The outbreak of meningitis due to Neisseria meningitidis W135 in 2003 in Burkina Faso and the national response: main lessons learnt.

Among the countries situated in the African meningitis belt, Burkina Faso is usually the one which pays the highest toll to this disease in terms of morbidity and mortality. Until 2002, the causal agent of the epidemic was usually Neisseria meningitidis serogroup A. At the onset of the 2002 epidemic, N. meningitidis W135 was identified as the predominant serogroup by the national reference hospital and the WHO, and this was confirmed by the WHO collaborating centre on meningitis in Oslo, Norway. Due to the nonavailability of an affordable and effective vaccine, the only adequate strategy was proper case management, taking advantage of the sensitivity of the bacteria to the currently used antibiotics. In order to avoid the repetition of such a situation, WHO and GlaxoSmithKline, with the financial support of the Bill and Melinda Gates Foundation, planned and actually realized the production of a trivalent ACW135 vaccine in anticipation of the 2003 epidemic season. In order for the vaccine to be effectively used in the field, it was imperative that various ethical, managerial and technical conditions be fulfilled. The successful use of the trivalent polysaccharide vaccine ACW135 in Burkina Faso during the 2003 outbreak was essentially due to the high level of leadership demonstrated by the national authorities of Burkina Faso, the facilitating role of WHO, the effective coordination of partners and activities, the transparency in the response to the epidemic and the management of the resources.