Chad 2013 © Natacha Buhler/MSF

Meningitis

Meningococcal meningitis is a highly contagious bacterial from of meningitis—a serious inflammation of the meninges—the thin lining that surrounds the brain and spinal cord.

Putting meningitis in context

Meningococcal meningitis is a highly contagious bacterial form of meningitis—a serious inflammation of the meninges—the thin lining that surrounds the brain and spinal cord.

The vast majority of meningitis cases and deaths occur in Africa.

During the dry season (December to June), epidemics regularly hit countries in the African ‘meningitis belt’, a region that stretches across the continent from Senegal to Ethiopia. Between 1994-2014, close to one million cases of meningitis were reported in Africa. 100,000 people died.

Even when the disease is diagnosed early and adequate treatment is started, five to ten percent of patients do not survive, typically within 24 to 48 hours after the onset of symptoms. Left untreated, up to 50 percent of cases may die.

Facts about meningitis

Meningococcal meningitis is highly contagious. People infected with the bacterium Neisseria meningitidis often carry the disease without showing symptoms and spread the bacteria through coughing and sneezing. Overcrowding and cramped living conditions increase the risk of spreading the disease.

When infected people begin to show symptoms, they often experience sudden and intense headaches, fever, nausea, vomiting, photophobia (a low tolerance to light), and stiffness of the neck. Although anyone of any age can become infected with meningitis, babies and children are particularly susceptible.

Diagnosing meningitis in the settings in which we work is often difficult as clinical examination is required—and quickly. A painful lumbar puncture is needed for the examination of spinal fluid and sometimes the bacteria can be seen under a microscope. However, the diagnosis is confirmed by growing bacteria from spinal fluid or blood. These diagnostic tests allow for further tests to see how effective certain antibiotics will be for the patient.

A range of antibiotics can treat the infection, including penicillin, ampicillin, chloramphenicol, and ceftriaxone. In areas with limited health infrastructure and resources, oily chloramphenicol or ceftriaxone are the drugs of choice because a single dose has been shown to be effective on meningococcal meningitis.

However, timely mass vaccinations are the most effective means of limiting the spread of epidemics. The WHO has estimated that mass immunizations have managed to prevent up to 70 percent of expected cases in individual meningitis outbreaks in Africa.

MSF vaccinated 33,900 people against meningitis in response to outbreaks in 2018.

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