Meningitis Outbreak in Eastern Chad Among Refugees from Darfur

A nurse working in the health center of the refugee camp in Touloum, Chad. In Touloum camp, where an estimated population of 18.000 refugees are based, MSF runs a health center (250 consultations a week) and supplementary feeding center.
Photo © Gael Turine

Abeche, Chad, 28 January 2005 - The international medical humanitarian aid organization Doctors Without Borders/Médecins Sans Frontières (MSF) is launching a meningitis vaccination campaign in eastern Chad, following a recent outbreak among refugees from Sudan's Darfur region. The campaign is aimed at protecting thousands of people in the area from the highly infectious disease, which is particularly threatening in the overcrowded camps.

MSF is working alongside local health authorities and the International Federation of Red Cross and Red Crescent Societies. Over a period of two weeks, MSF plans to vaccinate about 70,000 Sudanese refugees and local residents in and around the Bredjing and Farchana camps, and in the border town of Adré.

"This is a deadly disease which, without treatment, kills between 50 to 80 percent of those who contract it," explains Paul van Haperen, MSF head of mission in Chad. "High population density in the refugee camps makes the spread of meningitis more likely."

The first cases of meningitis were discovered in Bredjing and Treguine refugee camps at the beginning of January 2005. More than a year after people fled the war-torn region of Darfur, living conditions in these camps are still difficult. "The Chadian health authorities asked us to help respond to the situation," said van Haperen. "So MSF has mobilized its vaccination teams as quickly as possible."

In addition to a number of fixed vaccination sites in the refugee camps and three sites in Adré town, mobile teams will cover the outlying areas. MSF is also improving the surveillance system in the district and treating patients who have contracted the disease with antibiotics.

Meningitis is an infection of the meninges membrane that covers the brain and spinal cord. The current outbreak is caused by the relatively rare "W135" strain of the meningococcus bacterium.

Chad is within an area spanning sub-Saharan Africa known as the "meningitis belt," where epidemics affecting many thousands of people occur regularly. In Chad alone, outbreaks have occurred in 1998, 2000, and 2001.

MSF has been working along Chad's eastern border since September 2003 and is providing medical and surgical relief, nutritional support as well as water and sanitation facilities to 85,000 Sudanese refugees.

More on meningitis vaccinations

Today a meningitis vaccine, including one effective against the W135 strain, is available largely because of efforts by MSF and others like the World Health Organization (WHO), International Federation of the Red Cross and Red Crescent Societies (IFRC), UNICEF and international donors who campaigned to push GlaxoSmithKline (GSK) to produce this vaccine in 2002-2003 at an affordable price - near one dollar per dose. MSF was also instrumental in funding the pre-purchased stock of 6 million doses of the new product by mobilizing donor governments and individuals to gather the necessary funding.

While the current situation in Chad may be covered, the remaining 5.7 million doses of the new vaccine may not be enough if a large epidemic occurs involving many countries, or one big country like Nigeria. Since the production of the vaccine takes 6 months, it will be important for groups to monitor the situation and, if necessary, for GSK to produce sufficient vaccines at the same affordable price.

In the long term, there is a strong need for a vaccine that is effective for all meningitis strains (including W135) endemic in Africa. This is a more sophisticated type of vaccine that provides longer protection against bacteria, but unfortunately there are no such vaccines against meningitis in the R&D pipeline.