DAKAR/OUAGADOUGOU, 17 January 2008 (IRIN) - The World Health Organization has confirmed outbreaks of the deadly meningitis bacterium in three West African countries, marking the start of what experts have warned might be the worst meningitis epidemic to hit Africa in a decade.

"One district is on alert in Burkina Faso, an epidemic has been reported in a region of Nigeria and there are two cases in Niger, as well as cases in the Democratic Republic of Congo," Professor Kader Kondé, director of WHO's Ouagadougou-based Multi-Disease Surveillance Centre (MDSC) told IRIN.

The WHO warned in October that 80 million people out of roughly 350 million who live in 21 African countries stretching from Ethiopia in the east to Mauritania in the west might need to be vaccinated against the bacterium this year. http://www.irinnews.org/report.aspx?ReportId=74722

The meningitis bacterium, which usually reaches epidemic levels in the region often referred to as Africa's "meningitis belt" between December and May, could be especially severe this year as the region is heading toward the peak of a 10- to 12-year cycle of meningitis crises, health forecasters say.

High risk

Between 1995 and 1997, the last time there was a major epidemic in the region, at least 25,000 people died and 250,000 people were infected.

From December 2006 to May 2007, 53,000 cases of meningitis were reported and an estimated 4,000 people died across the region.

Semi-arid Sahelian countries are hit each year by outbreaks during the dry seasons between December and June when strong, dust-laden winds and cold nights make people more prone to respiratory infections. The meningitis bacterium is transmitted by sneezing or coughing.

According to Kondé, the situation could be worse this year because of high dust levels in the region and the low level of immunity among populations.

He said new research by WHO and national research centres also appears to have shown a new strain of the bacterium.

"If you take into account all these factors we find ourselves in a situation where the risk [of epidemics] is high," Kondé said.

Preparedness

Preparedness for meningitis epidemics is notoriously difficult because vaccines cannot be administered until it is known which of the many different forms of the bacterium are spreading.

In 2006-2007, the humanitarian response was further hindered by a shortfall of the cheaper vaccines usually used in the region as European producers focused on producing newer, longer-lasting but more expensive vaccines. Just 7 million doses were available.

In 2008, between 25 million and 30 million doses could be available, according to WHO. "We do find ourselves in a more favourable situation than last year," Kondé said.

Emergency health officials are due to meet in Dakar next week to coordinate responses to the expected epidemic.

Hans Hebbing, regional health coordinator of the International Federation of the Red Cross, told IRIN the Federation has already started training 25,000 volunteers across the region, and is educating people about how to recognise meningitis and the dangers.

"We know this is not really going to prevent a major outbreak. But we're hoping that early activity can prevent some spread of the disease and we do know that training and preparedness can make the response faster," he said.

Meningitis is an infection of the thin lining around the brain and spinal cord. Even when meningitis is diagnosed early and adequate therapy is available, between 5 and 10 percent of patients die, typically within 24 and 48 hours of experiencing the first symptoms. Many thousands of survivors are left with brain damage, hearing loss or learning disabilities.

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