Some 172 cases of meningitis have been reported in Cote d’Ivoire and 44 deaths since the beginning of January, but with only 400,000 vaccines available for the one million people at risk and health staff poorly prepared to deal with a meningitis epidemic, a wider crisis is feared.

Health staff are “not well-trained” in predicting and responding to meningitis outbreaks in Cote d’Ivoire, said Mamadou Guingaré, an epidemiologist at the World Health Organization’s Multidisease Control Centre in Burkina Faso, which means officials “do not know for certain” the full extent of the problem.

Only seven Ivorian health districts have reported meningitis cases, with many of the other 65 districts not reporting at all, despite 18 of them being known to be at risk, he said.

Epidemic levels have only been announced for the town of Tengréla in the north on the Mali border where 75,000 people have been vaccinated.

The towns Bouaké, Sakassou, Vavoua and Daoukro in the centre and centre-west of the country are on alert, according to Rémi Allah Kouadio the minister of health and hygiene.

Across the border in Burkina Faso, 255 people have died of the infection out of a total of 1,938 reported cases since the beginning of January.

Kouadio Aka Tanoh Bian from the World Health Organization said the WHO may have to call on emergency funding mechanisms such as the UN Central Emergency Response Fund, to buy more vaccines quickly for Cote d’Ivoire.

The WHO team in Cote d’Ivoire said it is supplying the government with 379,000 vaccine doses against two types of meningitis and has sent a request for 600,000 more for Cote d’Ivoire to the International Coordination Group for vaccine (ICG) on Vaccine Provision for Epidemic Meningitis Control which provides vaccines.

The meningitis bacterium, which usually reaches epidemic levels in the West Africa region between December and May, could be especially severe this year, forecasters have warned, as the region is heading toward the peak of a 10- to 12-year cycle of meningitis crises.