Meningitis: Towards getting a lasting foothold on the scourge
It’s no longer news that there is a meningitis outbreak in Nigeria- an outbreak that started from the Northwest states. Sporadic cases far from the epicenter are being reported in Ekiti State in Southwest Nigeria, and Akwa Ibom state, in South-south Nigeria.The suspected cases were first reported late 2016 in Zamfara state Northwest Nigeria, the […]
It’s no longer news that there is a meningitis outbreak in Nigeria- an outbreak that started from the Northwest states. Sporadic cases far from the epicenter are being reported in Ekiti State in Southwest Nigeria, and Akwa Ibom state, in South-south Nigeria.The suspected cases were first reported late 2016 in Zamfara state Northwest Nigeria, the state worst hit by the epidemic- the state has reported over 250 deaths (more than half of the total deaths to this outbreak) to date.
By February 2017 cases of meningitis were been reported in states bordering Zamfara state such as Katsina, Sokoto, Kebbi all in Northwest Nigeria and Niger state in the North central. It is also no longer news that the present meningitis outbreak is caused by Neisseria meningitidis serogroup C, a strain rarely involved in epidemics in Nigeria. The strain widely implicated in epidemics in this region belongs to the serogroup A which is the main caused of meningitis in the African meningitic belt comprising of about 25 countries extending from Senegal on the Atlantic coast to Ethiopia in the East, Nigeria belongs to this belt.
The meningococci, as the bacterium is also called, are inhabitants of the nasopharynx (the nasal cavity) in about 5-15% of the population. Some of these are entirely harmless. However when harmful strains colonize the nasal cavity of host that lacks the protective antibodies against the strain this leads to invasive disease. Meningococci infections are more frequent during the warm season. Transmission is by infected droplets (moist aerosols) emanating from humans that serve as reservoir, therefore the bacterial transmission requires close quartered individuals in a poorly ventilated environment that may be found in camps, some homes, schools, crowded environment, etc.
CSM is among the vaccine preventable diseases (VPD). That we have loss about 400 souls in these modern times due to a VPD is a sad reminder of how much need to be done to bring Nigeria to a developed country. It is heartening to note the reactive response of the government towards curtailing the spread of the infection. Reports have it that 500,000 doses of vaccine against N.meningitidis serogroup C have been imported from India and Britain. Yes this is a stop gap measure and may be successful in curtailing the spread of the germ and resulting death in the short run. But what happens in the long run? Even in ideal situations vaccine developed against a particular strain has recorded failures and vaccine deployment is required to cover a certain percentage of the population to be effective.
This write-up is a call to action, to do the right thing, the needful to prevent future occurrences, instead of spiritualizing the ugly incidence. A new strain causing outbreak can only come from existing strains or introduced from elsewhere. It is also important to look at host impact that may have influenced the outbreak by the new strain. All these will require some intensive scientific research, especially at the molecular level, that will keep us ahead of the evolving population of the causal organism.
Uzal Umar, Department of Microbiology, Abubakar Tafawa Balewa University, Bauchi