Africa Risks Large Meningitis Outbreak, Public Health Officials Warn

With Africa at risk of a large meningitis outbreak, an acute shortage of meningitis C-containing vaccine threatens to severely limit the world’s ability to minimize the number of people affected, four international public health organizations warned today.

International Federation of Red Cross and Red Crescent Societies (IFRC), Médecins sans Frontières (MSF), The United Nations Children's Fund (UNICEF), and the World Health Organization (WHO) (the four organizations, which together constitute the International Coordinating Group for Vaccine Provision for Epidemic Meningitis Control - ICG) are therefore calling today on vaccine manufacturers to step up meningitis C-containing vaccine production by 5 million doses before the 2016 meningitis season starts in January.

“Meningitis tends to hit Africa in cycles. Cases of meningitis C have been rising since 2013, first in Nigeria in 2013 and 2014, and then in Niger in 2015. We have to be ready for a much larger number of cases during the 2016 meningitis season,” said Dr William Perea, Coordinator for Control of Epidemic Diseases Unit at WHO.

“We have had preliminary discussions with vaccine manufacturers and impressed upon them the need to produce a stockpile of 5 million doses of vaccine so as to be ready for flare-ups of the disease next year in Africa, but so far they haven’t yet revised their production plans to meet demand,” says Dr. Imran Mirza, health specialist, Program Division, UNICEF.

While substantial progress has been made in recent years in protecting Africa from other main sub-types of meningitis with, for example, the introduction of the MenAfrVac vaccine against meningitis A in 2010, much work needs to be done to protect the African meningitis belt from meningitis C outbreaks.

“We have been working to reinforce detection and response systems, and are working to secure other sources of meningitis C vaccine in Cuba and Brazil, but the manufacturers have not yet submitted an application for WHO prequalification,” says Alejandro Costa, ICG Secretariat. "Until they do, we can only turn to those manufacturers who are already prequalified and have provided vaccine in the past. We need to get them to produce and provide vaccine, in the right quantity and at an affordable price.”

“In just the first six months of 2015, there have been 12,000 cases of meningitis C in Niger and Nigeria, and 800 deaths. At the same time, there has been a critical shortage of vaccine,” says Dr. Myriam Henkens, international medical coordinator for MSF. “The campaigns consequently were limited to the critically affected age groups and areas, and even so, had to be delayed until vaccine supply became available and we believe next year will be worse. We need vaccine manufacturers to plan production of multivalent vaccine now to allow sufficient lead time and capacity to meet this demand.”

The ICG stresses that vaccination remains key to preventing meningitis. “Since the introduction of the meningitis A conjugate vaccine (MenAfriVac) in 2010 in 15 countries in Sub-Saharan Africa, the meningitis disease burden has been dramatically reduced. No epidemics of meningitis A have been reported in areas where the population has been vaccinated. We need now to do the same for meningitis C,” says Amanda McClelland, senior officer of emergency health for IFRC.

Meningococcal meningitis is a bacterial form of meningitis, a serious infection of the thin lining that surrounds the brain and spinal cord. It can cause severe brain damage and is fatal in 50 percent of cases if untreated. Several different bacteria can cause meningitis. Neisseria meningitidis is the one with the potential to cause large epidemics. There are 12 serogroups of N. meningitidis that have been identified, six of which (A, B, C, W, X and Y) can cause epidemics. Geographic distribution and epidemic potential differ according to serogroup.

Source: WHO