Worst meningitis strain likely to break out
Jan 13, 2008
A new year is here and life may seem all merry from the long festive season. But last year’s warning by the World Health Organisation (WHO) about a possible outbreak of meningitis is now more imminent and it takes a prepared government to save the country from the looming threat.
By Irene Nabusoba
A new year is here and life may seem all merry from the long festive season. But last year’s warning by the World Health Organisation (WHO) about a possible outbreak of meningitis is now more imminent and it takes a prepared government to save the country from the looming threat.
Last October, the WHO predicted that Uganda and 13 other countries including neighbouring Kenya, Sudan and the DR Congo could face one of the worst meningitis strains early this year.
“It seemed like a far off threat when we announced our predictions last year.
But the epidemic is imminent now that the dry season has set in. I’m sure by the end of the dry spell, we shall be facing the epidemic,†says Dr. William Mbabazi, who is in charge of integrated disease surveillance and response at the WHO.
Mbabazi says the disease, which thrives in dry weather, is a yearly occurrence in Africa’s meningitis belt that stretches from Ethiopia, through central to West Africa.
“Uganda experienced it in early 2005, 2006 and even 2007. This year it could come around February or March,†he reveals.
The WHO made its prediction based on weather forecasts that indicate Africa is in for a severe drought this year, and on historical occurrences which have been constant for eight to 10 years.
Mbabazi says Kotido, Moroto, Kitgum, Pader, Gulu Adjumani, Yumbe, Arua and Nebbi districts should particularly be alert because they lie in the belt. He added that Masindi is also vulnerable because it is generally epidemic-prone.
“Some of these districts have been having unique strains of the disease, but since we have no vaccines, we have not been vaccinating and this leaves them vulnerable. It is only in Nakapiripirit where we were able to vaccinate the whole district. That is why it is not included in the vulnerable group,†Mbabazi says.
“Some of the districts have been earmarked because they have not had their share of the disease, yet they lie in the belt,†he adds.
However, health experts have warned that everyone should take precaution because meningitis is not a reserve of the ‘marked corridor’.
“We have had cases of a spill over given its kind of spread; It is just an epidemiological observation that even areas outside the meningitis belt can be affected because of changes in lifestyle, weather and the environment,†Mababazi says.
Is the ministry ready?
Dr Sam Zaramba, the director general of health services, says they have taken the WHO’s predictions seriously and are prepared for any eventuality.
“We have put aside funds to handle the situation. We have also developed public health messages and fact sheets on meningitis, both in English and local languages to step up awareness which is key in containing any epidemic,†Zaramba says.
“We shall use our trained staff. I am also confident that with the experience we have built over three years, when we experienced outbreaks, we should be able to contain it.
“Besides, diseases like meningitis are often treated with international attention. The Government and the international community often join hands to contain such epidemics,†he adds.
What is Meningitis?
Mbabazi defines it as the inflammation of the protective membranes covering the central nervous system. It presents in nine forms. Some forms are mild and resolve on their own, while some are fatal.
Nevertheless, meningitis is a potentially serious condition owing to the proximity of the inflammation to the brain and spinal cord. It can lead to death, leave alone long-term impacts such as brain damage and deafness, which affect many survivors.
www.doctorswithoutborders.org, an internet site on health, reveals that Meningococcal Meningitis is a contagious and potentially fatal infection of the brain membrane. It is caused by various strains, or serogroups of the Neisseria Meningitidis Bacterium. The site adds that strains A, B, C, Y and W135 are the most common.
Infected people often carry the disease without showing symptoms and spread the bacteria to others through droplets of respiratory or throat secretions through close contact and when they cough or sneeze.
Close and prolonged contact, especially through kissing, sneezing and coughing, living in close proximity and sharing food utensils, aid the spread. The disease is one of the most feared epidemics in Africa because of its rapid onset, high fatality rates and costs.
“Even when the disease is diagnosed early and adequate therapy instituted, 5-10% of patients die, within 24-48 hours of onset of symptoms,†the site reveals.
“Bacterial Meningitis may result in brain damage, hearing loss, or learning disability in 10-20% of survivors.
A less common, but more severe form of the meningococcal disease is Meningococcal Septicaemia. It is characterised by a rapid circulatory collapse,†the site adds adds. The average incubation period for meningitis is four days, ranging between two and 10 days.
Symptoms
Babies and toddlers:
Fever, cold limbs
Refusing to eat
Vomiting
Agitation
Pale, blotchy skin
Blank expression
Drowsy, difficulty in wake up
Stiff neck and backache
High-pitched cry
Children and adults
Vomiting
Fever, clod limbs
Headache, stiff neck
Joint stiffness and muscle pain
Dislike for bright lights and noise
Drowsiness
Confusion or delirium
Prevention
Mbabazi says out of the nine strains of meningitis, only A, C and W135 have vaccines. “We cannot vaccinate people until there has been an outbreak for us to ascertain the strain and determine which vaccine is suitable. You can give a wrong vaccine, waste finds and face a challenge containing the epidemic,†he says.
He urges the public to report suspicious cases so that heath personnel can carry out the tests in time and curb the spread.
“There have been instances of self-medication and prophylaxis (preventive treatment), but studies show that it does not offer any protection. It instead instills false security and people end up reporting late when medical interventions are not possible,†he notes.
Mbabazi urges the Ministry of Health to step up surveillance and stock vaccines and drugs. The public and health workers should also increase the level of suspicion of the disease so that cases are handled.
