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Meningitis Outbreak Caused by Vaccine-Preventable Bacterial Pathogens - Northern Ghana, 2016
Abstract:
Bacterial meningitis is a severe, acute infection of the fluid surrounding the brain and spinal cord that can rapidly lead to death. Even with recommended antibiotic treatment, up to 25% of infected persons in Africa might experience neurologic sequelae (1). Three regions in northern Ghana (Upper East, Northern, and Upper West), located in the sub-Saharan "meningitis belt" that extends from Senegal to Ethiopia, experienced periodic outbreaks of meningitis before introduction of serogroup A meningococcal conjugate vaccine (MenAfriVac) in 2012 (2,3). During December 9, 2015-February 16, 2016, a total of 432 suspected meningitis cases were reported to health authorities in these three regions. The Ghana Ministry of Health, with assistance from CDC and other partners, tested cerebrospinal fluid (CSF) specimens from 286 patients. In the first 4 weeks of the outbreak, a high percentage of cases were caused by Streptococcus pneumoniae; followed by an increase in cases caused by Neisseria meningitidis, predominantly serogroup W. These data facilitated Ghana's request to the International Coordinating Group* for meningococcal polysaccharide ACW vaccine, which was delivered to persons in the most affected districts. Rapid identification of the etiologic agent causing meningitis outbreaks is critical to inform targeted public health and clinical interventions, including vaccination, clinical management, and contact precautions.
Insights
Rapid identification of bacterial meningitis pathogens is crucial. In Ghana, Streptococcus pneumoniae and Neisseria meningitidis (serogroup W) were identified, enabling targeted vaccine interventions.
Area of Science:
- Epidemiology
- Infectious Diseases
- Public Health
Background:
- Bacterial meningitis poses a severe health risk, particularly in Africa's "meningitis belt," with significant rates of neurologic sequelae.
- Northern Ghana experienced periodic meningitis outbreaks before the MenAfriVac vaccine introduction in 2012.
- A significant outbreak occurred in northern Ghana between December 2015 and February 2016.
Purpose of the Study:
- To rapidly identify the causative agents of a meningitis outbreak in northern Ghana.
- To inform timely public health and clinical interventions during the outbreak.
Main Methods:
- Cerebrospinal fluid (CSF) specimens were collected and tested from suspected meningitis cases.
- Case data was reported to health authorities, including the Ghana Ministry of Health and CDC.
- Etiologic agents were identified over the course of the outbreak.
Main Results:
- During the initial 4 weeks, Streptococcus pneumoniae was the predominant cause.
- Subsequently, Neisseria meningitidis, primarily serogroup W, became more prevalent.
- These findings supported Ghana's request for specific meningococcal vaccines.
Conclusions:
- Prompt identification of meningitis pathogens is critical for effective outbreak response.
- The outbreak involved a shift in causative agents, necessitating adaptable intervention strategies.
- Timely data facilitated the deployment of targeted vaccination campaigns.
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