The head of the Red Cross Federation's Health and Care Department, Alvaro Bermejo, says lack of an affordable vaccine and proper treatment was responsible for the deaths. He says the medical situation in Burkina Faso has improved little in the months since the first outbreak. "Unfortunately, a time frame for reaching a solution and producing the vaccine is such that it clearly will not be available for this next meningitis season," he said. "So, many lives are already at risk for not having acted beforehand."

There is a vaccine that protects against the W-135 strain of meningitis, but it costs between US$5 and US$50. This is far more expensive than the vaccine that is used to treat the more commonly found A and C strains of meningitis, which costs just 25 cents a dose.

The so-called meningitis belt stretches from the West African coast to the Horn of Africa in the east. It encompasses about 200 million people, 140 million in Nigeria alone. The meningitis season begins in November and lasts until May.

Red Cross epidemiologist, Bernard Moriniere, says the new strain of meningitis is likely to cause a major health crisis in Africa. "If there is another large outbreak caused by the W-135 strain, there is no vaccine available or only very limited quantities at a very high price," he said.

"If there was to be large outbreaks in, for example, Nigeria, which is right in the middle of this area, you could easily see an outbreak in Nigeria with hundreds of thousands of cases and 10 000 deaths."

Dr. Moriniere says with no vaccines available this year, the only way to reduce the mortality rate is to detect meningitis cases early and bring the victims to a treatment centre where they can get proper care.

At next week's meeting in Ouagadougou, the capital of Burkina Faso, the World Health Organisation and its partners will urge pharmaceutical companies to make an affordable vaccine available.