Neisseria meningitis 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.

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Yaro, S. , Drabo, A. , Ouangraoua, S. , Kirakoya-Samadoulougou, F. , Mueller, J. , Sanou, O. , Tall, H. , Jaillard, P. , Njanpop-Lafourcade, B. , Macq, J. , Robert, A. and Ouedraogo, J. (2012) Neisseria meningitis serogroup X outbreak in Burkina Faso, 2009-2010. Open Journal of Internal Medicine, 2, 41-49. doi: 10.4236/ojim.2012.22010.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Lapeyssonnie, L. (1963) Cerebrospinal meningitis in Africa (in French). Bulletin of the World Health Organ, 28, 1-114.
[2] Greenwood, B. (1999) Manson lecture: Meningococcal meningitis in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 93, 341-353. doi:10.1016/S0035-9203(99)90106-2
[3] Molesworth, A.M., Thomson, M.C., Connor, S.J., Cresswell, M.P., et al. (2002) Where is the meningitis belt? Defining an area at risk of epidemic meningitis in Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene, 96, 242-249. doi:10.1016/S0035-9203(02)90089-1
[4] World Health Organization (1998) Control of epidemic meningococcal disease. WHO practical guidelines. 2nd Edition, WHO, Geneva.
[5] Schuchat, A., Robinson, K., Wenger, J.D., Harrison, L.H., et al. (1997) Bacterial meningitis in the United States in 1995. The New England Journal of Medicine, 337, 970-976. doi:10.1056/NEJM199710023371404
[6] Broome, C.V., Rugh, M.A., Yada, A.A., Giat, L., et al. (1983) Epidemic group C meningococcal meningitis in Upper Volta, 1979. Bulletin of the World Health Organ, 61, 325-330.
[7] Koumare, B., Bougoudogo, F., Cisse, M., Doumbia, T., et al. (1993) Bacteriological aspects of purulent meningitis in Bamako district: A propos of 1541 bacterial strains collected from 1979 to 1991 (in French). Bulletin de la Société de Pathologie Exotique, 86, 136-140.
[8] Parent du Chatelet, I., Traore, Y., Gessner, B.D., Antignac, A., et al. (2005) Bacterial meningitis in Burkina Faso: Surveillance using field-based polymerase chain reaction testing. Clinical Infectious Diseases, 40, 17-25. doi:10.1086/426436
[9] World Health Organization (2002) Meningococcal disease, serogroup W135, Burkina Faso: Preliminary report, 2002. Weekly Epidemiological Record, 77, 152-155.
[10] Campagne, G., Schuchat, A., Djibo, S., Ousseini, A., et al. (1999) Epidemiology of bacterial meningitis in Niamey, Niger, 1981-96. Bull World Health Organ, 77, 499-508.
[11] Etienne, J., Sperber, G., Adamou, A. and Picq, J.J. (1990) Epidemiological notes: Meningococcal meningitis of serogroup X in Niamey (Niger) (in French). Médecine Tropicale, 50, 227-229.
[12] Djibo, S., Nicolas, P., Alonso, J.M., Djibo, A., et al. (2003) Outbreaks of serogroup X meningococcal meningitis in Niger 1995-2000. Tropical Medicine & International Health, 8, 1118-1123. doi:10.1046/j.1360-2276.2003.01126.x
[13] Gagneux, S.P., Hodgson, A., Smith, T.A., Wirth, T., et al. (2002) Prospective study of a serogroup X Neisseria meningitidis outbreak in northern Ghana. The Journal of Infectious Diseases, 185, 618-626. doi:10.1086/339010
[14] Sidikou, F., Djibo, S., Taha, M.K., Alonso, J.M., et al. (2003) Polymerase chain reaction assay and bacterial meningitis surveillance in remote areas, Niger. Emerging Infectious Diseases, 9, 1486-1488.
[15] Chanteau, S., Sidikou, F., Djibo, S., Moussa, A., et al. (2006) Scaling up of PCR-based surveillance of bacterial meningitis in the African meningitis belt: Indisputable benefits of multiplex PCR assay in Niger. Transactions of the Royal Society of Tropical Medicine and Hygiene, 100, 677-680. doi:10.1016/j.trstmh.2005.09.006
[16] Taha, M.K. (2000) Simultaneous approach for nonculture PCR-based identification and serogroup prediction of Neisseria meningitidis. Journal of Clinical Microbiology, 38, 855-857.
