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Journal of Traditional Medicine & Clinical Naturopathy
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Summary of Meningitis Outbreaks across the World from 1905 to 2016

Souleymane Coulibaly*

Epidemiologist, National Institute of Public Health Research, Italy

*Corresponding Author:
Souleymane Coulibaly
Epidemiologist
National Institute of Public Health Research, Italy
Tel: (+223) 76266991
E-mail: [email protected]

Received Date: August 16, 2017; Accepted Date: August 28, 2017; Published Date: August 30, 2017

Citation: Coulibaly S (2017) Summary of Meningitis Outbreaks across the World from 1905 to 2016. J Tradit Med Clin Natur 6:237.

Copyright: © 2017 Coulibaly S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Introduction

The review of the literature of meningitis outbreaks recorded throughout the world shows us that meningitis is present on all 5 continents. Meningococcal meningitis is a global public health problem. Its incidence is variable: low in Europe and North America (1 case for 100,000), but high in Africa (800 to 1000 cases per 100,000) during epidemic outbreaks [1]. The history of meningitis dates back to 1805 in Geneva, then to the nineteenth century through Europe and North America, reaching Africa in 1840. Since then, the African continent remains the most affected by epidemics of bacterial meningitis. It is probably by the military garrisons from Europe that the bacteria have arrived on the African continent [2]. French troops based in Algeria experienced two major outbreaks in 1840 and 1847, as British troops in Egypt in 1889 and in Sudan in 1899 [3]. The first widespread manifestations of East-West from 1905 (Sudan), 1906 (Ghana), from 1914 (Sudan), 1919 (Ghana), affecting Nigeria and Niger. The progression is towards the north, then to the west Kordofan is reached in 1934, Darfur in 1936, Chad in 1936, as many cases of meningitis on both sides of the (theoretical) border in 1936, Then it was the turn of Upper Volta and Ghana in 1939, Mali in 1940 and Dakar in 1941 [4]. Epidemics occur almost as annually, according to the WHO definition of an epidemic year. A cumulative incidence greater than 100 cases per 100,000 populations, nationally [5]. The chronology outbreaks of bacterial meningitis having occurred in the world in general and in particular in the African meningitis belt from 1905 to 2016 are summarized in Table 1 [4,6-10]. Between 1995 and 1997, epidemics were the most important epidemics that Africa has ever experienced: more than 250,000 cases have been reported. Due to meningococcal A ST-5 of clone complex 5 (cc5), they start in 1995 in Niger (26,738 cases). In 1996, an epidemic peak of exceptional amplitude, with more than 150,000 reported cases, affected Burkina Faso (42,129 cases), Mali (7,244 cases), Niger (16,050 cases) and Nigeria (75,069 cases). This epidemic will continue in 1997, Burkina Faso (21,504 cases) and Mali (10,960 cases), followed by Ghana (18,551 cases), Togo (2,845 cases) and The Gambia 913 cases), while in Niger the number of cases is clearly decreased (3,922 cases). Year after year, all countries in the belt will be affected by A meningococci belonging to this clone [4]. The bacteria involved in meningococcal meningitis are Neisseria meningitidis. It is recognized as the most responsible bacterium for meningitis epidemics in Africa. There are 13 serogroups of Neisseria meningitidis and most invasive infections are due to 6 serogroups: A, B, C, X, Y and W135. Serogroup A was considered until 2010 to be hyperendemic in the meningitis belt. It is now sharply reduced by the introduction of conjugate vaccine A [11]. Serogroup W135 is present in all countries in the meningitis belt and has been on the increase since vaccination against serogroup A [12]. Serougroup X was mainly responsible for the epidemics in Niger, Kenya and Uganda [13]. In 2015, an epidemic of serogroup C meningitis is observed in Niger and other countries in the meningitis belt [6].

