On April 1 the Ministry of Health of Chad reported that during the first three months of 2010, over 1500 cases of suspected meningococcal meningitis were diagnosed. Meningococcal meningitis is a serious bacterial infection that attacks the lining of the brain. Untreated, it is fatal in about 50% of cases. Even with treatment, mortality rates average about 10%. Of those who survive, 15 to 20% lose their limbs, have seizures, become mentally retarded, or experience other long-term neurological problems. Each year the African “meningitis belt” that stretches from Senegal in the

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west to Ethiopia in the east, and with a population exceeding 300 million, reports thousands of cases of confirmed meningococcal infections. It’s high season. Most infections occur during the “dry season” (December to June) due to dust winds, overcrowding at the family level, and seasonal pilgrimages. The World Health Organization, the Red Cross, and the International Coordinating Group (ICG) on Vaccine Provision for Epidemic Meningitis are attempting to combat yearly outbreaks by providing immunizations to millions of at-risk children and young adults. The bacteria responsible for meningitis (Neisseria meningitides) are transmitted from person to person through nasal and throat secretions. Close and prolonged contact with someone who is coughing, sneezing, or sharing drinking utensils facilitates the spread of the illness. The average incubation period is four days, but symptoms of stiff neck, fever, severe headache and rash may occur anywhere from 2 to 10 days following exposure. Anyone who is considering travelling to the sub-Sahara region should receive the meningitis vaccine. There are two currently available in the United States:

  1. The Meningococcal polysaccharide vaccine (Menomune) available since the 1970s
  2. The Meningococcal conjugate vaccine (Menactra) available since 2005

Both vaccines are capable of providing immunity for the A and B subtypes responsible for the epidemics in Africa. Both vaccines also work well, and protect over 90% of those who receive it. Menactra is currently preferred by most infectious disease specialists for those between 10 and 55, as it is believed to give better, longer lasting protection. Menomune should be used for children 2 to 10 years old and adults over 55. Photo info: http://www.flickr.com/photos/teseum/3533755515/

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About The Author

Frank Gillingham, M.D. serves as Chief Medical Director for HTH Worldwide. Frank has led HTH Worldwide's international business development efforts in Europe and Canada and has been a guest speaker at international business conferences and has authored a series of articles on travel medicine, including pieces on travel information available on the Internet and the role of physicians working with travel insurers. Frank is a Board-Certified Internist and Emergency Medicine Specialist. He is also a private emergency physician in Southern California and a former emergency department director and member of the UCLA emergency department staff. Frank completed residency training at Los Angeles County/USC Medical Center, received his M.D. from Albert Einstein College of Medicine and his B.A. from the University of Pennsylvania .

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