Democratic Republic of the Congo declares meningitis outbreak in north-eastern province

[Shiloh]

Source: https://reliefweb.int/report/democra...outbreak-north


Democratic Republic of the Congo declares meningitis outbreak in north-eastern province

News and Press Release
Source: WHO
Posted: 8 Sep 2021
Originally published: 8 Sep 2021

Kinshasa, 8 September 2021 – The Democratic Republic of the Congo has declared an outbreak of meningitis in the north-eastern Tshopo Province where 261 suspected cases and 129 deaths—a high case fatality ratio of 50%—have been reported.

Confirmatory tests carried out by the Institut Pasteur in Paris detected Neisseria meningitidis – one of the most frequent types of bacterial meningitis with the potential to cause large epidemics.

The health authorities have deployed an initial emergency team, and with the support of the World Health Organization (WHO), efforts are underway to quickly ramp up the response. A crisis response committee has been set up in Banalia, the community affected by the outbreak, as well as in Kisangani, the capital of Tshopo, to accelerate the outbreak control efforts. WHO has provided medical supplies in Banalia and plans to deploy more experts and resources...

[Shiloh]

Source: https://www.who.int/emergencies/dise...c-of-the-congo

Meningitis - Democratic Republic of the Congo

20 September 2021


In early July 2021, an alert of a suspected outbreak was raised to the Health Division of Tshopo Province in the north-eastern region of the Democratic Republic of the Congo (DRC). The initial alert followed an increase in deaths among people presenting with symptoms including fever, headache, and stiff neck, and some with bloody diarrhea. Samples of blood and stool were collected and tested for Ebola virus disease, shigellosis and salmonellosis. These tested negative on 19 August by the National Institute for Biomedical Research (INRB) lab in Kinshasa.

Meningitis was suspected and as of 16 September, a total of 37 samples of cerebrospinal fluid (CSF) were sent from the University Clinics Laboratory of Kisangani to INRB lab in Kinshasa. Of these, seven were sent to the Pasteur Institute in Paris on 1 September from Kinshasa, and were confirmed to be Neisseria meningitidis by reverse transcriptase polymerase chain reaction (RT-PCR) on 6 September. Additional testing (serotyping) was conducted on these samples from 6 to 13 September, which were identified as Serogroup W by Pasteur Institute Lab in Paris . The remaining 30 samples are planned to be sent to Pasteur Institute, Paris.

Antibiotic susceptibility testing showed that this strain of meningococcus was susceptible to Ceftriaxone. Preliminary retrospective investigations suggested that the outbreak started in early June in two mining areas in Banalia Health Zone in the north of Kisangani, the capital of Tshopo Province. This outbreak is currently active and cases continue to be reported.

As of 18 September 2021, a total of 608 suspected including 12 confirmed cases of meningitis, and 161 deaths (case fatality ratio of 26%), have been reported in the Banalia health zone. Among these cases, 68% (416/608) are aged 15 years or older. Additionally, 16 out of the 20 health areas of the Banalia health zone have notified at least one suspected case of meningitis.



Public health response

The national health authorities, in coordination with WHO, are providing support in responding to this event. The response measures include the following:

• The local committee for the management of health emergencies is conducting regular meetings to coordinate response activities at the provincial level as well as in the Banalia health zone;
• A reactive vaccination campaign against meningitis, with vaccine containing meningococcal W antigen, is being planned;
• Continuation of in-depth investigations at community level to determine the epidemiological links;
• Active search for contacts and suspected cases in the mining quarries and in the community;
• Strengthening of community-based surveillance;
• Organized mobile clinics to support case management, sample collection and Infection Prevention and Control (IPC) measures in the affected areas;
• Supplying additional 5000 doses of Ceftriaxone by the International Coordination Group (ICG) to reinforce the antibiotic stock ;
• Implementing risk communication activities.

WHO risk assessment

Since 2015, the Democratic Republic of the Congo has reported a high number of suspected cases of meningitis. Parts of the country lie within the African meningitis belt ^[1], where bacterial meningitis is endemic and also experiences epidemics, with 6000 to 10,000 suspected cases reported annually. However, only a very small proportion (0-2%) of cases are laboratory confirmed each year.
From 1 January to 1 August 2021, the DRC reported a cumulative total of 3,842 suspected cases including 189 deaths, representing a case-fatality ratio of 5%.
In Tshopo Province, which is in the African meningitis belt, the last meningitis epidemic was reported in November 2009, with 214 cases and 18 deaths (case-fatality ratio of 8%). In May 2016, the province organised a preventive vaccination campaign against meningitis A during which almost 1.7 million people aged between 1 and 29 years were vaccinated. Since then, passive surveillance has been implemented in the province as part of integrated disease surveillance.
Meningococcal meningitis is associated with a high case-fatality ratio (up to 50% when left untreated) and a high incidence (over 10%) of severe sequelae. The current event has already affected 608 people , with 161 deaths. The number of cases and deaths is expected to increase given the infectiousness and lethality of bacterial meningitis.
Logistical challenges, in addition to accessing and communicating with many areas within the health zone, further prevents implementation of an adequate response.
Additionally, the country is responding to the COVID-19 pandemic which is impacting the health systems and disease surveillance capacities; and the existence of other ongoing epidemics in the country is limiting resources for the response to the meningitis outbreak.
At the national level, there is a high risk of the disease spreading to other health zones and to the city of Kisangani, the capital of Tschopo province, due to the movement of people between the affected area and other parts of the country.
At the regional level, the risk is assessed to be moderate due to the cross-border movements between the populations of the Central African Republic and the Tshopo province, and more than 100 mining sites in Banalia where people from neighbouring provinces and the Central African Republic travel for work. Although cross-border measures against COVID-19 may limit the travel and also enhance detection of symptomatic cases.
The risk at global level is assessed to be low...