Year Country
1905 Sudan
1906 Sudan, Ghana
1907 Sudan
1914 Sudan
1919 Ghana,
1921 High-Volta (Burkina Faso), Niger, Nigeria
1924-1931 Sudan
1932 Sudan, Chad
1933 Sudan
1934 Sudan
1935 Sudan, Chad
1936 Chad, Sudan
1937 Nigeria, Niger, High- Volta, Chad, Sudan
1938 Nigeria, Niger, High- Volta, Chad, Soudan
1939 Ghana, Nigeria, Niger, High-Volta, Chad, Sudan
1940 Algeria, Mali, Nigeria, Niger, High-Volta, Chad, Sudan
1941 Mali, Nigeria, Niger,  High-Volta, Chad, Senegal, Sudan
1942-1949 Nigeria, Niger, High-Volta, Chad, Sudan
1950 North America, Europe, Ghana, High -Volta,  Niger, Nigeria, Chad, Sudan
1951-1957 Nigeria, Niger, High-Volta, Chad, Sudan
1958 Brasil, Nigeria, Niger, High-Volta, Chad, Sudan
1959 France, Nigeria, Niger, High-Volta, Chad, Sudan, Zaire
1960-1962 Nigeria, Niger, High-Volta, Chad, Sudan
1965 Senegal
1968 Chad
1969 Senegal
1970 Norveg, Espagne, Italy, Portugal, Yougoslavie, Belgium, Senegal
1971 Brasil, Espagne, Italy, Portugal, Yougoslavie, Belgium, Senegal, Ivory Coast, Egypt, Chad
1972 Brasil, Senegal, Zaire
1973 France, Finland, Mongoly, Senegal
1974 Argentina, Brasil, Finlande, Mongoly, Royaume-Uni, Senegal
1975 Mongoly, Nigeria, Norvege, Royaume-Uni, Russia, Senegal, Ivory Coast, Egypt
1976 Islande, Senegal
1977 Vietnam, Nigeria, Senegal
1978 Algeria, France, Rwanda, Norvege, Iles Feroe, Senegal
1979 Algeria, Burkina Faso, Chili, Mali, Senegal
1980 Cuba, India, MongolY,  Nepal, Russia
1981 Iles Feroe
1982 New Delhi, Cuba
1983 Nepal, Ivoiry Coast
1984 Cuba, Nepal
1985 Burkina Faso, Ivory Coast, Mali, New Delhi, Niger, Nigeria, Tanzania
1986 Afghanistan, Saudi Arabia, Chili, Djibouti, Egypt, Emirats, France, Iran, Iraq, Jordania, Maroc, Pakistan, Syria, Sudan, Tunisia, Yemen
1987 Afghanistan, Saudi Arabia, Djibouti, Egypte, Emirats, France, Iran, Iraq, Jordania, Koweït, Maroc, Oman,  Pakistan, Syria, Soudan, Tunisia
1988 Afghanistan, Algeria, Saudi Arabia, Egypt, Emirats, Iran, Iraq, Jordania, Maroc, Pakistan, Syria, Sudan, Chad, Tunisia, Yemen, Ethiopia
1989 Afghanistan, Saudi Arabia, Brasil, Egypt, Iran, Iraq, Jordania, Maroc, Pakistan, Syria, Sudan, Tunisia, Yemen, Kenya, Uganda, Burundi
1990  Saudi Arabia,  Egypt,  Iran, Pakistan, Syria, Sudan, Tunisia
1991  Egypt, Iran, Iraq, Maroc, Pakistan, Syria, Sudan, Tunisia
1992  Burundi, Egypt, Iran, Iraq, Maroc, Niger, Pakistan, Syria, Sudan, Tunisia, Yemen
1993  Algeria, Chili, Egypt, Iran, Iraq, Maroc,  Syria, Sudan, Tunisia, Yemen
1994  Egypt, Iran, Iraq, Maroc, Syria, Sudan, Tunisia, USA
1995  Cameroun, Egypt, Ghana, Iran, Iraq, Maroc, Niger,   Pakistan, Syria, Sudan, Chad, Tunisia
1996  Burkina Faso, Cameroun, Ghana, Mali, Niger, Nigeria, Iran, Iraq, Sudan, Chad
1997 Burkina Faso,  Mali
1998 Algeria, Burkina Faso, Mali, Niger, Chad
1999 Burkina Faso, Cameroun,  Kenya, Ethiopia, Niger, Sudan, Chad
2000 Saudi Arabia, French,  Niger, Nigeria,  Chad
2001 Burkina Faso, Saudi Arabia, Niger,  Chad, RDC
2002 Burkina Faso, Benin,  Niger, Nigeria, Senegal, Chad, RDC
2003 Burkina Faso, Benin, Centrafrique, Ghana, Niger, Nigeria, Mali, Ethiopia, Tchad
2004 Burkina Faso; Central African, Ethiopia, Ghana, Kenya, Niger, Nigeria, Uganda, Cameroun, Chad
2005 Burkina Faso, Benin, Cameroun, Kenya, Uganda, Mali, Niger, Sudan, Chad, Togo,  Ivory Coast, Eritrea, Ethiopia
2006  Burkina Faso, Benin,  Ivory Coast, French, Guinea, Kenya, Mali, Niger, Nigeria, Sudan, Uganda, Chad, Togo
2007 Burkina Faso,  Benin, Cameroun, Central African, Kenya, Ghana,  Uganda, Niger, Nigeria,  Sudan, Chad, Togo,  Ivory Coast, Ghana, Guinea, Mali, Uganda, RDC
2008 Burkina Faso,  Benin, Central African, Ivory Coast, Guinea, Mali, Niger, Nigeria, Uganda, RDC, Chad, Togo
2009 Cameroun, Burkina Faso, Benin, Central African, Ivory Coast, Ethiopia, Ghana, Mali, Niger, Nigeria, Chad, Togo, RDC
2010 Burkina Faso, Benin, Central African, Ivory Coast, Cameroun, Ghana, Mali, Niger, Nigeria, Chad, Togo, RDC
2011 Burkina Faso, Benin, Cameroun, Ethiopia, Ghana, Guinea, Mali, Niger Nigeria, Chad, Togo, RDC
2012 Burkina Faso
2015 Niger
2016 Burkina Faso, Ghana, Mali, Niger, Togo, RDC

