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Serogroup A Neisseria meningitidis outside meningitis belt in Southwest Cameroon.

Article Excerpt
To the Editor: Epidemic meningitis associated with serogroup A Neisseria meningitidis is a devastating disease in the absence of vaccination (1). Without treatment, the case-fatality rate is high, approaching 100%. In Africa, such epidemics occur regularly (1) within a well-limited geographic zone, the so-called African meningitis belt (2). In the countries within the meningitis belt, the illness is endemic and sporadic: numerous cases of meningococcal meningitis are reported each year during the dry season, and every 6-12 years a large outbreak occurs. Serogroup A N. meningitidis also causes sporadic cases of meningitis outside the meningitis belt, accounting for 10% to 30% of cases with identified causes (1,3). Outbreaks may also occur outside of the belt, but they do not exhibit the same epidemiologic aspects. We report an epidemic of meningococcal meningitis in the South-West Province of Cameroon (~500 km south of the African meningitis belt and 350 km east of Yaounde, the country's capital), involving 61 cases and 13 (21%) deaths.

Clinical and epidemiologic information was collected from medical records at Bechati Health Centre and Fontem Missionary Hospital, the only two care centers in the epidemic area. A case was defined as sudden fever [greater than or equal to] 38[degrees]C and neck stiffness if the patient was > 12 months of age, or bulging fontanelle if the patient was 100,000 has the specificity and probability to predict a meningococcal epidemic within the meningitis belt (1). In...