Clusters of more than a few cases are uncommon. In parts of Africa, widespread epidemics of meningococcal meningitis occur regularly. In 1996, the biggest wave of meningococcal meningitis outbreaks ever recorded hit West Africa. An estimated 250,000 cases and 25,000 deaths in Niger, Nigeria, Burkina Faso, Chad, Mali, and other countries paralyzed medical care systems and exhausted vaccine supplies. With the decline in Hib disease, cases of bacterial meningitis have decreased since 1986.
Meningococcal meningitis is a continuing threat in day-care centers and schools.
Healthy children and young adults are susceptible, and death can occur within a few hours of onset. The vaccines against Hib are very safe and highly effective. By age 6 months of age, every infant should receive at least three doses of an Hib vaccine. The vaccine is sometimes used to control outbreaks of some types of meningococcal meningitis in the United States. New meningococcal vaccines are under development.