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 43: 18 - 24 October 2021
Data as reported by: 17:00; 24 October 2021
...

Meningitis Democratic Republic of the Congo
(Tshopo Province)

2 395 Cases
200 Death
8.4% CFR

EVENT DESCRIPTION

On 7 September 2021, the Democratic Republic of the Congo
declared a meningitis outbreak following laboratory confirmation by
the Pasteur Institute of Paris in France. Preliminary investigations
started after suspected cases and deaths of a meningococcal illness
were reported in two mining areas along the Aruwimi River known
as Carrière Wabelo and Intervention Rapide in the Panga health area
of Banalia health district located at north of Kisangani, the capital of
Tshopo province.

As of 23 October 2021, a total of 2 395 suspected meningitis
cases, including 14 confirmed and 200 deaths (case fatality ratio =
8.4%), have been reported in Banalia health district. Among these
cases, 32.0% (764/2 395) are aged between 15 - 45 years. The case
fatality ratio has decreased significantly from 100% at the onset
of the outbreak (week 20 ending 23 May 2021) to 8.4% at week
42 (ending 24 October 2021). This decrease would be a result of
intensified community sensitization for early health seeking behavior
by suspected cases and the improvement of case management
practices. Out of the suspected 2 395 cases, 313 (13.0%) reported
history of vaccination during the preventive vaccination campaign
against meningitis serotype A with MenAfriVac vaccine that took
place in the Tshopo province in May 2016.

There are currently 35 patients under medical care in five health
centers, while 70 patients are undergoing outpatient treatment in
Banalia health district. Psychosocial support has been provided to five
admitted patients and their relatives at the Banalia referral hospital.
Since the onset of the outbreak, 175 laboratory samples have been
collected for investigation from suspected cases, including 145
patients for cerebrospinal fluid (CSF) and blood samples, 11 patients
for CSF only, and 19 patients for blood only. A total of 67 CSF samples
were analyzed and results confirmed 14 positives: 13 for Neisseria
meningitidis serotype W (six samples by culture, seven samples
by real time polymerase chain reaction (RT-PCR)) and one for
Haemophilus influenza (by culture), giving a positivity rate of 21%.
The outbreak remains limited in the Banalia health district and all
the 20 health areas have notified at least one suspected case of
meningitis. A total of 16 health areas out of 20 (80%) are still active
and four health areas of Akuma, Alolo, Babise and Zambeke were in
alert by week 41 (ending 17 October 2021).

Reactive vaccination campaign started on 9 October 2021 and a
total of 153 052 people were vaccinated so far, giving a coverage of
104.1% of the targeted population in the entire Banalia health district.
This vaccination coverage is not uniform for all health areas of the
Banalia health district and ranges from 79.5% to 172.4%, due to the
fact that the vaccination campaign did not start at the same date in
all health areas.

PUBLIC HEALTH ACTIONS

A reactive vaccination campaign against meningitis, with vaccine
containing meningococcal W antigen, is ongoing.

The local committee for the management of health emergencies
is conducting regular meetings to coordinate response at the
province as well as in Banalia health zone.

Strengthening of community-based surveillance is underway.
Continuation of in-depth investigations at community level in the
affected health district of Banalia as well as in the other at-risk
neighbouring health districts including Bengamisa and Tshopo
health districts

Active search for contacts and suspected cases in the mining
quarries and in the community is ongoing.

Provincial rapid response teams have been deployed to conduct
investigations and organise mobile clinics to conduct case
management, sample collection and infection prevention and
control (IPC) measures in the affected areas.

Enhanced case management activities including supplying
of additional 5 000 doses of Ceftriaxone by the International
Coordination Group (ICG) to reinforce the antibiotic stock has
been done.

Implementation of risk communication activities is ongoing.

Laboratory capacities at the Tshopo province have been
enhanced with ability to perform RT-PCR testing

SITUATION INTERPRETATION

A meningitis outbreak is currently ongoing in the Democratic
Republic of the Congo. Efforts have been made to significantly
reduce the CFR through improved case management, but the delay
in confirming the outbreak affected the rapid implementation of
control measures. Difficult access to the affected areas remains one
of the major challenges for the management of this outbreak. An
improved coordination mechanism would greatly help the response
and could potentially lead to control as stakeholders pull resources
especially for surveillance and vaccination.
...

https://apps.who.int/iris/bitstream/handle/10665/347061/OEW43-1824102021.pdf

[Shiloh]

Source: http://www.xinhuanet.com/english/202...320047f/c.html

DR Congo declares end of meningitis outbreak in northeastern region
Source: Xinhua
Editor: huaxia
2021-12-24 03:13:40

KINSHASA, Dec. 23 (Xinhua) -- Democratic Republic of the Congo (DRC) declared Thursday the end of a meningitis outbreak in the territory of Banalia, in northeastern Tshopo province, according to Health Minister Jean-Jacques Mbungani.

Declared in early September of 2021, the meningitis outbreak has killed 205 out of a total of 2,662 notified cases, said the health minister.

"Considering that there has been no contamination for several weeks and the infection rate has fallen below the alert threshold for two consecutive weeks, I am happy to declare the end of the outbreak of meningitis in the Banalia health zone in the Tshopo Province," said Mbungani...

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