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[THE AFRICAN MENINGITIS BELT] Episodes of meningitis occur around the world and tend to increase in the winter and spring. The area of the world most significantly affected by meningitis epidemics is the semi-arid area of sub-Saharan Africa. Known as the African “meningitis belt”, this area extends from Senegal to Ethiopia and has a population of approximately 300 million people. Usually, outbreaks in the meningitis belt are identified as Neisseria meningitides serogroup A. A recent global outbreak in 2000, however, was associated with N. meningities W135. To date, existing vaccines are only partially effective; current vaccines do not produce long-lasting protections, do not protect very young children, and do no decrease transmission of the organism in the population. _______________________________________ [GLOBAL INITIATIVES] 1) International Coordination Group (ICG) on Vaccine Provision for Epidemic Meningitis Control: In 1997, The World Health Organization (WHO) and member countries developed a meningococcal disease preparedness and control initiative for Africa and the Eastern Mediterranean. This initiative strives to strengthen national and regional health systems is the following ways: - Improve epidemiological surveillance fore early detection of outbreaks as well as laboratory capacity for the diagnosis of disease. -Establishing a contingency stock of vaccine, drugs, and injection materials. -Generating guidelines for using the vaccine. -Creating a system to coordinate the response to an epidemic. Since its inception, 9.6 million doses of meningococcal have been disseminated by ICG mechanisms and 20 million doses have been provided by sub-group members. 2) WHO-Multi Disease Surveillance Center Ouagagougou, Regional Meningitis Surveillance: Developed in 2001, this center conducts field surveillance in 9 countries in the meningitis belt. Based in Burkina Faso, a regional team collects, integrates, and analyzes epidemiological and laboratory information and published weekly epidemiological reports. 3) Meningitis Vaccine Project: This partnership between the WHO and the Program for Appropriate Technology in Health (PATH) was established in 2001. Funded by the Bill and Melinda Gates Foundation, the goal of this initiative is to eliminate epidemic meningitis in sub- Saharan Africa by introducing a conjugated meningococcal vaccine to the region. 4) Paediatric Bacterial Meningitis (PBM) Surveillance Network- WHO/AFRO: This network assists WHO member countries in Africa to establish accurate surveillance of cases in meningitis in children. Meningitis caused by Haemophilus influenza type B (Hib), Streptococcus pneumoniae, and Neisseria meningitides are the particular focus of this initiative. _______________________________________ [TRAVEL ADVICE] Activities that increase risk of exposure to meningitis are: -travel in areas of high meningitis prevalence -prolonged duration of exposure -close contact with the local population though accommodations or public transport -health care work and work with refugees Note: The monovalent vaccine will not provide protection against the serogroups of meningitis that travelers may encounter. The quadrivalent vaccine is recommended for travelers. A few resources for travelers:  For more information on the meningitis and the meningicoccal vaccine, refer to the Canadian Immunization Guide, 6th edition (2002) by the National Advisory Committee on Immunization (NACI) at: http://www.phac-aspc.gc.ca/publicat/cig-gci/pdf/ cdn_immuniz_guide-2002-6.pdf  For more information on meningitis worldwide, visit the World Health Organization (WHO) at: http://www.who.int/topics/meningitis/en/.  For International Reports of Meningitis activity, visit the Travel Medicine Program's page at: http://www.phac-aspc.gc.ca/tmp-pmv/men_e.html.  For travel medicine professionals, refer to the CATMAT Travel Medicine Statement on Meningococcal Vaccination for Travellers at http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/99vol25/25sup/acs5.html.  For more Know before you go! information, visit the Travel Medicine Program's page at: http://www.phac-aspc.gc.ca/tmp-pmv/travel/advice_e.html _______________________________________

[THE AFRICAN MENINGITIS BELT]

Episodes of meningitis occur around the world and tend to increase in the winter and spring. The area of the world most significantly affected by meningitis epidemics is the semi-arid area of sub-Saharan Africa. Known as the African “meningitis belt”, this area extends from Senegal to Ethiopia and has a population of approximately 300 million people.

Usually, outbreaks in the meningitis belt are identified as Neisseria meningitides serogroup A. A recent global outbreak in 2000, however, was associated

with N. meningities W135.

To date, existing vaccines are only partially effective; current vaccines do not produce long-lasting protections, do not protect very young children, and do no decrease transmission of the organism in the population.

_______________________________________

[GLOBAL INITIATIVES]

1) International Coordination Group (ICG) on Vaccine Provision for Epidemic Meningitis Control:
In 1997, The World Health Organization (WHO) and member countries developed a meningococcal disease preparedness and control initiative for Africa and the Eastern Mediterranean. This initiative strives to strengthen national and regional health systems is the following ways:
- Improve epidemiological surveillance fore early detection of outbreaks as well as laboratory capacity for the diagnosis of disease.
-Establishing a contingency stock of vaccine, drugs, and injection materials.
-Generating guidelines for using the vaccine.
-Creating a system to coordinate the response to an epidemic.

Since its inception, 9.6 million doses of meningococcal have been disseminated by ICG mechanisms and 20 million doses have been provided by sub-group members.

2) WHO-Multi Disease Surveillance Center Ouagagougou, Regional Meningitis Surveillance:
Developed in 2001, this center conducts field surveillance in 9 countries in the meningitis belt. Based in Burkina Faso, a regional team collects, integrates, and analyzes epidemiological and laboratory information and published weekly epidemiological reports.

3) Meningitis Vaccine Project:
This partnership between the WHO and the Program for Appropriate Technology in Health (PATH) was established in 2001. Funded by the Bill and Melinda Gates Foundation, the goal of this initiative is to eliminate epidemic meningitis in sub- Saharan Africa by introducing a conjugated meningococcal vaccine to the region.

4) Paediatric Bacterial Meningitis (PBM) Surveillance Network- WHO/AFRO:
This network assists WHO member countries in Africa to establish accurate surveillance of cases in meningitis in children. Meningitis caused by Haemophilus influenza type B (Hib), Streptococcus pneumoniae, and Neisseria meningitides are the particular focus of this initiative.

Activities that increase risk of exposure to meningitis are:
-travel in areas of high meningitis prevalence
-prolonged duration of exposure
-close contact with the local population though accommodations or public transport
-health care work and work with refugees

Note: The monovalent vaccine will not provide protection against the serogroups of meningitis that travelers may encounter. The quadrivalent vaccine is recommended for travelers.

A few resources for travelers:
 For more information on the meningitis and the meningicoccal vaccine, refer to the Canadian Immunization Guide, 6th edition (2002) by the National Advisory Committee on Immunization (NACI) at: http://www.phac-aspc.gc.ca/publicat/cig-gci/pdf/
cdn_immuniz_guide-2002-6.pdf

 For more information on meningitis worldwide, visit the World Health Organization (WHO) at: http://www.who.int/topics/meningitis/en/.

 For International Reports of Meningitis activity, visit the Travel Medicine Program's page at: http://www.phac-aspc.gc.ca/tmp-pmv/men_e.html.

 For travel medicine professionals, refer to the CATMAT Travel Medicine Statement on Meningococcal Vaccination for Travellers at http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/99vol25/25sup/acs5.html.

 For more Know before you go! information, visit the Travel Medicine Program's page at: http://www.phac-aspc.gc.ca/tmp-pmv/travel/advice_e.html