22 May 2015

Meningococcal meningitis: Niger

The Ministry of Public Health of Niger has reported 6,179 suspected cases of meningococcal meningitis

On 15 May 2015, the World Health Organization (WHO) advised that the Ministry of Public Health of Niger has reported 6,179 suspected cases of meningococcal meningitis, including 423 deaths, from 1 January to 12 May 2015.  Neisseria meningitidis (Nm) capsular group C (MenC) has been confirmed in most cases, with capsular group W (MenW) serogroup identified in several samples [1].

The WHO has expressed concern regarding the unprecedented features of this outbreak, which is rapidly growing and described as the first large-scale meningitis outbreak caused by Men C to affect any country in Africa’s meningitis belt [1].

Eleven districts from the regions of Niger are reporting case numbers of epidemic proportions. In the capital city, Niamey, which has a population of over one million people, 4,099 suspected cases, including 226 deaths have been reported. Due to the risk of rapid spread and the potential for many cases to occur in such a densely populated area, this outbreak is of high concern [1].

A mass vaccination campaign and other emergency control measures are being implemented by the Government of Niger, with support from WHO and partners [1, 2].

Meningococcal meningitis occurs throughout the African meningitis belt (26 countries in sub-Saharan Africa stretching from Senegal in the west to Ethiopia in the east).  Outbreaks in the meningitis belt sometimes reach epidemic proportions during the dry season (December to June) [3].  During 2015, large outbreaks of meningococcal meningitis have also been reported from Ghana and Nigeria. Information on disease outbreaks can be found on the Outbreak Surveillance Database.

Advice for Travellers

The bacteria that cause meningococcal disease are common and live naturally at the back of the nose and throat; at any time, one in ten people carry the bacteria but they usually cause no harm to the carrier. The bacteria are passed from person to person through inhaling or having direct contact with respiratory secretions e.g. coughing, sneezing, kissing. Rarely, these bacteria can cause serious illness including meningitis (infection of the lining of the brain), septicaemia (blood poisoning) and pneumonia. The risk of infection is greatest in crowded conditions or after prolonged close contact with a carrier or a person with the illness.

You should consider pre-travel vaccination with meningococcal ACWY (MenACWY) vaccine if you are visiting outbreak areas, and, are:

  • Likely to have close contact with the local population (e.g. living or working with local people)
  • Planning a long-stay visit
  • Visiting friends and relatives
  • An aid or health worker

Advice for meningococcal vaccination for travellers from the UK can be found here.

Information on health risks for travellers to Niger can be found here.

Advice for health professionals

Guidance on meningococcal vaccination is available in Immunisation against infectious disease Chapter 22.

In the UK, meningococcal disease is notifiable. Any case of suspected meningococcal disease should be notified to the local Health Protection Team.

PHE have produced guidance on the clinical and public health management of meningococcal disease.

Resources

Nigeria: yellow fever outbreaks

Suspected and confirmed cases of yellow fever reported to the World Health Organization Read more

Measles in Europe

A reminder for seasonal travellers to ensure they are up to date with measles vaccine Read more

Diphtheria in the Caribbean and South America

A reminder for travellers to be up to date with diphtheria vaccine Read more

Polio: Public Health Emergency of International Concern

An update on the polio Public Health Emergency of International Concern (PHEIC) Read more

Hepatitis B vaccine shortage and vaccine prioritisation: advising the traveller

Public Health England and NaTHNaC update the temporary recommendations for hepatitis B containing vaccine use in children and adults travelling to countries of intermediate/high prevalence Read more
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