The Meningitis Outbreak

The recent outbreak of the cerebrospinal meningitis is an emergency situation that requires urgent attention. Olawale Olaleye writes

From 328 casualties penultimate weekend in 16 states and across 90 local governments to 338 deaths by early last week, the body count in the recent cerebrospinal meningitis outbreak has continued to increase exponentially in a way that de-emphasizes premium on life. Although such disregard for life appears a common trait in Nigeria, the dimension of the meningitis outbreak is both alarming and disturbing.

Meningitis is an inflammation (swelling) of the protective membranes covering the brain and spinal cord known as the meninges. It is usually caused by an infection of the fluid surrounding the brain and spinal cord. It is usually caused by bacteria or viruses, but could also be a result of injury, cancer, or certain drugs. Knowing the specific cause is however important because the treatment differs depending on the cause.

The affected states include Zamfara, Katsina, Sokoto, Kebbi, Niger, Nassarawa, Jigawa, FCT, Gombe, Taraba, Yobe, Kano, Osun, Cross Rivers, Lagos and Plateau. Government has also said about five neighbouring countries within the Meningitis belt – Niger, Chad, Cameroun, Togo, and Burkina Faso – have equally begun to face similar challenge at the moment.

A statement signed by the Director, Media and Public Relations, Ministry of Health, Mrs. Boade Akinola, explained that as part of efforts geared towards containing and effectively tackling the outbreak, functional Isolation centers/units had been identified in all states. The ministry put the total number of people so far affected across the 16 states at 2,524 with the majority of about 131 samples confirmed in the laboratory to be Neisseria Meningitis type C. The current outbreak, government said, started in Zamfara State sometime in November last year.

Unfortunately, the fear of the epidemic nature of the meningitis outbreak was identified on Tuesday, when the Senate raised the alarm that the Internally Displaced Persons (IDPs) camps, prisons and detention centres were locations susceptible to the current health challenge due to overcrowding and unhygienic conditions common in such places.

The Senate therefore called on the National Emergency Management Agency (NEMA), Nigerian Prison Service, and Nigeria Police to urgently take steps to prevent infections and outbreaks in their premises and camps. At the same time, the Nigerian Centre for Disease Control (NCDC), National Primary Healthcare Development Agency (NPHDA), and relevant partners have distributed a total of 500,000 doses of Meningitis C vaccines to some of the affected states for immediate outbreak response vaccination.

The NCDC in a statement by its Technical Adviser, Communications, Dr. Lawal Bakare, said an additional 823,970 doses of Meningitis C vaccines were expected from the United Kingdom to support vaccination activities in other affected states. He also said the Emergency Operating Centres (EOC) will support state-wide vaccination campaign which starts in Zamfara State on April 5, 2017.

But the lawmakers have also directed the Federal Ministry of Health and its agencies to work closely with the World Health Organisation (WHO) and UNICEF to acquire sufficient vaccines needed to respond to the outbreak. This is in addition to massive sensitisation campaign to raise awareness among the citizenry about the diseases as well as provide education about its symptoms and actions that could help prevent infection.

Curiously though, the body count has continued to increase from state to state, thus making several other states vulnerable to the disease outbreak. But, however this debate is viewed, it still boils down to leadership. Whenever the story of the latest meningitis outbreak is told, its management and containment would not be divorced from leadership capacity and response at such a time.

This is even more so that the disease is not alien to the nation’s health sector as it has been around for some time now, including some of the neighbouring countries. Thus, how it has been allowed to fester to the point of claiming over 300 lives has definitely called to question, the kind of leadership in place at this material time.

This, of course, explains why the Zamfara State Governor, Abdulaziz Yari, has come under stringent attacks since his non-correlative position on the cause of the virus. Yari had said during an interview with State House correspondents last Tuesday after a meeting with President Muhammdu Buhari, that the current outbreak of the Type C Meningitis in the country was God’s way of punishing Nigerians for disobeying him.

