Scramble to contain meningitis epidemic

Aid agencies and the authorities in the Central African Republic (CAR) have joined forces to vaccinate hundreds of thousands of people at risk of meningitis in the northwest of the country, officials said.

Toby Lanzer, the UN humanitarian coordinator in CAR, said the latest vaccination effort was targeting at least 80,000 people at the centre of the epidemic.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) reported on 11 February that meningitis was spreading across three northwestern districts and was threatening up to one million people. The announcement followed a declaration by national authorities of an outbreak of meningitis after several cases and numerous deaths were reported in Ouham, Ouham Pendé and Nana-Grebizi districts in the first five weeks of this year.

"In the town of Kaga Bandoro and neighbouring villages alone, 38 cases of meningitis have been reported, of which several were lethal," OCHA reported. "The ill are now being treated."

Meningitis takes its name from the meninges, the protective membranes covering the central nervous system, which become inflamed as a result of infection by bacteria, viruses or other agents. Meningitis can kill unless quickly treated with antibiotics.

The type spreading in CAR is caused by the meningococcus bacterium. Symptoms can rapidly progress from fever, headache and neck stiffness to coma and, in around 10 percent of cases, death.

CAR is part of the meningitis belt that stretches from Senegal to Ethiopia. Annual outbreaks occur mainly in the dry season (January-May).

The UN World Health Organization (WHO) had requested US$100,000 from the UN Emergency Response Fund (ERF), and the money has been released to buy vaccines. The ERF is part of an aid programme in CAR, supported by donors, with $69 million to protect, feed and care for people displaced and affected by violence.

Bisimwa Ruhana Mirindi, the health coordinator for the International Rescue Committee in Kaga Bandoro, who has been coordinating the fight against meningitis, said the country was beyond the threshold for an epidemic, which is 10 cases per 100,000 people.

"We are very worried, very afraid," he said. "Outbreaks are being reported in new communes, such as Ngenga in Nana-Grebizi district, and it is continuing to spread.

"The most important thing is to make vaccines available to everyone. We are more than a month into this situation and we are still waiting for vaccines."

OCHA said national stocks of vaccines for the disease were running short.

"Protecting the people in the north of the Central African Republic will prevent meningitis from spreading to the rest of the country and into neighbouring Chad," OCHA said.

The agency said the health situation in the conflict-torn north of the country remained dire, with over three-quarters of the population having little, if any, access to healthcare. Life expectancy stands at 43 years, one of the lowest in the world.

Violence affects at least one million people in northern CAR. OCHA estimates there are 197,000 internally displaced people in the country while 98,000 others have sought refuge in Chad, Cameroon, or Sudan.

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