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Benin - Outbreak of meningitis in Banikoara Commune, Alibori Department

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  • Benin - Outbreak of meningitis in Banikoara Commune, Alibori Department

    WEEKLY BULLETIN ON OUTBREAKS
    AND OTHER EMERGENCIES
    Week 2: 6 – 12 January 2020
    Data as reported by: 17:00; 12 January 2020

    ...
    Meningitis Benin

    77 Cases
    13 Deaths
    17% CFR


    EVENT DESCRIPTION

    On 6 January 2019, the Ministry of Health of Benin notified WHO
    of an outbreak of meningitis in Banikoara Commune, Alibori
    Department, Northern Benin.
    The current outbreak reportedly began
    in week 50 (week ending 15 December 2019) when a cluster of four
    case-patients with signs and symptoms suggestive of meningitis
    were reported from Banikoara Commune. Of these, three were
    subsequently confirmed as having bacterial meningitis infection. In
    the following week, an additional 13 cases were reported from the
    same area, thus exceeding the epidemic threshold for the disease.
    The outbreak peaked in week 1 (week ending 5 January 2020), when
    28 new cases were reported.

    From 9 December 2019 to 8 January 2020, a cumulative total of 77
    cases with 13 deaths (case fatality ratio 17%) have been reported
    Banikoara Commune. Of these, 16 cases with six deaths have been
    confirmed for bacterial meningitis infection. The predominant
    pathogen isolated is Neisseria meningitides serogroup C (n=10),
    followed by N. meningitides serogroup X (n=4), Haemophilus
    influenzae type B (n=1), and Streptococcus pneumoniae (n=1). The
    age group 5 – 14 years old are the most affected accounting for
    71.4% (n=55) of the cumulative cases reported to date.
    The epicentre of the current outbreak recently experienced two
    deaths attributed to meningitis among children attending the same
    primary school. The first case was an eight-year-old girl who
    presented to a local health facility on 20 October 2019 with signs
    and symptoms suggestive of meningitis and died on the same
    day while seeking care. The second case, a 12-year-old boy, also
    developed similar signs and symptoms on the same day as the first
    case. He was treated as an outpatient at a local facility but later died
    on the same day at home. It is unclear whether the current outbreak
    is related to these events in October 2019 as there were no cases
    reported in the six weeks immediately prior to the beginning of the
    current epidemic.

    PUBLIC HEALTH ACTIONS

    A National Crisis Committee chaired by the Minister of Health
    with support from WHO and partners has been activated to
    coordinate response to the outbreak. A national level rapid
    response team was dispatched to support local teams in the
    Alibori Health Department and Banikoara Health Zone conduct
    field investigation and other response activities.
    Surveillance at healthcare facilities in the affected areas is
    being strengthened through provision of refresher training
    and mentorship to healthcare workers in the application of the
    case definition for detecting and reporting suspected cases of
    meningitis.

    Clinical management of cases according to the standard
    operational procedure for treatment of patients with meningitis
    is ongoing at health facilities in the affected areas. A total of 650
    vials of ceftriaxone have been deployed to Banikoara Commune.

    A reactive vaccination campaign was held on 2 January 2019,
    in D?roubou, a village at the epicentre of the outbreak, during
    which a total of 893 people aged 1 – 29 years were vaccinated
    with Meningococcal ACWY vaccine.

    The Ministry of Health of Benin has submitted a request to the
    International Coordinating Group (ICG) on vaccine provision for
    additional doses of the Meningococcal ACWY vaccine as well
    as ceftriaxone in order to extend the immunization campaign in
    affected and defined areas.

    Social mobilization and risk communication activities have been
    scaled-up through awareness messaging via a local community
    radio station as well as advocacy meetings with local elected
    officials to galvanize support for coordination and implementation
    of response activities.

    SITUATION INTERPRETATION

    Although Benin is not fully part of the meningitis belt in sub-Saharan
    Africa, the current outbreak is being reported at the time of the usual
    seasonal increase in cases of meningitis in sub-Saharan Africa. The high
    case fatality ratio associated with the current outbreak is of concern.
    Response measures need to be enhanced to ensure early detection
    and treatment of cases to prevent further mortality. Furthermore, there
    is a need to rapidly acquire additional doses of vaccines to extend
    the vaccination campaigns to neighbouring health zones. Finally, the
    proximity of the affected areas to neighbouring Burkina Faso, Niger, and
    Nigeria is another cause for concern pointing to the need for crossborder collaboration and strengthening of surveillance in these areas
    during this period of the year.

    https://apps.who.int/iris/bitstream/...0612012020.pdf
    "Safety and security don't just happen, they are the result of collective consensus and public investment. We owe our children, the most vulnerable citizens in our society, a life free of violence and fear."
    -Nelson Mandela
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