Killer Hib virtually wiped out in Africa

12.08.2005

A pioneering vaccination programme for children has virtually wiped out a killer bug in the Gambia – and could save hundreds of thousands of young lives across Africa.

The vaccinations have slashed the incidence of the disease, which causes meningitis and other diseases in babies and infants, to virtually zero.

Paul Milligan of the London School of Hygiene & Tropical Medicine said: “This is an extremely valuable result. It proves that a routine vaccination to eradicate a major killer is achievable and practical.

“And it points the way for other African countries to introduce the same sort of vaccination programme, which has the potential to save a lot of lives and help meet the Millennium Development Goal of cutting the under-five mortality rate in the developing world by two-thirds.”

Since 1997, children in the Gambia have been vaccinated against H. influenzae type b, known as Hib. The bacterium is a major cause of meningitis, which can kill or leave children severely disabled and of potentially fatal pneumonia.

The World Health Organisation (WHO) estimates that Hib kills as many as 700,000 children every year – mostly among children in the developing world aged under five.

Dr Milligan added that, even though there were interruptions to the supply of vaccine in the Gambia programme and less than 70 percent of children got a complete course, the long-term programme, which started in 1997, has still proved highly effective.

He said: “Virtual eradication of the disease has been achieved, even with a less-than-perfect programme, which is particularly relevant to other sub-Saharan African countries.”

Before the introduction of the programme Hib meningitis alone affected 200 per 100,000 babies aged under 12 months and 60 per 100,000 children aged under five.

Only 45 percent of children affected recovered fully from Hib disease and 30 percent of those who contracted meningitis died.

The study was led by the UK Medical Research Council’s Dr Richard Adegbola, and part-funded by WHO.

The research showed that since 2002, Hib transmission has been virtually eliminated – in both vaccinated and unvaccinated children, because the vaccination programme has meant transmission is less likely.

Before the vaccination programme, around 12 percent of children between one and two years old carried the infectious bacteria – that rate is now less than 0.5 percent.

Dr Milligan said: “The study shows the vaccination programme has been an outstanding success – we now need similar programmes across the developing world to reduce the massive rate of death and disability associated with Hib.”