The governor, who spoke in Hausa, had posited that “What we used to know as far as meningitis is concerned is the Type A virus. The World Health Organisation (WHO) has carried out vaccinations against this Type A virus not just in Zamfara, but many other states. However, because people refused to stop their nefarious activities, God now decided to send Type C virus, which has no vaccination.

“People have turned away from God and He has promised that ‘if you do anyhow, you will see anyhow’. That is just the cause of this outbreak as far as I am concerned. There is no way fornication will be so rampant and God will not send a disease that cannot be cured,” Yari reckoned.

Coming from a sitting governor, who clearly lacked the capacity to see that the outbreak was a case of medical emergency but would rather insinuate some spiritual twists, then, it is understandable why the virus could kill as many in one fell swoop in a seemingly helpless circumstance.

The Ebola experience is still fresh in the memories of many Nigerians and their neighbours. As deadly and contagious as it was, leadership at that period, which had been labeled ‘clueless’, stood up to the challenge and tackled the deadly virus to global acclaim. That was leadership by all standards.

While not dismissing the present leadership and its capacity to manage the meningitis outbreak, the body count cannot continue to rise as if the nation is still struggling to shed her cave age toga. Government must therefore declare emergency in this sector and contain this scourge before it degenerates any further. It is a huge threat to the health of the nation and must be treated as such.

FAST FACTS ON MENINGITIS

What causes meningitis?

Meningitis is generally caused by infection of viruses, bacteria, fungi, parasites, and certain organisms. Anatomical defects or weak immune systems may be linked to recurrent bacterial meningitis. In the majority of cases the cause is a virus. However, some non-infectious causes of meningitis also exist.

How is meningitis transmitted?

Meningitis is transmitted to people by many methods. Both bacterial and viral meningitis are spread person to person similarly. Person-to-person spread can happen with direct and indirect contact between individuals (coughing up droplets, contact with the feces, sneezing, saliva, kissing, or eating contaminated food). Indirect spread by using the same utensils, cups, and other items used by an infected individual can also spread the disease to others. Some fungal infections are transmitted by airborne dust particles. In addition, other types of meningitis can be transferred to humans by vectors such as mosquitoes (for example, West Nile virus) or ticks (Lyme disease).

How long does meningitis last?

Viral meningitis lasts about seven to 10 days with symptoms receding gradually. Bacterial meningitis is usually cured by antibiotics. The time to cure varies with each individual and corresponds with the decrease of symptoms. If bacterial meningitis is not treated rapidly with antibiotics, there can be long-term injury to the brain and even death.

Early symptoms of meningitis broadly include:

• Vomiting
• Nausea
• Muscle pain
•  High temperature (fever)
•   Headache
•   Cold hands and feet

A rash that does not fade under pressure. This rash might start as a few small spots in any part of the body – it may spread rapidly and look like fresh bruises. This happens because blood has leaked into tissue under the skin. The rash or spots may initially fade, and then come back.

In babies, you should look out for at least one of the following symptoms:

•  a high-pitched, moaning cry
• a bulging fontenelle
•   being difficult to wake
•  floppy and listless or stiff with jerky movements
•  refusing feeds
•   rapid/ unusual/ difficult breathing
•   pale or blotchy skin

red or purple spots that do not fade under pressure

In older children, you should look out for:

• a stiff neck
•  severe pains and aches in your back and joints
•  sleepiness or confusion
•  a very bad headache (alone, not a reason to seek medical help)
•  a dislike of bright lights
• very cold hands and feet
•   shivering
•  rapid breathing
• red or purple spots that do not fade under pressure

When should someone seek medical care for meningitis?

Individuals should contact a medical caregiver immediately about meningitis if they suspect that they have been exposed to bacterial meningitis. Meningitis, especially bacterial meningitis, is considered a medical emergency; if an individual develops early symptoms of meningitis (high fever, headache, and/or neck stiffness) or becomes ill after contacting an individual known to have contagious meningitis, he or she should seek medical care emergently. Bacterial meningitis has about a 10% death rate unless it is treated early in the infection.

Sources: MedicalNewsToday/Medicinenet.com