Table 1: Epidemics of meningitis in the world from 1905 to 2016 [4,6-10].

The evolution of meningococcal serogroups through the epidemics recorded from 1950 to 2016 is summarized in Table 2 [4,6-10,13]. These data show that meningitis occurs almost everywhere in the world, but to varying degrees depending on the climate and period.

Year Country Serogroup Year Country Serogroup
Neisseria meningitidis A Neisseria meningitidis B
1950 North America, Europe A 1970 Norvege B
1974 Brasil, Finland A 1982-84 Cuba B
1978 Rwanda A 1986 Chili B
1983-84 Nepal A 1993 Chili B
1987 Saudi Arabia A 1989 Brasil B
1988-89 Ethiopia, Sudan A 1994 USA B
1989-92 Burundi, Kenya, Uganda A 1975-78 Norvege B
1995-97 Burkina Faso, Mali, Niger, Nigeria, Tanzania A 1976 Island B
1982-84 New Delhi A 1978-81 Iles Feroe B
1980 India, Nepal A 1986 Chili B
1985 New Delhi A 1980-84 Cuba B
1972-74 Brasil A 1988 Algeria, Brasil B
1977-78 Vietnam A 1993 Chili B
1975 North Nigeria A 2000 France B
1979 Burkina Faso, Mali A Neisseria  meningitidis C
1973-74 Finland A 1970 Nigeria, Niger C
1974 Brasil A 1985 France C
1973-74 Mongoly A 1972-74 Brasil C
1983 Nepal A 1977-78 Vietnam C
1977 Nigeria A 1975 North Nigeria C
1978 Algeria, Rwanda A 1979 Burkina Faso C
1983 Ivory coast A 1979 Mali C
1985 Ivory coast A 1975 Nigeria C
1987 Saudi Arabia A 1979 Burkina Faso C
1988 Algeria, Ethiopia, Chad, Sudan A 1979 Mali C
1989 Ethiopia, Kenya, Sudan, Uganda A 1992 Niger C
1992 Burundi, Kenya, Uganda A 1971-72 Brasil C
1995 Niger A 1977 Vietnam C
1996 Burkina Faso, Mali, Niger, Nigeria A 1979 Algeria, Burkina Faso, Mali C
1997 Burkina Faso, Mali A 2011 Ghana C
1998 Burkina Faso, Mali A 2002 France C
1999 Burkina Faso A 2015 Niger C
2000 Saudi Arabia A 2016 Mali C
2001 Burkina Faso A Neisseria meningitidis W135
2003 Burkina Faso, Benin, Ghana, Niger A France, Royaume-Uni, W135
2004 Burkina Faso, Central African, Ethiopia, Ghana, Mali, Niger A 2000 Saudi Arabia
2005 Burkina Faso, Niger A 2001 Saudi Arabia W135
2006 Burkina Faso, Guinea, Mali, Nigeria, Chad A 2002 Burkina Faso, Niger W135
2007 Burkina Faso, Benin, Niger , Nigeria, Togo A 2003 Burkina Faso, Niger W135
2008 Benin, Burkina Faso, Central African, Ivory coast, Guinea, Mali, Niger A 2004 Niger W135
2009 Burkina Faso, Niger, Nigeria, Chad A 2005 Niger W135
2010 Burkina Faso, Niger, Nigeria, Chad A 2006 Niger W135
2011 Cameroun, Nigeria, Chad A 2007 Togo W135
2014 Guinea A 2009 Niger, Chad W135
2015 Guinea A 2010 Ghana, Niger, Nigeria, Chad W135
Neisseria meningitidis X 2011
2004 Niger X 2015 Togo W135
2006 Niger X 2016 Togo W135
2008 Niger, Togo X
2009 Ghana X
2010 Burkina Faso X
2011 Burkina Faso, Niger X

