Seasonal Meningococcal Meningitis Outbreaks in Nigeria: A Need for an Accelerated Introduction of a Conjugated Meningococcal Vaccine into the National Routine Immunization Schedule

ABSTRACT

Epidemic meningococcal meningitis affects huge populations annually in sub-Saharan Africa with differentially higher death rates among children. Nigeria is one of the twenty-six countries that lie in ‘African meningitis belt’. This paper briefly describes the epidemiology of seasonal recurrent meningococcal meningitis, current efforts to address the epidemics, and then argues for an accelerated introduction of conjugated meningococcal vaccine into routine immunization in Nigeria. This paper also highlights the nature of the epidemics with its attendant impacts on the population; the weaknesses of the current strategies; the emergence of mixed pathogens; the challenges and potential opportunities associated with an introduction of routine vaccination against meningococcal meningitis. The quick introduction of the conjugated meningococcal vaccine into expanded program on immunization (EPI) schedule will mitigate the risk of future massive outbreaks and its attendant morbidity, mortality and larger societal cost. Furthermore, authors suggest the introduction of polyvalent conjugated meningococcal vaccine rather than monovalent (targeting only serotype A), as this will potentially prevent emerging outbreaks of other serotypes such as NmC and W135.