[17] Garcia, P., Garcia, J.L., Garcia, E. and Lopez, R. (1986). Nucleotide sequence and expression of the pneumococcal autolysin gene from its own promoter in Escherichia coli. Gene, 43, 265-272. doi:10.1016/0378-1119(86)90215-5
[18] Falla, T.J., Crook, D.W., Brophy, L.N., Maskell, D., et al. (1994). PCR for capsular typing of Haemophilus influenzae. Journal of Clinical Microbiology, 32, 2382-2386.
[19] Tzeng, Y.L., Noble, C. and Stephens, D.S. (2003) Genetic basis for biosynthesis of the (alpha 1→4)-linked N-acetyl-d-glucosamine 1-phosphate capsule of Neisseria meningitidis serogroup X. Infection and Immunity, 71, 6712-6720. doi:10.1128/IAI.71.12.6712-6720.2003
[20] Boisier, P., Nicolas, P., Djibo, S., Taha, M.K., et al. (2007) Meningococcal meningitis: Unprecedented incidence of serogroup X-related cases in 2006 in Niger. Clinical Infectious Diseases, 44, 657-663. doi:10.1086/511646
[21] Gagneux, S., Wirth, T., Hodgson, A., Ehrhard, I., et al. (2002) Clonal groupings in serogroup X Neisseria meningitidis. Emerging Infectious Diseases, 8, 462-466.
[22] Gesner, B.D., Mueller, J.E. and Yaro, S. (2010) African meningitis belt pneumococcal disease epidemiology indicates a need for an effective serotype 1 containing vaccine, including for older children and adults. BMC Infectious Diseases, 10, 10-22. doi:10.1186/1471-2334-10-22
[23] David, M.M., Guillermo, P., Judith, M., Charles, N., et al. (2009) Epidemiology and risk factors for serogroup X Meningococcal Meningitis during an outbreak in Western Kenya, 2005-2006. The American Journal of Tropical Medicine and Hygiene, 80, 619-624.
[24] Etienne, J., Sperber, G., Adamou, A. and Picq, J.J. (1990) Epidemiologic notes: Meningococcal meningitis of serogroup X in Niamey (Niger). Médecine Tropicale, 50, 227-229.
[25] Campagne, G., Schuchat, A., Djibo, S., Ousséini, A., et al. (1999) Epidemiology of bacterial meningitis in Niamey, Niger, 1981-96. Bulletin of the World Health Organ, 77, 499-508.
[26] Leimkugel, J., Hodgson, A., Adams Forger, A., et al. (2007) Clonal waves of Neisseria colonization and disease in the African meningitis belt: Eight year longitudenal study in Northern Ghana. PLoS Medicine, 4, 0535-0544.
[27] Materu, S., Cox, H.S., Isaakidis, P., Baruani, B., et al. (2007) Serogroup X in meningococcal disease, Western Kenya. Emerging Infectious Diseases, 13, 944-945. doi:10.3201/eid1306.070042
[28] Taha, M.K., Deghmane, A.E., Antignac, A., Zarantonelli, M.L., Larribe, M. and Alonso, J.M. (2002) The duality of virulence and transmissibility in Neisseria meningitidis. Trends Microbiology, 10, 376-382. doi:10.1016/S0966-842X(02)02402-2
[29] MacLennan, J.M., Urwin, R., Obaro, S., Griffiths, D., et al. (2000) Carriage of serogroup W-135, ET-37 meningococci in the Gambia: Implications for immunisation policy? The Lancet, 356, 1078. doi:10.1016/S0140-6736(00)02734-3
[30] Lingappa, J.R., Al-Rabeah, A.M., Hajjeh, R., Mustafa, T., et al. (2003) Serogroup W135 meningococcal disease during the Hajj, 2000. Emerging Infectious Diseases, 9, 665-671.
[31] Traoré, Y., Njanpop-Lafourcade, B.M., Adjogble, K.L., Lourd, M., et al. (2006) The rise and fall of epidemic Neisseria meningitidis serogroup W135 meningitis in Burkina Faso, 2002-2005. Clinical Infectious Diseases, 43, 817-822.
[32] WHO (2007) Improved meningitis vaccine for Africa could signal eventual end to deadly scourge. Weekly Epidemiological Record, 24, 222-224.
[33] Singleton, R.J., Hennessy, T.W., Bulkow, L.R., Hammitt, L.L., et al. (2007) Invasive pneumococcal disease caused by nonvaccine serotypes among Alaska native children with high levels of 7-valent pneumococcal conjugate vaccine coverage. The Journal of the American Medical Association, 297, 1784-1792. doi:10.1001/jama.297.16.1784

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