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Epidemic group C meningococcal meningitis in Upper Volta, 1979
Abstract:
Group C meningococci were isolated during an epidemic of meningococcal meningitis which occurred between January and May 1979 in eastern Upper Volta, an area previously associated with endemic and epidemic group A disease. A total of 539 cases of meningitis, 55 of which were fatal, were reported, giving an attack rate of 517 cases per 100 000 inhabitants. Attack rates were higher for children under 15 years of age. Clinical and bacteriological data suggested that the group C meningococci were sulfonamide-resistant. The last meningococcal epidemic in Upper Volta occurred in 1970 and was nationwide. Epidemic cycles of group A meningococcal meningitis have occurred at 10-15 year intervals in the sub-Saharan region, raising concern that the current increase in activity may presage more wide-spread disease in the next dry season.
Insights
An epidemic of group C meningococcal meningitis occurred in Upper Volta in 1979, with higher attack rates in children. The causative bacteria were sulfonamide-resistant, raising concerns for future outbreaks.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Background:
- Group A meningococcal meningitis has historically caused epidemics in Upper Volta (now Burkina Faso) at 10-15 year intervals.
- Previous meningococcal meningitis outbreaks in the region were primarily caused by group A strains.
- Eastern Upper Volta had been associated with endemic and epidemic group A disease prior to 1979.
Purpose of the Study:
- To document and characterize a meningococcal meningitis epidemic caused by group C meningococci in Upper Volta.
- To assess the clinical and epidemiological features of this outbreak.
- To identify the antimicrobial susceptibility of the isolated group C meningococci.
Main Methods:
- Retrospective analysis of reported meningitis cases between January and May 1979.
- Isolation and identification of Neisseria meningitidis serogroup C from cerebrospinal fluid samples.
- Clinical data collection including case numbers, fatalities, and age distribution.
- Sulfonamide resistance testing of isolated bacterial strains.
Main Results:
- A total of 539 cases of meningitis were reported, resulting in 55 deaths.
- The attack rate was 517 cases per 100,000 inhabitants, with higher rates in individuals under 15 years.
- Clinical and bacteriological findings indicated sulfonamide resistance in the group C meningococci.
- This marked a shift from previous group A dominated meningococcal disease in the region.
Conclusions:
- The 1979 epidemic in Upper Volta was caused by sulfonamide-resistant group C meningococci.
- The outbreak highlights the potential for emergence of different serogroups during meningococcal meningitis epidemics.
- The findings raise concerns about the potential for wider spread of meningococcal disease in the upcoming dry season, necessitating enhanced surveillance and preparedness.