CSM – The forgotten killer buried in Coronavirus

Since December 2019, the world has been shackled by a single disease, making countries, weak and powerful alike, crawl on their knees.

The novel coronavirus (COVID-19) has caused damage to every facet of human life and has affected every sector of the global village. From agriculture, politics, economy, education, health, among others, none has been spared the effect of the deadly scourge, declared a global pandemic by the World Health Organisation (WHO).

While coronaviruses, a large group of viruses that affect the lungs, may not be entirely new to the world, experts say COVID-19 is not only a new strand of the already known coronaviruses but a deadly one at that.

So far, close to three million people worldwide have been diagnosed of the disease, with over 206,000 dead, as at April 27. Experts say cases involving people with low immunity and the aged are likely to result in more fatalities. Several measures have been put in place by countries to prevent its importation, contain its spread and ultimately limit its impact on the economic and socio-cultural lives of the people.

Ghana’s case

In Ghana, out of a total of 100,622 samples tested, 1,550, representing 1.5 per cent, have turned out to be positive, with 11 people dead. Like the world all over, many people keep recovering from the disease daily, giving all of us some hope. Already 155 people in Ghana have recovered from the disease.

In anticipation of finding a lasting solution to the disease, President Nana Addo Dankwa Akufo-Addo and the government have put measures in place to limit and stop the importation of the virus; contain its spread; provide adequate care for the sick; limit the impact of the virus on social and economic life; and inspire the expansion of our domestic capability and deepen our self-reliance.

The country thus started by closing its borders to all passenger flights coming into the country and mandatorily quarantined all those who entered the country for testing. Again, schools, churches, mosques and all public gatherings have been temporarily banned. There was a three-week lockdown of some major cities, including Accra, Kasoa and Kumasi and their contiguous districts.

The lock down was meant, according to the government, to study and understand the dynamics of the disease in the country and to also enhance the country’s contact tracing. Wearing of face masks have been made mandatory.

A new deputy Minister of Health, whose entire vetting duration focused on Covid-19, has been appointed to support the fight.

The government has devoted GH¢1.2 billion Coronavirus Alleviation Programme (CAP) to support households and businesses. Out of this amount, GH¢280 million is being used to provide food for the vulnerable and free water for all Ghanaians for three months, i.e. April, May and June; GH¢323 million is being used to motivate health workers; and GH¢600 million of assistance is being provided to micro, small and medium-scale businesses.

Government, during the lockdown, spent at least GHC2million daily to feed some 400,000 vulnerable people in the affected areas. To mitigate the hardship, policy rate have been brought down by about 150 basis point, with the Economist Intelligence Unit (EIU), in its latest Country Report on Ghana, predicting a further decline in the policy rate. A new 100-bed Infectious Disease and Isolation facility, expected to be built within six weeks, is currently ongoing at the Ga East municipality.

CSM

In the face of all the measures to fight Covid-19, the country seems to have gone to sleep on another deadly outbreak that is causing havoc, especially in the northern part of the country. While Covid-19 has so far claimed just about 11 lives (though every single life is precious and cannot be accounted for), this disease called Cerebrospinal Meningitis has claimed about 40 lives.

The CSM is said to be one of the families of meningitis. Meningitis is the inflammation of the brain and the spinal cord. Experts say there are three types, ie meningococcal, viral and tuberculosis meningitis.

Cerebrospinal meningitis (CSM), also referred to as meningococcal meningitis, is an infection of the meninges, the thin lining that surrounds the brain and the spinal cord. It is caused by Neisseria meningitides, and the incubation period is one to seven days. Even with appropriate treatment, around 10 per cent of patients die and up to 20 per cent of survivors have serious permanent health problems like epilepsy or mental retardation.

This is way higher than the global fatality rate of Covid-19, which is around five per cent, with Ghana’s far below one per cent. The bacteria are transmitted from person to person through droplet and mostly occur in the dry season. According to the WHO, the five northern regions of Ghana are located within the “Meningitis belt”, which covers about 25 countries with around 450 million people. In 1996/1997, the worst epidemic in CSM hit Ghana where 18,703 cases were reported, with 1,356 deaths mostly recorded in the northern regions.

Unlike Covid-19, CSM has a vaccine, hence the absolute reduction in its infection and death rates over the years. That notwithstanding, this year has seen a spike in a new strand of CSM killing over 40 people in the northern regions of Ghana. The worst-hit region in this new wave of cases is the Upper West Region, which has recorded over 300 cases out of the total cases. According to the Upper West Regional Minister, Hafiz Bin Salih, the death rate of the disease stands at 15.5 per cent, a situation he describes as ‘worrying’.

Symptoms and treatment

Common symptoms of CSM include fever, headache, photophobia (fear of light), stiffness of neck (nuchal rigidity), convulsion and irritability. In the case of children, symptoms include poor suckling of breast, bulging and fontanels.

Luckily, CSM can be treated with early identification. Measures to treat include isolation of the infected person, immunization at early stage, treating all upper respiratory tract infections properly and staying in places with good ventilation. Experts say meningitis can be treated using broad spectrum antibiotics.

The disease can be diagnosed through usage of CT scan (scan of the head to detect any swelling), physical examination of the skin for rashes and checking of stiff neck.

In extreme cases, complication of the disease can lead to deafness, inflammation of the spinal cord, blindness, death, among others.

Let us therefore attach the level of seriousness in fighting Covid-19 to fighting this outbreak as soon as possible. The time to kick CSM out is now. Let us in our anxiety to deal with Covid-19 not lose sight of the devastating effect of other sicknesses. Let us continue to educate people on the disease much as the same way that we are dedicating effort to educating people on Covid-19. As a country, let us devote much attention and resources to preventing the disease.

As the President said in his eighth address to the nation, “in our time, nobody should die of the disease”.

The author is the General Secretary of the Graduate Students Association of Ghana (GRASAG National) and a Masters of Arts (Communication Studies) student of the Department of Communication Studies, University of Ghana.