Nigeria has become the first country in Africa’s “meningitis belt” to roll out a new meningitis vaccine called Men5CV or ‘MenFive’. It is the world’s first vaccine to provide protection against all five strains of the meningococcal bacteria that cause meningitis.
Around half of meningitis cases and deaths occur in children under 5 years old, according to the World Health Organization (WHO).
Since 2010, Africa, which sees the highest burden of meningitis infection in the world, has been fighting outbreaks using the MenAfriVac vaccine. Although it has successfully eradicated about 80% of meningitis infections across the continent, the vaccine only protects against a single strain of the meningococcal bacteria, serogroup A.
That means Africans haven’t had protection against the four other strains of the bacteria (C, W, Y and X), all of which cause the disease. Cases of meningitis have continued to rise in meningitis-prone areas, and have been attributed to the C, W, Y, and X strains, but not the A strain.
Last year, reported meningitis cases jumped 50% across Africa, according to the WHO.
“According to any standards, it’s unbearable to keep this disease burden,” Marie-Pierre Preziosi, an expert on meningitis at the WHO, told DW.
Between October 2023 and mid-March of this year, Nigeria experienced an outbreak of the C strain, which led to around 1,700 suspected meningitis cases and some 150 deaths across the country, the WHO reports. The vaccine was rolled out to address that epidemic.
Other countries, such as Togo, have seen similar outbreaks in past years.
Meningitis belt
Africans located in the 26 countries considered part of the continent’s meningitis belt are more susceptible than anyone in the world to meningitis. Preziosi said that is because of the area’s climate.
At any given time, around 10% of the global population is carrying the bacteria that causes meningitis in the back of their throat or nose. The bacteria normally sits in their mucus membranes, which protect them from bacterial infection spreading. Trouble only comes if that membrane is breached, allowing the bacteria to enter the bloodstream.
Preziosi said that in the dry season in Africa’s “meningitis belt”, which generally takes place between December and June, dry, dusty winds blow from east to west. When inhaled, the material that blows with these winds can breach the mucus membranes. Many studies have shown that meningitis outbreaks can be clearly tracked with this dry season.
Before the rollout of the MenAfriVac shot, countries in the belt saw major outbreaks every five to 12 years, according to Gavi, the Vaccine Alliance, an international health organization that will help distribute the shot. During the worst of these outbreaks, up to one in 100 people were infected.
Africa’s 1996-97 meningitis outbreak represents one of the country’s worst, leading to at least 25,000 deaths and infecting some 250,000.
Meningitis causes serious long-term health issues
Even with early diagnosis and antibiotics, meningitis is deadly in about 10% of cases, and about 20% experience long-term health issues.
“For those who survive, one in five can develop long lasting disabilities — that can be neurological disabilities, loss of hearing, deafness, also losing limbs,” said Preziosi. “So it’s quite dramatic, and it can drive a whole community into poverty.”
Meningitis is most commonly spread through droplets from coughing, sneezing or kissing. The incubation period is generally between three and four days.
Initial symptoms are usually non-specific and can look like the flu. If untreated, the carrier can develop high fever, light sensitivity, neck stiffness, bleeding in the skin and, in the worst cases, blood poisoning that can lead to sepsis. Infection leads to the inflammation of membranes surrounding and protecting the brain and spinal cord.
By protecting people from all five strains of meningitis, experts hope the new Men5CV vaccine will prevent the burden of the disease initially in the African meningitis belt, but eventually in other meningitis-prone regions.
Men5CV vaccine rollout
The Men5CV vaccine rolled out in Nigeria has been in the works for 13 years. It uses the same mechanism used by the MenAfriVac to fight infection.
“When you get the vaccine … your body will react in creating antibodies, these are the defense mechanisms to protect from infectious diseases,” said Preziosi. “Those antibodies could also generate some specific mucus antibodies at the surface of your nose or throat,” she said, which prevent the bacteria from latching on.
At this point, the new Men5CV vaccine will only be used to address outbreaks. The WHO hopes to see countries start launching it by 2025 for preventative measures in all children from the age of 2.
At $3 (€2.80) per shot, this vaccine is slightly more expensive than the MedAfriVac, which is less than $1 (€0.94). But Preziosi says that if there is broad uptake, the price could go down.
Preziosi hopes the new five-strain vaccine will be as successful eradicating all strains of meningitis as the A vaccine, which has almost eradicated that specific form of meningitis from the meningitis belt.
Edited by: Fred Schwaller
