MENINGOCOCCAL DISEASE, W135 - BURKINA FASO
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[see also:
2001
------
Meningococcal disease, W135 surveillance - Global 20010623.1195
Meningococcal dis., W135 surveill. - Czech Republic 20010530.1060
Meningococcal disease, W135 surveillance - Europe 20010517.0959
Meningococcal disease, W135, Haj-related (04) 20010501.0842
Meningococcal disease, W135, Haj-related 20010420.0776
2000
------
Meningococcal disease, W135 surveillance - Europe 20001119.2017
Meningococcal disease, Haj - ex Saudi Arabia (04) 20000513.0743
Meningococcal disease, Haj - ex Saudi Arabia 20000423.0604
Meningococcal disease - Netherlands ex Saudi Arabia 20000418.0559
Meningococcal disease - Saudi Arabia 20000417.0555
Meningococcal disease - Pakistan ex Saudi Arabia 20000413.0525
Meningococcal disease - UK, France ex S. Arabia (02) 20000412.0519
Meningococcal disease - UK, France ex Saudi Arabia 20000410.0511
1996
------
Meningitis, meningococcal - Texas USA (2) 19960123.0161]

[1]
Date: Sat 30 Mar 2002, 06:25 GMT
From: ProMED-mail <promed@promedmail.org>
Source:  BBC Online 30 Mar 2002
<http://news.bbc.co.uk/hi/english/world/africa/newsid_1901000/190136
5.stm>


Meningitis toll rising in Burkina Faso
----------------------------------------
Health officials in Burkina Faso say that more than 600 people have 
died so far this year in an outbreak of meningitis.

The officials say the strain of the disease, known as W-135, is found 
only in Saudi Arabia, and they believe it was brought to Burkina Faso 
by Muslim pilgrims returning from Mecca after the Hajj.

Last week the authorities said they would start offering free vaccines 
and health care to fight the disease, but World Health Organization 
officials say there are just 25 000 doses of vaccine for the Saudi strain 
in the world, and none are available in Burkina Faso.

Last year, meningitis [including serogroup W135] claimed almost 2000 
lives out of some 13 000 cases reported in Burkina Faso.

The worst outbreak in recent years was in 1996, when 4000 people died.

*****
[2]
Date: 21 Mar 2002
From: ProMED-mail <promed@promedmail.org>
Source: WHO CSR 21 Mar 2002
<http://www.who.int/disease-outbreak-
news/n2002/march/21amarch2002.html>


Meningococcal disease in Burkina Faso - Update 2
----------------------------------------------
As of  20 Mar 2002, WHO has reported 3 579 cases including 544 
deaths (case-fatality rate, 15%) in the entire country. Twelve out of 15 
districts have reached the epidemic threshold and 13 districts are on 
alert for reaching the threshold. Vaccination campaigns were carried 
out in 2001 and recently in 2002 (see previous report) .

_Neisseria meningitidis_ serogroup W135 has been laboratory 
confirmed in cases from 5 districts by the WHO Collaborating Centre 
for Reference and Research on Meningococci, Oslo, Norway.

A Crisis Committee has been set up by the  Ministry of Health, Burkina 
Faso.  A WHO team is working with the Committee to consider the 
most appropriate strategy to control the outbreak, given the presence of 
the W135 strain.   Measures include epidemiological surveillance, 
collection and testing of samples, social mobilization, training and 
coordination.

*****
[3]
Date:  Thu 21 Mar  2002 9:39 AM EST
From: ProMED-mail <promed@promedmail.org>
Source:  UN Integrated Regional Information Networks/All Africa 
Global Media via COMTEX), AllAfrica.com  21 Mar  2002 [edited]


Meningitis Deaths Now 544, New Strain Present
----------------------------
Meningitis has killed 544 people in Burkina Faso since January [2002] 
a leading government health official, Dr. Jean Wango, secretary-general 
of the Health Ministry, said on Wednesday, but he called for calm.

Since January [2002], he said, there had been 3574 cases of meningitis 
in Burkina Faso; 10 of the country's 53 health districts have been 
declared epidemic zones, with at least 10 cases reported for every 100 
000 inhabitants. Officials said the high death rate was due to low levels 
of vaccination.

Meningitis is an infection of the fluid in a person's spinal cord and the 
fluid that surrounds the brain. In Africa, the disease often surfaces 
during annual dry seasons when strong desert winds blow  south, 
raining in dust over the area. Wango said the dust and heat wave 
presented favourable conditions for the disease, which affected 
thousands of people from Senegal, in the west of the continent, to 
Ethiopia in the east.

