As of last week, 526 cases with 23 deaths (a case fatality rate of 4.37 per cent) have been reported across the country and epidemic thresholds have so far been crossed in the states of Blue Nile, Gedaref, Kassala and South Kordofan, the UN World Health Organization (WHO) said. Mass vaccination campaigns with bivalent vaccines are continuing in South Kordofan and Gedaref, while two campaigns have already been completed in Blue Nile and Kassala. Another outbreak has been confirmed at a displaced persons’ camp in war-torn West Darfur where 28 cases and one death (case fatality rate of 3.57 per cent) have been reported to WHO. A vaccination campaign is expected to start there later this week.WHO, the UN Children’s Fund (UNICEF) and non-governmental organizations are collaborating in the effort to stem the spread of the disease, which even when diagnosed early and with adequate therapy instituted, kills 5 to 10 per cent of patients, typically within 24 to 48 hours of the onset of symptoms, the most common of which are stiff neck, high fever, sensitivity to light, confusion, headaches and vomiting. WHO Sudan is providing technical guidance for outbreak control and case management in addition to drugs and other emergency supplies for outbreak investigation. Meningitis may result in brain damage, hearing loss, or learning disability in 10 to 20 per cent of survivors. The bacteria are transmitted from person to person through droplets of respiratory or throat secretions.Close and prolonged contact such as kissing, sneezing and coughing on someone, living in close quarters, and sharing eating or drinking utensils, facilitates the spread. The incubation period ranges between two and 10 days.