‫بسم هللا الرحمن الرحيم‬

Prevention & Control of

Meningitis
UNIVERSITY OF SINNAR
FACULTY OF MEDICINE & MEDICAL
SCIENCE
DR. ELSADIG ADAM MOHAMED
January 2021
• Meningococcal meningitis is a bacterial form
of meningitis, a serious infection of the
meninges that affects the brain membrane.
• It can cause severe brain damage and is
fatal in 50% of cases if untreated.

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• Even with early treatment 5 -10% of the
patients die within the first 24 - 48 hours
since the onset of symptoms.
• While others can survive but be deaf or
develop epilepsy or other cognitive issues.

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• Several different bacteria can cause meningitis.
• Three common:
Haemophilus influenza type b (Hib)

Neisseria meningitidis
Causes Meningococcal Meningitis
Streptococcus pneumoniae
Causes Pneumococcal Meningitis
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• Neisseria meningitidis is the one with the
potential to cause large epidemics.
• There are 12 sero-groups of N. meningitidis
that have been identified, 6 of which (A, B, C,
W, X and Y) can cause epidemics.
• Geographic distribution and epidemic
potential differ according to sero-group.
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 Neisseria meningitides

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• Before 2010 and the mass preventive
immunization campaigns, Group A
meningococcus accounted for an estimated 80–
85% of all cases in the meningitis belt, with
epidemics occurring at intervals of 7–14 years.
• Since then, the proportion of the A sero-group
has declined dramatically.

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 Transmission

• The bacteria are transmitted from person-to-person through

droplets of respiratory or throat secretions from carriers.

• Close and prolonged contact – such as kissing, sneezing or

coughing on someone, or living in close quarters with an
infected person (a carrier) – facilitates the spread of the
disease.

• The average incubation period is 4 days, but can range

between 2 and 10 days.

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• Neisseria meningitides only infects humans;
there is no animal reservoir.

• The bacteria can be carried in the throat

and sometimes, for reasons not fully
understood, can overwhelm the body's
defenses allowing infection to spread
through the bloodstream to the brain.
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• It is believed that 10% to 20% of the
population carries Neisseria meningitides in
their throat at any given time.
• However, the carriage rate may be higher in
epidemic situations.

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 Outbreak trends

• Meningococcal meningitis occurs in small

clusters throughout the world with
seasonal variation and accounts for a
variable proportion of epidemic bacterial
meningitis.

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• The largest burden of meningococcal disease
occurs in an area of sub-Saharan Africa
known as the meningitis belt, which
stretches from Senegal in the west to
Ethiopia in the east.
• (26 countries), has the highest rates of the
disease.
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• The 26 countries include: Benin, Burkina Faso,
Burundi, Cameroon, Central African Republic,
Chad, Côte d’Ivoire, Democratic Republic of
Congo, Eritrea, Ethiopia, The Gambia, Ghana,
Guinea, Guinea Bissau, Kenya, Mali, Mauritania,
Niger, Nigeria, Rwanda, Senegal, South Sudan,
Sudan, Tanzania, Togo and Uganda.
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• The risk of meningococcal meningitis
epidemics differs within and among these
26 countries.

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• During the dry season between December
to June, dust winds, cold nights and upper
respiratory tract infections combine to
damage the nasopharyngeal mucosa,
increasing the risk of meningococcal
disease.

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• At the same time, transmission of N.
meningitides may be facilitated by overcrowded
housing and by large population displacements
at the regional level due to pilgrimages and
traditional markets. This combination of factors
explains the large epidemics which occur
during the dry season in the meningitis belt.

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 Prevention

• WHO promotes a strategy comprising

epidemic preparedness, prevention and
response.
• Preparedness focuses on surveillance,
from case detection to investigation and
laboratory confirmation.

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• Prevention consists of vaccinating all 1-29
year-olds in the African meningitis belt with the
MenA conjugate vaccine.

• It is planned that all 26 African countries

considered at risk for meningitis epidemics and

targeted by this vaccine introduction programme

will have introduced this vaccine by 2016.

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 Chemoprophylaxis of Close Contacts

• Household members, daycare center classmates,

and teachers.
• Anyone directly exposed to oral secretions

• Rifampicin 600mg b.d for 2 days.

• Ciprofloxacin 500mg once.

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• Epidemic response consists of prompt
and appropriate case management with
reactive mass vaccination of populations not
already protected through vaccination.

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 THANK YOU

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