Meningitis kills 16 in Sudan

[AlaskaDenise]

The latest case of ABBF...they tested 5 of the 231 suspected cases... http://www.afrol.com/articles/22822

afrol News, 21 November - An outbreak of meningitis has added salt to injury in Southern Sudan that has been crippling with war, famine and other crisis. Already, health experts have discovered 231 cases of suspected meningitis from September to November. 16 of this number have died. Also a possible outbreak of bird flu is investigated.

According to a report released by the World Health Organisation (WHO) today, the cases of meningitis were found in Greater Yei County in the Central Equatorial state of autonomous South Sudan.

"The epidemic threshold was crossed in this county during the last week of October. Five cerebral spinal fluid specimens have tested positive for Neisseria meningitidis serogroup A by latex test," a WHO statement said, adding that an outbreak investigation was conducted by the Ministry of the Central Equatorial State with the support of WHO's Early Warning and Response Network (EWARN) team and the US Centres for Disease Control and Prevention.

Also, there was a national multisectoral task force established earlier this year, which includes county health authorities, UNICEF, WHO and non-governmental organisations in coordinating the outbreak response.

"Enhanced surveillance, case management, and social mobilization are underway, as well as the preparation of a vaccination campaign targeting ca 294,000 people in the affected area."

Meningitis, also referred to as meningococcal disease, is a contagious bacterial disease caused by the meningococcus bacteria. It is spread by person-to-person contact through respiratory droplets of infected people.

The disease has three main clinical forms - meningeal syndrome, septic form and pneumonia. And according to health experts, the onset of symptoms is sudden and death can follow within hours. In as many as 10-15 percent of its survivors, there are persistent neurological defects, including hearing loss, speech disorders, loss of limbs, mental retardation and paralysis.

It is also believed that between 5 and 10 percent of a population may be symptomatic carriers of the disease. Overcrowding, prolonged droughts and dusty storms are said to have strained the seasonal disease, which is mainly common among young children.

In addition to the proven meningitis outbreak, South Sudan authorities are struggling with a presumed outbreak of avian flu in Juba, the autonomous region's capital. Tests have still to be verified abroad, but authorities fear a bird flu outbreak may have severe consequences for peasants, many of whom hold chicken as a supplementary food source. In the worst case, large numbers of birds will have to be culled.

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[HenryN]

Re: Meningitis kills 16 in Sudan

In the worst case, large numbers of birds will have to be culled.

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I think most can come up with a worse worst case.

[Sharpe]

Re: Meningitis kills 16 in Sudan

I think most can come up with a worse worst case.

As in, H5N1 will be doing the culling. It's quite interesting actually that in a study of a population of healthy Spanish children, on average > 5% of them carried meningococcus at any one time. That would mean that if this population had been healthy Europeans, 12 or 13 of them would have had meningococcus anyway--without any symptoms. In a British university population, the numbers of healthy carriers are on average in the 15 to 20% range. Since the southern Sudanese are neither healthy nor wealthy, those numbers should be much higher, perhaps even above the 50% mark. They found the bacteria in the CSF, mind you, however. But still, I'm skeptical--especially if they tested them all and only found it in 5. That's VERY concerning. It should be at very high, obviously detectable levels if so many died of it. H5N1 is in the area, and the symptoms and lethality can be indistinguishable.

http://cat.inist.fr/?aModele=afficheN&cpsidt=13411029

http://www.studentbmj.com/back_issues/0500/papers/ppr.html

[LMonty]

Re: Meningitis kills 16 in Sudan

Thats an awfully low death rate for bacterial meningitis, isnt it? I'd expect t least an order of magnitude higher. Off the top of my head, thats around a3.7% CFR isnt it?

[Sharpe]

Re: Meningitis kills 16 in Sudan

Thats an awfully low death rate for bacterial meningitis, isnt it? I'd expect t least an order of magnitude higher. Off the top of my head, thats around a3.7% CFR isnt it?

It's about 7% actually. I wouldn't worry about that so much--they're probably all lumped in one basket, when in actuality, they're probably in actuality three or more different types of diseases.

[Daisy]

Re: Meningitis kills 16 in Sudan

http://www.alertnet.org/thenews/newsdesk/B840837.htm

Sudan meningitis outbreak strikes 211, kills 17
22 Jan 2007 17:53:51 GMT
<!-- 22 Jan 2007 17:53:51 GMT ## for search indexer, do not remove-->Source: Reuters

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AIDS
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JUBA, Sudan, Jan 22 (Reuters) - A meningitis outbreak sweeping through southern Sudan has killed 17 people and infected 211, the World Health Organisation (WHO) said on Monday, adding it had enough vaccines to contain the outbreak.
"As of Jan. 17 the number of cases was 211 of which only 17 died and that includes Central Equatoria states and Warap states," said Abdullahi Ahmed, head of WHO in south Sudan.
He said health officials had not confirmed any disease other than meningitis but laboratory tests were under way.
Ahmed said medical workers had enough vaccines to cover the most affected county in Warap state.
On Sunday, the governor of south Sudan's central Warap state said in a statement that at least 1,000 people had died in one week in an outbreak of meningitis and another unknown disease.
On Monday Governor Anthony Bol Madut dismissed the WHO figures, saying there was a serious health crisis in his region.
"This is a lie -- there are hundreds dying in just one area," he told Reuters from Wau town in south Sudan where he was meeting U.N. officials to mobilise relief efforts.
"They are not on the ground -- this is an emergency there are people dying every day," he said.
John Rumunu, director for preventative medicine in south Sudan's Ministry of Health, also questioned the WHO numbers.
"What our (WHO) colleagues are reporting are cases that have been presented to health facilities but we don't know what's happening in communities," Rumunu said.
"Health coverage is only of about 25 percent of the population in southern Sudan," he told Reuters.
South Sudan, after suffering decades of civil war, has little or no infra-structure and is particularly at risk to outbreaks of disease.
Meningitis outbreaks affect Sudan during the dry season, as part of the "meningitis belt" which runs from East to West Africa. It accounts for more than half the cases of the disease worldwide each year.
Meningitis is an infection of the thin lining that surrounds the brain and spinal cord. It can cause complications including brain damage and deafness. About 5 percent to 10 percent of patients die from the illness, according to the WHO.
Hundreds of thousands of southern Sudanese returning home after a January 2005 peace deal are especially at risk because they live in crowded camps where infectious diseases like meningitis thrive.
Madut said he and a group of 14 doctors from the north Sudan Sennar state would travel on Tuesday to the most affected areas.
"But they don't have enough vaccines and we are appealing for more," he said.

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