The latest vaccine, Men5CV, endorsed by the World Health Organization (WHO) to guard against five strains of meningococcus bacteria, was introduced in Nigeria as a significant milestone in global healthcare. Idris Mohammed, an expert in infectious diseases and immunology who previously chaired Nigeria’s National Programme on Immunization, was interviewed to provide insight into the new vaccine and its potential effects. Infection-induced inflammation of the tissues enveloping the brain and spinal cord can result in the deadly condition known as meningitis.
Various microorganisms, including bacteria, viruses, fungi, and parasites, can be responsible for causing meningitis. Bacterial meningitis carries the greatest worldwide impact in terms of disease burden. Approximately 16% of individuals afflicted with this condition succumb to it, while 20% experience significant complications. Neisseria meningitidis, Haemophilus influenzae, and Streptococcus pneumoniae are the primary bacteria that cause the illness. Symptoms include a sudden fever, back pain, neck stiffness, headaches, nausea, vomiting, and sensitivity to light. Severe infections may result in patients showing symptoms such as confusion, delirium, and unconsciousness.
Northern Nigeria bears the highest burden of epidemic meningitis.
Also, meningitis is a condition that can impact individuals across all age groups. Transmission of meningitis-causing bacteria occurs via respiratory droplets or throat secretions from carriers and can be facilitated by kissing, sneezing, coughing, or close proximity to an infected individual. The average incubation period for the disease is four days, with a possible range of two to 10 days. Meningitis outbreaks are a global issue, with a notable concentration in sub-Saharan Africa. Known as the African meningitis belt, this region spans 26 countries from Senegal and The Gambia to Ethiopia, experiencing high rates of the disease.
Canada, Belgium, France, Brazil, and Denmark have all experienced outbreaks in addition to those in Africa. The African meningitis belt encompasses Nigeria’s 19 northern states. Meningitis risk factors abound in northern Nigeria due to a combination of factors such as lack of vaccination, carrier presence, malnutrition, overcrowding, limited rainfall, low humidity, and extreme temperatures reaching as high as 45°C, with average temperatures exceeding 35°C. While northern Nigeria bears the highest burden of epidemic meningitis, instances of infection are scattered throughout the country.
Vaccination using polysaccharide vaccines that are currently available.
Africa has five distinct strains of meningitis: A, C, W, X, and Y serotypes. Both strains exhibit identical infectivity and clinical characteristics, including symptoms and indications. Serotype A, the initial and predominant strain in the region, was responsible for determining these features. In north-western Nigeria, some cases have shown that the new variants like group C meningococcal may lead to a more severe infection. Meningococcal meningitis has been causing devastation in the African meningitis belt for over one hundred years.
Early efforts to prevent disease included the utilization of sulfur-based medications and antibiotics derived from penicillin. However, the attempts to stop outbreaks were unsuccessful. Another option to explore would be vaccination using polysaccharide vaccines that are currently available. These vaccines contain distinct components of the pathogen, such as its protein, sugar, or outer shell. At the time, there was just one vaccine that existed – the A C vaccine by Institut Merieux. Despite never having been widely used before, this vaccine successfully ended an epidemic in Bauchi in 1978 within a short period of time. John Robbins and other researchers have strongly promoted the increased use of polysaccharide vaccines through mass vaccinations.
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Additionally, the MenAfriVac vaccine, developed through collaboration between WHO, PATH, and funded by the Bill and Melinda Gates Foundation, successfully immunized over 260 million individuals in the African meningitis belt. As a result, the meningococcal A serotype was nearly eradicated. New strains C, W, X, and Y became prevalent, highlighting the significance of MenFive, also called Men5CV, vaccination. Utilizing the 5-in-1 vaccine consistently and effectively can help eradicate outbreaks of meningococcal meningitis in Africa. This vaccine, which targets the five major serotypes responsible for meningitis in Nigeria, is expected to greatly improve disease control. Nigeria, the most populous country in the African meningitis belt which includes 26 African countries, will benefit immensely from this vaccine.
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