146 6 6 Niger Chikungunya: 2016-2018 Sudan is the only country in the Eastern 3370 3510 218 232 Mediterranean Region of WHO which is Pakistan [8,513 (0)] Nigeria in the “African Meningitis Belt” and 14542 14766 1166 1207 Cholera: 2017-2018 faced repeated outbreaks of meningococ- cal meningitis during the dry (epidemic) * Data for epidemic seasons (weeks 1–26) and for the whole year (weeks 1–52) Somalia [1,613 (9), 0.6%] season. During 2013, Sudan implement- Yemen [ 1,081,420 (2267), 0.2%] ed a mass preventive campaign using meningococcal meningitis caused by Conjugate-A vaccine, for the age group serogroup-C in Sudan in the coming Diphtheria: 2018 of 1-29 years. This brought a cohort of years. Yemen [1,412 (81), 5.7%] immunized population in the community As of prevailing circumstances, a contin- Bangladesh [6,250 (38), 0.6%] and there was a sharp reduction in the ued risk of large scale N.m. C epidemics number of the reported cases from men- in the region and in Sudan during com- Dengue fever: 2017-2018 ingitis. During 2016, Sudan became the ing years can be predicted. In order to Sudan [197 (3), 1.5%] first country in the “African meningitis improve the effectiveness of outbreak belt” to introduce meningitis A vaccine response, improved efforts to strengthen MERS: 2012-2018 into a routine immunization programme. meningitis surveillance are needed with Saudi Arabia [1,812 (707), 39.1%] After the introduction of MACV in the enhanced laboratory capacities for early Wild poliovirus: 2018 countries of “African Meningitis Belt”, a confirmation. new strain of serogroup –C emerged Afghanistan [5 (0)] There is a limited supply of vaccines in causing large scale epidemics in Niger, Yellow Fever: 2017-2018 Nigeria and in some other neighbouring the international stockpile against N.m. C countries of Sudan. Owing to the absence and this remains a huge concern in case a Brazil [723 (237)] 32.7 % of the immunity against this new strain, large outbreak unfolds. In order to elimi- the people in Sudan will remain suscepti- nate meningococcal meningitis out- ble to infection caused by this new breaks, the accelerated development of a serogroup. This necessitates enhanced multivalent conjugate vaccine remains a surveillance and control strategies for high priority. Published by World Health Organization, Regional Office for Eastern Mediterranean, Cairo, Egypt Tel: +20 2 22765492 Fax: +20 2 2765456 Email: [email protected] Previous issues are available at http://www.emro.who.int/surveillance-forecasting-response/weekly-epidemiological-monitor/ 12 .
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