Meningitis in Emergencies

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Meningitis in Emergencies
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Meningitis

• Causative agents of epidemic meningitis-
• Most commonly N. meningitidis- serogroup A
• B, C, W135 also possible
• Outbreaks occur throughout region
• Not just in humantarian emergencies

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Examples of Meningitis Outbreaks in Emergencies
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Surveillance

• Meningitis surveillance part of greater
  surveillance system
• Standard case definition for suspected, probable,
  and confirmed cases
• Capacity for diagnosis must be assured

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Epidemic Thresholds

• Populations gt30,000
• 15/100,000 per week
• 10/100,000 per week- high risk zones
• Populations lt30,000
• 5/100,000 per week OR
• Doubling of cases from one week to the next for 3
  consecutive weeks

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Case Management

• Main Goal- to prevent mortality
• Presumptive treatment
• Ceftriaxone / Chloramphenicol single dose IM
• Both cost effective and efficient

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Prevention

• 3 approaches
• Adequate vaccination in areas that are high risk
• Early detection and vaccines available in the
  field
• Surveillance with an emergency stock pile
  available

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Prevention

• Vaccines currently available for serogroups A, B,
  C W135
• Routine vaccination is not cost effective (as it
  does not effect herd immunity)
• if there is an impending outbreak, vaccination
  should be undertaken
• vaccination recommended for age group 24 months
  and above to prevent epidemics

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Meningitis in Morni Camp
Number of Cases
Week Beginning
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Meningitis in Morni Camp, West Darfur

• Population of Morni 72,000
• 29 cases (38 ) reported from one IDP camp
  Morni, West Darfur
• 3 deaths (75) CFR 10.3
• Laboratory confirmed Meningococcus A
• Vaccination of 2-30 year olds carried out with
  93 coverage

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Earthquake in Pakistan, October 8, 2005
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Survivors Ask Aid for Flu, PneumoniaContributed
by Admin    Views125                       
                                     MUZAFFARABAD,
Pakistan - Hundreds of survivors of Pakistan's
huge earthquake filled hospitals Thursday for
treatment of pneumonia and flu as temperatures
plunged below freezing with the arrival of the
brutal Himalayan winter.
Survivors Ask Aid for Flu, PneumoniaContributed
by Admin    Views125                       
                                     MUZAFFARABAD,
Pakistan - Hundreds of survivors of Pakistan's
huge earthquake filled hospitals Thursday for
treatment of pneumonia and flu as temperatures
plunged below freezing with the arrival of the
brutal Himalayan winter.
Thursday, December 01 2005 _at_ 0756 PM EST
Survivors Ask Aid for Flu, PneumoniaContributed
by Admin    Views125                       
                                     MUZAFFARABAD,
Pakistan - Hundreds of survivors of Pakistan's
huge earthquake filled hospitals Thursday for
treatment of pneumonia and flu as temperatures
plunged below freezing with the arrival of the
brutal Himalayan winter.
Thursday, December 01 2005 _at_ 0756 PM EST
Survivors Ask Aid for Flu, Pneumonia
MUZAFFARABAD, Pakistan - Hundreds of survivors of
Pakistan's huge earthquake filled hospitals
Thursday for treatment of pneumonia and flu as
temperatures plunged below freezing with the
arrival of the brutal Himalayan winter.
Source www.pakquake2005.com
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Case studyYou are an ARI expert at CDC. You
are asked your opinion of whether Hib vaccination
should be added to a measles vaccination campaign
for Pakistani children displaced by an
earthquake. Pakistan does not routinely immunize
against Hib.