Meningitis outbreak confirmed in the east - WHO

The World Health Organisation (WHO) said on Wednesday that it had received reports of 27 deaths out of 283 cases of meningococcal meningitis diagnosed in the town of Bukavu in South Kivu province in eastern Democratic Republic of the Congo (DRC). News agencies reported that the Katana health zone has been particularly affected, with authorities expressing concern about their ability to contain the spread of the disease in light of a severe shortage of vaccine. WHO has provided 30,000 doses of vaccine and 1,000 doses of oily chloramphenicol, but additional vaccine is being sought to administer to a wider target population. Local health authorities have said 300,000 doses of vaccine are needed, and have warned of serious logistical difficulties in transporting patients to medical centres where appropriate care is available. The International Rescue Committee (IRC) is working with WHO and health authorities to control the outbreak, and has conducted a selective vaccination campaign of school children and medical personnel in the affected areas. Other measures being taken include community mobilisation, health education and training of health care workers. According to WHO, meningococcal meningitis is the only form of bacterial meninigitis that causes epidemics. The largest epidemics of meningococcal meningitis in the world occur in sub-Saharan countries within the "meningitis belt" extending from Ethiopia in the east to Senegal in the west. While the highest disease rates are found in young children, during epidemics older children, teenagers and young adults are also affected. A large, widespread epidemic can follow a localised outbreak the previous year, with incidence rates remaining elevated during the following one to two years unless appropriate control measures such as mass immunisation are instituted. Warning signs of meningococcal meningitis infection include sudden onset of intense headache, fever, nausea, vomiting, photophobia, and stiff neck. Neurological signs include lethargy, delirium, coma and/or convulsions. Infants may become ill without sudden onset and stiff neck. Even when the disease is diagnosed early and adequate therapy instituted, the case fatality rate is between 5 percent and 10 percent, and may exceed 50 percent in the absence of treatment. In addition to the mortality associated with meningococcal meningitis, 15 percent to 20 percent of those who survive will suffer neurological damage, including deafness and mental retardation, as a result of their illness.