Pathfinder
Editor, Senior Moderator
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/handle/10665/330398/OEW02-0612012020.pdf
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/handle/10665/330398/OEW02-0612012020.pdf