MENINGITIS: GAUTENG PATTERN NORMAL

Issued by: Gauteng Provincial Government

4 September 1997

The outbreak of meningo-coccal meningitis in the Democratic Republic of Congo has raised public concern about the situation in Gauteng, where we had an outbreak a year ago.

Since last year, the Gauteng Health Department has put a plan in place to cater for any future outbreaks. We have drawn on technical experts with international experience in preparing this plan, which involves the following:

• Developing early warning systems for outbreaks - that is, disease notifications and surveillance systems.
• Forming teams who can respond to an epidemic. This has involved identification of team members and training.
• Drawing up technical guidelines on meningo-coccal meningitis, based on World Health Organisation guidelines.
• Setting up contingency plans for mass immunisation, based on our experience with recent measles immunisation campaigns.

This year, in terms of the new plan, we have implemented an "Active Surveillance" system on meningo-coccal meningitis during our peak risk months of July and August and we will extend it into September. Every week hospitals report confirmed meningitis cases to the district health team and we monitor to detect any increase in cases in any locality.

Each year there is a slight seasonal increase in incidence of meningo-coccal meningitis in the winter months and 1997 has been no exception. However, we can confidently say that we have not had a significant increase in total cases reported and have not identified any local concentrations of infection.

Last year, with the outbreak, we had 104 cases and 14 deaths. This year there have been no reported deaths and in August (for instance), with surveillance operating quite smoothly, we had 20 reported cases.

The peak risk period for a meningitis outbreak in Gauteng is nearly over. If a significant problem was developing, it should have shown already. The relatively early spring this year had also reduced the environmental factors promoting an outbreak.

Meningo-coccal meningitis has existed within South Africa for many years. The potential presence of a small number of infected foreigners (or travellers) would have a minimal effect on our pre-existing situation.

Our advice to the public is.

• Be aware of the symptoms of acute meningitis: Sudden onset of a high fever with a very severe headache, stiff neck and vomiting.
• If you experience these symptoms, seek urgent medical assistance as early treatment prevents serious complications. (However, remember that meningo-coccal meningitis is just one of several causes of similar symptoms).
• If you are travelling to a country with an epidemic of meningo-coccal meningitis you may choose to be immunised. Remember that meningitis is usually passed on in crowded conditions, through close personal contact. For many travellers these conditions would not be applicable. Travel immunisation is provided by the private sector not by the Gauteng Health Department.

The Gauteng Health Department will only undertake immunisation on a targeted basis to communities and institutions where a certain number of cases has occurred. Our surveillance notification system provides the information on which to take such a decision.

Dr Liz Floyd Director for AIDS and Communicable Diseases

Released by the Directorate for Health Promotion & Communication, Gauteng Health Department Inquiries: Jo-Anne Collinge 082 574 5510