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[Chronical of a declared meningococcal meningitis epidemic (Goma, Zaire, August 1994)]
1centrale du service de santé des armées, France.
Abstract:
The authors relate their experience controlling an epidemic of meningitis which broke out in the refugee camps of the Goma region, in northern Zaire, after the dramatic events which had happened in Rwanda in April and June 1994. Out of the 348 cases of purulent meningitis diagnosed by the Bioforce team, meningococcal etiology was confirmed 327 times. The isolated meningococci were all of the serogroup A, serotype A; 4; P 1,9. They were resistant to streptomycin and to sulphamides. The epidemic lasted one month, touched people of all ages and spread progressively to all the camps. The epidemic surveillance set up meant that vaccination was carried out very quickly and the epidemic brought rapidly under control, even if other factors did intervene. All those called upon to intervene in such a context should be made aware of the interest of the basic triad to fight these epidemics: rapid vaccination, treatment of cases with oily chloramphenicol and bio-epidemiological surveillance.
Insights
Rapid vaccination, case treatment, and surveillance quickly controlled a meningitis epidemic in Goma refugee camps. This strategy, involving meningococcal serogroup A, proved effective against resistant strains.
Area of Science:
- Epidemiology
- Infectious Diseases
- Microbiology
Context:
- Meningitis outbreak in Goma refugee camps, northern Zaire, following Rwandan events in 1994.
- Overcrowded camp conditions likely facilitated rapid disease transmission.
Purpose:
- To describe the experience of controlling a purulent meningitis epidemic.
- To highlight the effectiveness of a combined intervention strategy.
Summary:
- 348 cases of purulent meningitis diagnosed; 327 confirmed as meningococcal etiology.
- Isolated meningococci identified as serogroup A, serotype A; 4; P 1,9, exhibiting resistance to streptomycin and sulphamides.
- Epidemic lasted one month, affecting all ages and spreading across camps.
Impact:
- Rapid vaccination and bio-epidemiological surveillance were key to controlling the epidemic.
- Effective management relied on the triad of rapid vaccination, case treatment with oily chloramphenicol, and surveillance.
- Awareness of this triad is crucial for future interventions in similar crisis contexts.