<i>Neisseria meningitis</i> serogroup X outbreak in Burkina Faso, 2009-2010

Background: Centre MURAZ of Bobo-Dioulasso (Burkina Faso) organized in 2009 and 2010 a system of Cerobro-Spinal Fluid (CSF) collection in eight pilot Districts as an initial step for the future Ministry of Health’s led strategy of individual surveillance in a context of meningococcal conjugate A vaccine introduction. Methods: CSF samples were analyzed with Polymerase Chain Reaction (PCR). This allowed for meningitis etiologies dynamics studies in the pilot Districts. Results: Because of geographical difficulties and lack of means, less than 40% of suspected cases had their CSF analyzed at PCR reference laboratory. In 2009, among confirmed cases at reference laboratory, Sp (Streptococcus pneumonia), NmA (Neisseria meningitis A) and Hib (Hemophilus influenzae b) were responsible respectively for 90%, 6.6% and 4.4% of cases. In 2010, serogroup distribution among confirmed cases was: Sp 62.7%, NmX 32.2% and NmA 5.1%. Sp which was continuously present in Burkina Faso takes more significant proportions, just as serogroup X which until there was sporadically encountered. The attack rates of NmX were tree to twelve times higher than for NmA in the two Districts where NmX has been notified. Conclusion: As a consequence of such results, efforts must be maintained in epidemiologic surveillance field and in reinforcement of laboratory capacities. Fast care should be guaranteed to patients with adequate antibiotics according to country national guideline and chemoprophylaxis measures should be undertaken among contacts of patients to prevent secondary cases. A plea must be made on one hand for pneumococcal vaccine introduction in Burkina Faso and on other hand towards manufacturers for taking into account serogroup X into meningococcal polyvalent vaccine composition. With this polyvalent vaccine including serougruop X, we suggested to conduct periodically mass campaign vaccination of people before the beginning of meningitis epidemiological season.