Officials are offering free vaccinations and health care for people in the 
13 worst hit health districts in Burkina Faso, while the World Health 
Organisation (WHO) has said it would provide the government with 
1.9 million doses of vaccines.

Officials also said a new strain of the disease, the W135 meningitis 
germ present in Saudi Arabia, has appeared in Burkina Faso, most 
likely brought by pilgrims from Mecca in 2000. Vaccines to counter 
this strain are not yet available in Burkina Faso where, officials said; till 
now only meningitis forms A and C were present.

Researchers from at the US Centers for Disease Control and 
Prevention, and WHO are in Burkina Faso, Mali and Niger 
investigating the Saudi meningitis strain. A WHO specialist on 
meningitis told IRIN on Thursday that there was a worldwide scarcity 
of the Tetravalent vaccine (which combats the meningitis strains A, C, 
Y and W135). Saudi authorities, the official said, were now demanding 
that all pilgrims to Mecca be vaccinated against meningitis before being 
allowed entry into the country.

In January, health officials launched a US $1.66 million "mass 
prevention campaign" against meningitis aimed at immunising 3 million 
people aged from 2- 30 years. In 2001, meningitis killed 1854 of the 13 
293 cases registered in Burkina Faso; but the worst recent occurrence 
was in 1996 when 4000 died.

[Prior to the Hadj related meningococcal W135 outbreaks in 2000 and 
2001, W135 was a sporadic isolate in cases of W135.  Of interest is the 
warning of possible W135 outbreak activity related to the Hadj in 1995 
(ref. 8).  This outbreak in Burkina Faso suggests that serotype W135 
may [now] be a predominant "player" in meningitis outbreaks in the 
classical meningitis belt in sub-Saharan Africa.  It had already been 
identified as one of the serotypes in circulation in Burkina Faso at the 
end of 2001 (ref.1), [responsible for 37% of cases - JW].  

Currently, vaccine that includes the W135 component is not used in 
Africa for meningitis control programs.  It is not clear from these 
articles if W135 is the predominant strain responsible for the outbreak 
or just for small numbers of isolates tested that were positive for 
W135.  Information on the true contribution of W135 to the ongoing 
outbreak is important.  If W135 becomes a predominant organism 
responsible for meningitis epidemics in Africa, it carries significant cost 
implications for the region in terms of meningitis control programs and 
activities. 

1:  Taha MK, Parent Du Chatelet I, Schlumberger M, Sanou I, Djibo S, 
de Chabalier F, Alonso JM.  Neisseria meningitidis Serogroups W135 
and A were Equally Prevalent among Meningitis Cases Occurring at the 
End of the 2001 Epidemics in Burkina Faso and Niger. J Clin  
Microbiol. 2002 Mar;40(3):1083-1084.

2:  Hahne SJ, Gray SJ, Jean-Francois, Aguilera, Crowcroft NS, Nichols 
T, Kaczmarski EB, Ramsay ME.  W135 meningococcal disease in 
England and Wales associated with Hajj 2000 and 2001. Lancet. 2002 
Feb 16;359(9306):582-3.

3:  Fonkoua MC, Cunin P, Sorlin P, Musi J, Martin PM.  [Bacterial 
meningitis in Yaounde (Cameroon) in 1999-2000] Bull Soc Pathol 
Exot. 2001 Nov;94(4):300-3.

4:  Taha MK, Antignac A, Renault P, Perrocheau A, Levy-bruhl D, 
Nicolas P, Alonso JM.  [Clonal spread of Neisseria meningitidis W135] 
Presse Med. 2001 Oct 27;30(31 Pt 1):1535-8.

5:  Matsika-Claquin MD, Perrocheau A, Taha MK, Levy-Bruhl D, 
Renault P, Alonso JM, Desenclos JC.   [Meningococcal W135 infection 
epidemics associated with pilgrimage to Mecca in 2000] Presse Med. 
2001 Oct 27;30(31 Pt 1):1529-34.

6: [Meningococcal disease, serogroup W135 (update).] Wkly Epidemiol 
Rec. 2001 Jul 13;76(28):213-4.

7:  Kwara A, Adegbola RA, Corrah PT, Weber M, Achtman M, Morelli 
G, Caugant DA, Greenwood BM.  Meningitis caused by a serogroup 
W135 clone of the ET-37 complex of Neisseria meningitidis in West 
Africa. Trop Med Int Health. 1998 Sep;3(9):742-6.

8:  Yousuf M, Nadeem A. Fatal meningococcaemia due to group W135 
amongst Haj pilgrims: implications for future vaccination policy.  Ann 
Trop Med Parasitol. 1995 Jun;89(3):321-2.
- Mod. MPP]
...............................mpp/jw
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