MEDICAL NEWS

Meningococcal disease – Nigeria

Disease outbreak news
13 March 2015

Between 26 January and 5 March 2015, the Nigeria Centre for Disease Control (NCDC) of the Federal Ministry of Health of Nigeria notified WHO of 652 suspected cases of meningococcal disease, including 50 deaths. Cases have been reported in 10 local government areas of 2 states, Kebbi and Sokoto. Laboratory tests have confirmed the predominance of Neisseria meningitidis serogroup C in the affected areas, with no other serogroups being identified.

In Zamfara state, there has been a recent emergence of suspected cases of meningococcal disease; however, an outbreak has not yet been confirmed.

Public health response

A national task force was activated to manage the outbreak. WHO and partners, including Médecins Sans Frontières and UNICEF, are closely monitoring the situation, and providing support to the government of Nigeria for the implementation of a mass vaccination campaign and other emergency control measures. The International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis Control has released 204 850 doses of vaccine, with the support of the GAVI Alliance, as well as 5 000 antibiotic vials to respond to the outbreak. Case management and social mobilisation activities are also ongoing.

Background

Cerebrospinal meningitides is a bacterial disease caused by infection of several microorganisms; among these, Neisseria Meningitides (Nm) is the most common cause of bacterial meningitis. The disease is highly contagious with seasonal epidemics in many African countries. Since the introduction of the Men A conjugate vaccine (MenAfrivac), which protects against the most prevalent type of Nm (serogroup A) the occurrence of the disease has declined significantly. From 2011 to 2014, the government of Nigeria conducted mass campaigns with the type A vaccine in all states at risk, including Kebbi state. Still, the risk of other types of Neisseria meningitides persists, as evidenced by the current Nm C outbreak. The disease can be cured with antibiotics and prevented with vaccines.

WHO recommendation

WHO does not recommend any travel or trade restriction to Nigeria based on the current information available on this outbreak.

First Ebola vaccine to be tested in affected communities one year into outbreak

Press release – 25 March, 2015

Guinea WHO Country Office

Ring vaccination starts in Coyah, Guinea

Conakry, 25 March, 2015 – The Guinean Government with the World Health Organization (WHO) initiated the very first efficacy trial of an Ebola vaccine this week in an affected community of the Basse-Guinée, one of the areas where most Ebola cases are found in the country. Ring vaccination tests of VSV-EBOV, a lead Ebola vaccine developed by the Public Health Agency of Canada, received an excellent response from the community in a small village in the Coyah prefecture, where the trial team arrived on 23 March.

“This landmark operation gives hope to all of us, in Guinea and in the world, that we might soon have an effective public health tool against Ebola, should the vaccine prove to be safe and effective,” stated the WHO Representative in Guinea, Dr. Jean-Marie Dangou. “The start of ring vaccination clinical testing today in Guinea is therefore one of the most important milestones we have achieved in seeking a modern line of defense against Ebola.”

Trained medical staff, vaccines and other essential equipment were dispatched from Conakry to Coyah to vaccinate contacts of recently infected people who have given consent in a village of the Coyah prefecture. Vaccinations for now will include only adults, who are most at risk of infection, with the exception of pregnant women.

“We are committed to ending this epidemic,” said Dr. Sakoba Keita, National Coordinator of the Fight against Ebola in Guinea. “Combined with control measures that we are putting in place with our partners, a safe and effective vaccine will allow us to close this trying chapter and start rebuilding our country.”

The ring vaccination strategy consists in identifying recently infected patients and vaccinating all their contacts, thereby creating a ‘ring of immunity’ around them to stop the virus from spreading.

“This very same strategy was a key contribution to eradicating smallpox in the 1970’s, and allows us to vaccinate all those at greatest risk,” explained WHO Coordinator for the Guinea Vaccine Trial, Dr. Ana Maria Henao Restrepo.

Dr. Bertrand Draguez, Medical Director for the Non-governmental Organization Médecins sans Frontières (MSF) stressed that: “The trial is organized on a voluntary basis, and participation is confidential, free and non-remunerated.”

The Guinean Government is fully committed to the success of the vaccine clinical trial. In a 20 March official letter addressed to all the Mayors, Prefects and local Health Officials in Guinea, the Head of the National Coordination Against Ebola in Guinea, Dr Sakoba Keita, asked all local public actors for their full cooperation and support.

A total of around 10 000 people are planned to be vaccinated in 190 rings within a six-eight week period. Volunteers will be followed for three months. Results could be available as early as July 2015.

Note to editors

About the vaccine and the vaccination strategy:

VSV-EBOV Vaccine was developed by the Public Health Agency of Canada. The vaccine was licensed to NewLink Genetics, and on November 24, 2014, NewLink Genetics and Merck announced their collaboration on the vaccine.
The concept of ring vaccination applied to the Guinea Ebola vaccine clinical trial is based on vaccinating the “rings” (group of contacts of a newly diagnosed Ebola “index case”) either immediately after confirmation of the Ebola diagnosis of the “index case”, or three weeks later (delayed vaccination). This strategy allows all the known contacts to be vaccinated within a short period of time, and it constitutes an excellent alternative to the use of a placebo. The ring vaccination trial design was developed by an international group of experts from Canada, France, Guinea, Norway, Switzerland, United Kingdom, United States, and WHO. This group included Professor Donald A. Henderson, who led the WHO smallpox eradication effort.

About the partners:

The Guinea Ebola vaccine trial is a coordinated effort among numerous international partners. The trial is implemented under the responsibility of the Guinean government. The World Health Organization (WHO) is the sponsor of the study. The Government of Guinea, Doctors without Borders / Medecins sans Frontières (MSF), Epicentre, the Norwegian Institute of Public Health and WHO are coordinating its implementation. The trial is funded by MSF; the Research Council of Norway through the Norwegian Institute of Public Health; the Canadian government through the Public Health Agency of Canada, Canadian Institutes of Health Research, International Development Research Centre and Department of Foreign Affairs, Trade and Development; and WHO, with support from the Wellcome Trust, United Kingdom.


Contacts: WHO Guinea – Kevin Gompertz, +224624827287,
kevin@mcbg-conseil.fr

WHO Geneva : Daniela Bagozzi, +41 79 60 37 281, bagozzid@who.int

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