New Delhi, May 5: MENINGOCOCCAL meningitis has been a scare in 2005 across the world. Massive outbreaks have been reported in Phillipines, Chad and Sudan. The epidemic had assumed such high proportions that the respective governments had ordered mass vaccination. Delhi, however, which has registered a toll of 14, has ruled out vaccination.

The toll this year, according to WHO:

*Jan - March 16: 387 cases including 53 deaths (case fatality rate, 13%) in Chad

* January: 19 deaths, 33 cases reported in Philippines. Case fatality ratio 58%, of meningococcemia-like illness in Baguio City

* As of March 25: 71 suspected cases including 5 deaths in Sudan

Most of the outbreaks in these parts of the world is also being caused by Neisseria meningitidis serogroup either sero group A, which is prevalent in Delhi, or sero group W135.

The cases in Delhi have been been reported from a particular sub type of the bacteria, Neisseria meningitidis — serotype A. The same sub-type has been responsible for all major epidemics in Asia and Sub-Saharan Africa (the menigococcal belt of the world). ‘‘The bacteria is of 12 kinds or subtypes or serogroups. N. meningitidis. A, B, C and W135 are recognised to cause epidemics,’’ said Dr N.P.Singh, professor of Medicine, Maulana Azad Medical College.

The disease seems to be following a 20-year pattern in the Capital. First reported in India in 1883 in Shikarpur jail and again in 1965, the biggest outbreak was in 1985, with 800 deaths. Of these, 70 deaths were reported in Delhi. The epidemic was again seen on a very limited scale in 1986 and 1987. ‘‘The disease was first seen reported in 1965 and again in 1985. Now 2005 makes it another 20 years,’’ said S.P. Agarwal, Principal Secretary Health, Delhi government.

In 1985, the epidemic was mostly located in West zone — Raja Garden, Rajouri Garden, Tilak Nagar, Vikas Puri, Subhash Nagar, Naraina and Karol Bagh. This time, officials say it is mostly found in city zone (including Sahi Ilaka, Daryagunj, Kadi Bawali and Chandni Chowk).