Table 2: Meningococcal serogroups circulating around the world from 1950 to 2016 [4,6-10,13].

The American, Asian, European and Oceanic continents are less affected compared to the African continent [2,14,15]. In Africa, this is the so-called “African meningitis belt” where the majority of cases of meningitis are recorded. It extends from Senegal to Ethiopia and covers 26 countries [16]. Meningitis is one of the pathologies that have caused human suffering for centuries [14,15]. Since 1905, meningitis has become a public health problem in the world, especially epidemics of meningococcal meningitis A (Neisseria meningitidis A) until the introduction of conjugate vaccine A “MenAfriVac” in 2010 in the African meningitis belt [2,17]. In 1970 there was the appearance of new strains: The first was Neisseria meningitidis B in some countries of America, Europe, Asia and an African country, namely Algeria [2,14,15]; Second was the Neisseria meningitidis C in Africa, America, Asia and Europe [2,14]. It has been the cause of the recent epidemic in Niger [17,18]. The NmW135 appeared in 2000 in France, the United Kingdom and Saudi Arabia. Africa in turn was affected in 2002 through Burkina Faso during the return of the pilgrims [4,8,17]. NmX was detected in 2006 in Niger [9], in 2008 in Togo, in 2009 in Ghana, in 2010 in Burkina Faso, in 2014 in Mali [4,8,17]. Since 2010, the gradual introduction of “MenAfriVac” into the epidemic-prone areas of the 26 countries of the African meningitis belt has led to a dramatic decline in the number of cases of NmA meningitis and the elimination of NmA epidemics. At the same time, the relative proportion of cases due to other serogroups (W, X and C) and Streptococcus pneumoniae (Spn) increased [17,19]. Our results have been confirmed by other studies in Africa and around the world. The study of Guindo in 2013 in Mali [20], Kenza in 2010 in Morocco [21], Isabelle in 2012 in France [22] and that of Jessica in 2015 in the United States [23].

Conclusion

These results show the dynamics of the epidemiological monitoring in Mali in all its components with a major observation, the reduction of epidemics on a large scale substituted by sporadic or endemic forms at the pediatric level. The introduction of A-conjugate vaccine could be an alternative to Mali because NmA has almost disappeared but replaced by other serogroups including NmW135, NmC and NmX. We believe that the use of vaccines against S. pneumoniae and Hib under the Expanded Program for Immunization (EPI) would prevent significant endemic morbidity and many deaths due to meningitis. However, it would be necessary to improve some points: Control of emerging meningococcal serogroups; case-by-case monitoring at all levels of the health pyramid; the number of serotypes covered by vaccines.

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