title: Response to the meningococcal meningitis epidemic (MME) at Aminu Kano Teaching Hospital, Kano (2008-2009).
abstract: In December 2008 an outbreak of Meningococcal Meningitis swept across sub Saharan Africa with Nigeria, especially its northern states worst affected. The management of Aminu Kano Teaching Hospital constituted an Emergency Preparedness & Response (EPR) committee. Over the course of 18 weeks from 5 January 2009 to 15 May 2009, AKTH managed 222 cases of suspected meningitis with 14 deaths (case fatality rate [CFR] of 6.3%). Twenty three per cent (23%) were microbiologically proven as meningococcal meningitis while 9% were confirmed to be pneumococcal meningitis. Male to female ratio was 1:1 with most patients (81%) aged below 14 years. The epidemic peaked in weeks 10 and 13 with 38 admissions in the respective weeks. Meningococcemia with purpura fulminans, post meningitic immune complex cutaneous vasculitis and polyarthritis were observed. Control measures instituted included provision of free ceftriaxone, chemoprophylaxis to contacts, vaccines to staff/families, and creation of dedicated isolation wards. Clinical management guidelines were developed and hospital staffs were also enlightened. Lessons learnt included the difficulty of discriminating between nosocomial transmission and community clusters; relative increase in pneumococcal meningitis during the epidemic; unreliability of penicillin/chloramphenicol; the utility of internet for communication; and the inadequacy of vaccines to meet staff & public demand.
authors.affiliation: Department of Medicine, AKTH, Kano, Nigeria.
authors.forename: G
authors.initials: G
authors.lastname: Iliyasu
authors.forename: H
authors.initials: H
authors.lastname: Lawal
authors.forename: A G
authors.initials: AG
authors.lastname: Habib
authors.forename: F
authors.initials: F
authors.lastname: Hassan-Hanga
authors.forename: I S
authors.initials: IS
authors.lastname: Abubakar
authors.forename: U
authors.initials: U
authors.lastname: Bashir
authors.forename: U
authors.initials: U
authors.lastname: Tanko-Yakasai
authors.forename: S
authors.initials: S
authors.lastname: Abubakar
authors.forename: M S
authors.initials: MS
authors.lastname: Abba
authors.forename: I S
authors.initials: IS
authors.lastname: Rano
authors.forename: H
authors.initials: H
authors.lastname: Abdu
authors.forename: B
authors.initials: B
authors.lastname: Musa
authors.forename: G D
authors.initials: GD
authors.lastname: Gwarzo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008585:Meningitis, Meningococcal / Q000453:epidemiology* / Q000517:prevention & control*; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology