Response to the meningococcal meningitis epidemic (MME) at Aminu Kano Teaching Hospital, Kano (2008-2009)

In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from...

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Published inNigerian journal of medicine Vol. 18; no. 4; p. 428
Main Authors Iliyasu, G, Lawal, H, Habib, A G, Hassan-Hanga, F, Abubakar, I S, Bashir, U, Tanko-Yakasai, U, Abubakar, S, Abba, M S, Rano, I S, Abdu, H, Musa, B, Gwarzo, G D
Format Journal Article
LanguageEnglish
Published Nigeria 01.10.2009
Subjects
Adolescent
Adult
Aged
Child
Child, Preschool
Cross Infection - epidemiology
Cross Infection - prevention & control
Disease Outbreaks
Female
Hospitals, Teaching
Humans
Infant
Infant, Newborn
Male
Meningitis, Meningococcal - epidemiology
Meningitis, Meningococcal - prevention & control
Middle Aged
Nigeria - epidemiology
Nigeria
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Summary:In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from 5 January 2009 to 15 May 2009, AKTH managed 222 cases of suspected meningitis with 14 deaths (case fatality rate [CFR] of 6.3%). Twenty three per cent (23%) were microbiologically proven as meningococcal meningitis while 9% were confirmed to be pneumococcal meningitis. Male to female ratio was 1:1 with most patients (81%) aged below 14 years. The epidemic peaked in weeks 10 and 13 with 38 admissions in the respective weeks. Meningococcemia with purpura fulminans, post meningitic immune complex cutaneous vasculitis and polyarthritis were observed. Control measures instituted included provision of free ceftriaxone, chemoprophylaxis to contacts, vaccines to staff/families, and creation of dedicated isolation wards. Clinical management guidelines were developed and hospital staffs were also enlightened. Lessons learnt included the difficulty of discriminating between nosocomial transmission and community clusters; relative increase in pneumococcal meningitis during the epidemic; unreliability of penicillin/chloramphenicol; the utility of internet for communication; and the inadequacy of vaccines to meet staff & public demand.
ISSN:1115-2613