Health authorities in Burkina Faso have launched a mass vaccination campaign in the capital, Ouagadougou, to combat a rapidly spreading meningitis epidemic that has claimed more than 600 lives.

“Ouagadougou has been hit to an extent that we did not expect,” said Jean Gabriel Wango, secretary general of the country’s health ministry.

Authorities are dispatching two health agents to each of the city’s 620 vaccination sites. The vaccinations, which are free of charge, were to begin on Monday but officials said a shortage of health workers prompted a delay by one day. Authorities sought additional health workers from the medical school in Ouagadougou.

“We wanted to start the vaccinations after we got the vaccines on Sunday but to launch the campaign in a large number of sites is not easy,” Wango said. “We are asking people to stay at home and we will send teams to their neighbourhoods to vaccinate them.”

Health Minister Alain Yoda said it was necessary to take “robust and rapid measures” in the capital to help stem the spread of meningitis throughout the city and the rest of the country.

Since January more than 600 people have died of meningitis in Burkina Faso among at least 10,000 who have been infected, according to the health ministry. Twenty-two of the nation’s 55 health districts are experiencing an epidemic and 15 others are on alert.

“I am really afraid of the disease and I am here to get vaccinated with my daughter,” said 23-year-old Fatou Zine as she waited for her shot. She said three of her neighbours had died of meningitis.

Meningitis is an infection of the thin lining around the brain and spinal cord. Typically, five to 10 percent of meningitis patients die within 24 to 48 hours of the first symptoms, while 10 to 20 percent of survivors suffer brain damage, hearing loss, and learning disabilities.

Epidemics across Africa’s semi-arid ‘meningitis belt’, which stretches from Senegal in the west to Ethiopia in the east, flare up each year during the dry season between December and June when strong, dust-laden winds and cold nights make people more prone to respiratory infections. The meningitis bacteria are transmitted by sneezing or coughing.

Sudan, Uganda and the Democratic Republic of Congo have also suffered epidemics this year. Other countries with outbreaks include Côte d’Ivoire, Niger, Mali, Benin, Ghana, Togo and Guinea.

In Cote d’Ivoire health authorities began a vaccination campaign on Tuesday in Boundiali, 800km north of the main city, Abidjan. Thirty-six cases have been reported in that region since mid-February, including six deaths, according to the United Nations.

The International Coordination Group on Vaccine Provision for Epidemic Meningitis Control (ICG) provided 550,000 vaccines to Burkina Faso on Sunday and officials said they were expecting to provide another one million doses later this week. The World Health Organisatin (WHO) says an additional US$1.2 million is needed for the Burkina Faso vaccination campaign.

WHO helped establish the ICG to ensure rapid and equal access to low-cost vaccines and medicine to treat meningitis after major outbreaks in Africa in 1995 and 1996. The ICG is managed by WHO, Medecins Sans Frontieres, the UN children’s agency (UNICEF) and the International Federation of the Red Cross. Other agencies provide expertise and technical advice.

The Burkinabe health ministry said last week it had taken measures to prevent possible theft of the meningitis vaccines. Every dose is tagged with a number and the ministry has asked all health districts to return the empty tubes to track their use.

Health authorities said they are investigating why last year six districts with epidemics that benefited from a vaccination campaign have had a resurgence of the disease this year.