To reduce the impact of meningitis epidemics, adequate preparedness is crucial, a meeting at the World Health Organization (WHO) concluded today. Preparedness includes carrying out thorough disease surveillance in countries at risk, and having ready sufficient stocks of meningococcal meningitis vaccine, the antibiotic oily chloramphenicol, and single-use syringes for efficient distribution. If such a mechanism is in place, many cases of meningitis, as well as some fatalities resulting from the disease, can be avoided.

The ICG met for the fifth time, since its creation, from 8 to 9 December 1999. ICG members include WHO, UNICEF, the International Federation of Red Cross and Red Crescent Societies (IFCR), Médecins sans Frontières (MSF), l'Association pour la Médecine Préventive (AMP), WHO Collaborating Centres, other international non-governmental organizations and manufacturers of meningococcal meningitis vaccine, single-use syringes and antibiotics.

At this meeting ICG members discussed how preparedness for epidemics can be better ensured, analyzed past experiences, made projections of new epidemics and reviewed current research.

"WHO and its partners are supporting national authorities in developing Epidemic Preparedness Plans so that when an outbreak occurs, the roles and responsibilities are already clearly defined and control actions can begin immediately," said Dr Lindsay Martinez, Director of the WHO Department of Communicable Diseases Surveillance and Response.

Epidemic Preparedness Plans include the following actions: reinforcing epidemiological surveillance, strengthening communications, reinforcing laboratory capacity, reinforcing preventive activities and plans for mass vaccination of the most susceptible groups, improving preparedness of stocks, making available in advance the necessary budget lines for the emergency purchase of vaccine and reinforcing co-operation amongst countries.

Last year Sudan suffered a huge meningitis epidemic with almost 32,000 cases and over 2,200 deaths reported. The potential size of this outbreak, however, was considerably diminished through the rapid and co-ordinated control efforts of the Sudanese health authorities and their international partners. In 1996, a record 180,000 cases of meningitis were reported in Africa. Such an alarming epidemic spurred the creation of the ICG in early 1997. This year the ICG has supplied vaccine and other emergency supplies to Sudan and Guinea Bissau.

18 countries in sub-Saharan Africa, stretching from Ethiopia in the east to Senegal in the west, are at particular risk for large meningitis epidemics especially during the dry season. Meningococcal meningitis is the only form of bacterial meningitis which causes epidemics. Young children are usually the most affected, but older children, teenagers and young adults also contract the disease during epidemics.

Once the start of a meningitis outbreak is detected, a mass vaccination campaign must be rapidly implemented to halt the spread of this communicable and potentially fatal disease.