Health workers are advised to treat the matter with urgency like tapping water from the back.
A new year is here and life may seem all merry from the long festive season. But last year’s warning by the World Health Organisation (WHO) about a possible outbreak of meningitis is now more imminent and it takes a prepared government to save the country from the looming threat.
Last October, the WHO predicted that Uganda and 13 other countries including neighbouring Kenya, Sudan and the DR Congo could face one of the worst meningitis strains early this year.
“It seemed like a far off threat when we announced our predictions last year.
But the epidemic is imminent now that the dry season has set in. I’m sure by the end of the dry spell, we shall be facing the epidemic,†says Dr. William Mbabazi, who is in charge of integrated disease surveillance and response at the WHO.
Mbabazi says the disease, which thrives in dry weather, is a yearly occurrence in Africa’s meningitis belt that stretches from Ethiopia, through central to West Africa.
“Uganda experienced it in early 2005, 2006 and even 2007. This year it could come around February or March,†he reveals.
The WHO made its prediction based on weather forecasts that indicate Africa is in for a severe drought this year, and on historical occurrences which have been constant for eight to 10 years.
Mbabazi says Kotido, Moroto, Kitgum, Pader, Gulu Adjumani, Yumbe, Arua and Nebbi districts should particularly be alert because they lie in the belt. He added that Masindi is also vulnerable because it is generally epidemic-prone.
“Some of these districts have been having unique strains of the disease, but since we have no vaccines, we have not been vaccinating and this leaves them vulnerable. It is only in Nakapiripirit where we were able to vaccinate the whole district. That is why it is not included in the vulnerable group,†Mbabazi says.
“Some of the districts have been earmarked because they have not had their share of the disease, yet they lie in the belt,†he adds.
However, health experts have warned that everyone should take precaution because meningitis is not a reserve of the ‘marked corridor’.
“We have had cases of a spill over given its kind of spread; It is just an epidemiological observation that even areas outside the meningitis belt can be affected because of changes in lifestyle, weather and the environment,†Mababazi says.
Is the ministry ready?
Dr Sam Zaramba, the director general of health services, says they have taken the WHO’s predictions seriously and are prepared for any eventuality.
“We have put aside funds to handle the situation. We have also developed public health messages and fact sheets on meningitis, both in English and local languages to step up awareness which is key in containing any epidemic,†Zaramba says.
“We shall use our trained staff. I am also confident that with the experience we have built over three years, when we experienced outbreaks, we should be able to contain it.
“Besides, diseases like meningitis are often treated with international attention. The Government and the international community often join hands to contain such epidemics,†he adds.
What is Meningitis?
Mbabazi defines it as the inflammation of the protective membranes covering the central nervous system. It presents in nine forms. Some forms are mild and resolve on their own, while some are fatal.
Nevertheless, meningitis is a potentially serious condition owing to the proximity of the inflammation to the brain and spinal cord. It can lead to death, leave alone long-term impacts such as brain damage and deafness, which affect many survivors.
www.doctorswithoutborders.org, an internet site on health, reveals that Meningococcal Meningitis is a contagious and potentially fatal infection of the brain membrane. It is caused by various strains, or serogroups of the Neisseria Meningitidis Bacterium. The site adds that strains A, B, C, Y and W135 are the most common.
Infected people often carry the disease without showing symptoms and spread the bacteria to others through droplets of respiratory or throat secretions through close contact and when they cough or sneeze.
Close and prolonged contact, especially through kissing, sneezing and coughing, living in close proximity and sharing food utensils, aid the spread. The disease is one of the most feared epidemics in Africa because of its rapid onset, high fatality rates and costs.
“Even when the disease is diagnosed early and adequate therapy instituted, 5-10% of patients die, within 24-48 hours of onset of symptoms,†the site reveals.
“Bacterial Meningitis may result in brain damage, hearing loss, or learning disability in 10-20% of survivors.
A less common, but more severe form of the meningococcal disease is Meningococcal Septicaemia. It is characterised by a rapid circulatory collapse,†the site adds adds. The average incubation period for meningitis is four days, ranging between two and 10 days.
Symptoms
Babies and toddlers:
Fever, cold limbs
Refusing to eat
Vomiting
Agitation
Pale, blotchy skin
Blank expression
Drowsy, difficulty in wake up
Stiff neck and backache
High-pitched cry
Children and adults
Vomiting
Fever, clod limbs
Headache, stiff neck
Joint stiffness and muscle pain
Dislike for bright lights and noise
Drowsiness
Confusion or delirium
Prevention
Mbabazi says out of the nine strains of meningitis, only A, C and W135 have vaccines. “We cannot vaccinate people until there has been an outbreak for us to ascertain the strain and determine which vaccine is suitable. You can give a wrong vaccine, waste finds and face a challenge containing the epidemic,†he says.
He urges the public to report suspicious cases so that heath personnel can carry out the tests in time and curb the spread.
“There have been instances of self-medication and prophylaxis (preventive treatment), but studies show that it does not offer any protection. It instead instills false security and people end up reporting late when medical interventions are not possible,†he notes.
Mbabazi urges the Ministry of Health to step up surveillance and stock vaccines and drugs. The public and health workers should also increase the level of suspicion of the disease so that cases are handled.
Health workers are advised to treat the matter with urgency like tapping water from the back.