Since December 1999, reported cases of meningococcal meningitis in Chad and the Central African Republic (CAR) have risen at an alarming rate. In Chad, cases are reportedly high in the south west (Logone region), and have spread in the last two weeks to Chari region. In the CAR, the most serious outbreaks are in the north of the country along the border with Chad. Initial reports indicate an alarmingly high case fatality ratio, with 179 deaths from 1,441 (or 12.4%) cases in Chad, (357 of which are new cases reported in the first two weeks of March), while in the CAR, 639 case have been recorded, with 146 deaths (or 22.8%).
The governments of the two countries have approached the Red Cross and Red Crescent for the provision of vaccines, needles and syringes, and antibiotics. Chad has requested 800,000 doses of vaccine, while the CAR has requested 60,000 doses. Limited information is available regarding the exact size of the epidemic, the needs on the ground, and the co-ordination of the response. While reports of the outbreak have been circulating among various organisations, official information from the governments to the WHO has been limited. The International Federation's Health Department is liaising closely with WHO on the matter.
Red Cross/Red Crescent Action
The Federation has concluded that the best course of action is to organise and send an initial assessment mission to the affected areas in the two countries to gather information, co-ordinate with relevant ministries, UN bodies and NGOs, and to assist in formulating a plan of action in support of the Red Cross of Chad and the Central African Red Cross Society. To facilitate the assessment process, CHF 21,000 has been allocated from the Federation's Disaster Relief Emergency Fund (DREF). A public health physician from the Mali Red Cross Society has been identified to carry out the assessment, and is traveling to Yaoundé, Cameroon to start the mission by Tuesday of this week.
The decision to launch an appeal will be based on the results of the assessment mission. A meningococcal meningitis outbreak, as with all epidemics, requires a rapid and co-ordinated response. A lack of timely and accurate information from the countries involved has already delayed a response, and it is vital that information and a plan of action are received as soon as possible. It is equally important that the Federation is prepared to respond immediately should the situation be deemed urgent, Lastly, funds are sought to reimburse the DREF released to carry out the assessment mission.
Operations Funding and Reporting Department