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Nigeria has developed the world’s first vaccine against all types of meningitis. The shot will help reduce the burden of the disease in Africa’s “meningitis belt.” Nigeria has become the first country to introduce the new Men5CV or ‘MenFive’ meningitis vaccine in Africa’s “meningitis belt”. It is the world’s first vaccine that provides protection against all five strains of meningococcal bacteria that cause meningitis. According to the World Health Organization (WHO), about half of meningitis cases and deaths occur in children under 5 years of age.
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 eliminated about 80% of meningitis infections across the continent, the vaccine only protects against a single strain of meningococcal bacteria, serogroup A.
This means Africans are not protected against the four other strains of the bacteria (C, W, Y and X), all of which cause disease. Meningitis cases continue to increase in meningitis-prone areas, and have been attributed to the C, W, Y, and X strains, but not the A strain.
According to WHO, meningitis cases increased by 50% across Africa last year. “By any standards, carrying the burden of this disease is unbearable,” Marie-Pierre Preziosi, an expert on meningitis at WHO, told DW. According to the WHO report, between October 2023 and mid-March this year, an outbreak of the C strain occurred in Nigeria, causing about 1,700 suspected meningitis cases and about 150 deaths across the country. The vaccine was released to deal with that epidemic. Other countries, such as Togo, have seen similar outbreaks in previous years.
meningitis belt
Africans, who live in 26 countries considered part of the continent’s meningitis belt, are more vulnerable to meningitis than any other country in the world. Preziosi said this is due to the climate of the area.
At any given time, about 10% of the global population is carrying bacteria in the back of their throat or nose that causes meningitis. The bacteria usually reside in the mucus membrane, which protects the bacterial infection from spreading. Trouble comes when the membrane ruptures, allowing bacteria to enter the bloodstream.
Preziosi said that when the dry season arrives in Africa’s “meningitis belt” — typically between December and June — dry, dusty winds blow from east to west. When inhaled, the material these winds carry can rupture mucous membranes. Several studies have shown that meningitis outbreaks are more pronounced in the dry season.
Before the rollout of the MenAfriVac shot, countries in the belt saw large outbreaks of meningitis every five to 12 years, according to the Vaccine Alliance, an international health organization that will help distribute the shot. During the worst of these outbreaks, one in 100 people were infected. The 1996–97 meningitis outbreak in Africa, which caused at least 25,000 deaths and infected 250,000 people, remains one of the continent’s worst outbreaks.
Meningitis causes serious long-term health problems
Even with early diagnosis and antibiotics, meningitis is fatal in about 10% of cases, and about 20% of those infected experience long-term health problems. “Of those who survive, one in five may develop long-term disability — which could be neurological disability, hearing loss, deafness, even losing a limb,” Preziosi said. “So this is quite dramatic, and it can push entire communities into poverty.” Meningitis is usually spread by droplets from coughing, sneezing or kissing. The incubation period is usually between three to four days.
Initial symptoms are usually non-specific and may appear flu-like. If left untreated, carriers may develop high fever, light sensitivity, stiff neck, skin bleeding, and in the worst case, blood poisoning, leading to sepsis. Infection causes swelling of the membranes that surround and protect the brain and spinal cord.
By protecting people from all five types of meningitis, experts hope the new Men5CV vaccine will curb the disease burden initially in the African meningitis belt, but eventually in other meningitis-prone areas.
Men5CV vaccine rollout
The Men5CV vaccine introduced in Nigeria has been in the works for 13 years, and uses the same infection-fighting mechanism as MenAfriVac.
“When you get vaccinated … your body will respond by making antibodies, these are defense mechanisms to protect against infectious diseases,” Preziosi said. “Those antibodies may also produce some specific mucus antibodies on the surface of your nose or throat, which keep the bacteria from growing,” he said.
At this point, the new Men5CV vaccine will only be used to address the outbreak. WHO says it hopes countries can start using it as preventive protection for all children aged two and older by 2025. At $3 (€2.80) per shot, this vaccine is slightly more expensive than MedAfriVac, which is less than $1 (€0.94). , But Preziosi says if there is widespread uptake, the price could go lower.
Preziosi hopes the new five-strain vaccine will be as successful in eliminating all forms of meningitis as the A vaccine was in virtually ridding the meningitis belt of that particular type.
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