Large Outbreak of Neisseria meningitidis Serogroup C — Nigeria, December 2016–June 2017

Abstract

© 2017, Department of Health and Human Services. All rights reserved. What is already known about this topic? Meningococcal disease caused by Neisseria meningitidis causes severe illness, and could lead to permanent disability or death if not quickly detected and treated. The largest global burden of meningococcal disease is in sub-Saharan Africa, where annual epidemics caused mainly by N. meningitidis serogroup A were previously common. After the introduction of meningococcal A vaccines in 2013, meningitis caused by serogroup A declined. However, N. meningitidis serogroup C (NmC) has now emerged as a cause of large outbreaks. What is added by this report? During December 2016–June 2017, the largest global epidemic of meningitis caused by NmC occurred in northern Nigeria, with 14,518 suspected cases and 1,166 deaths reported. An emergency operations center coordinated rapid development and implementation of an emergency outbreak response plan, including administration of meningococcal serogroup C– containing vaccines to > 2 million persons. Multiple logistical challenges were encountered during the response; the outbreak was declared over in June 2017. What are the implications for public health practice? National and regional evaluations of the outbreak response have outlined recommendations for improving meningitis outbreak prevention, timely detection, and response in Nigeria. Implementation of these recommendations will be key to reducing future meningitis outbreaks. Expanding availability of multivalent vaccines that are effective against non-A serogroups of N. meningitidis might prevent future outbreaks in this region.