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The Ghana Ministry of Health, with assistance from CDC and other partners, tested cerebrospinal fluid (CSF) specimens from 286 patients.

In the first 4 weeks of the outbreak, a high percentage of cases were caused by Streptococcus pneumoniae; followed by an increase in cases caused by Neisseria meningitidis, predominantly serogroup W.

The findings of this report are subject to at least four limitations.

First, lack of laboratory reagents and supplies required for bacterial culture might have led to underdiagnosis or misidentification of the etiologic agent.

A suspected meningitis case was defined as the occurrence of fever, neck stiffness, or other meningeal signs (e.g., headache, altered mental status, or bulging fontanelle in an infant) in a resident of northern Ghana.