Yellow Fever

Yellow Fever - - _ "Angust 3,1979! Vol. 28 '/...

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Unformatted text preview: - _ "Angust 3,1979! Vol. 28 '/ No.30 I ' - -. ' Current Trends ' - - ' _' 349 Measles - Un‘ited States . _ . 351 _ Special Summer Program for Measles ' Elimination —- RegionsVlI and mu _ - - International-Notes . - _ ' -' 35-1 '} Yet-tow Fever Epidemic — a ” ' The Gambia, 1978-4979 _ :1 ' . -_ Epidemiologic Notes. and Reports 35'} Outbreak of Tric-hi-n'osis -- L3. 358 Infant Metabolic Alkalosis and Soy-Based Formula --- United States _-Yellow Fever Epidemic -—~'T—heGambia-1.9734979: International Notes ' 7 in October 1978, an epidemic of suspected. yell-ow fever (YF) was recognized by phy- ' " sicians in the. eastern regibn of The Gambia. In November, investigations were initiated . 1 by the Medical Research Council Laboratories, Faia-ra, The Gambia, and by the Ministry Vof Health; and in December-a mass vaccination campaign was begun,-using I70 vaccine - administered by iet—injecmr (.1). Indenuary 1979, further studies of the: Outbreak were; ' conducted by a meld-national team from the World Health Organization. - ' _ 7 ' Casedinding methods, active surveillance, and review of hospital recordsresulted-ing _ the identification of 271 suspected cases: diagnostic; specimens were'obtained' from 1313- _' .- - Of these patients. Eleven cases were; confirmed (10 by )tiafoid rise in. complement-fixing "V-MICF] antibody and 1- case by serologyand YF virus isolation), and 83 were-presume' _ tively diagnosed by the presence of CF antibodies in a; single C'on'vaiescent«ph'ase serum. " Specimen. The first laboratory-coefirmed case occurred in June'1978'in the fareastem ' ' - pa-rt'of- the country. Cases were-cenfined to the eastern half at The Gambia (MacCarthy island and Upper Riv-er divisions) until December '17978and January. 197.9, when scattered I 5 Cases appeared in western Gambia (North'Ban-k‘ Division).'.The estimated attads rates in 2' - MacCarthy island and Upper River divisions were 135 and 94 per 100,000, respeetively; - the attack'rate for the rest of the-.,_country. was 5.5 per 100,000. Nearly all recognized _ . cases. occurred from September 1978through January 1979-, with a peak incidence in October. ', . ._ _- I _ _' Surveys were_..condu.cted in_'9 villages in the severeiy affected M'acCar-th-yljls‘ia-nd and _ . . Upper. River divisions to obtain demographic data,'histories of ilineSsmm-patibie with ' ' _. YF, and 'seroflogic samples. When only laboratOry-e-onfirmed ca-ses'vvere consider_ed.-,. the ' ' 352 ‘ Yellow Fever —— Continued attack rate was 2.6% in these villages. However, High prevalence of CF antibodies an orbivirus, probably A‘nOphe/es-bame, rep also found. However, there w ' ' ' Aseptic meningitis Brucellasis Chickenpox Diphtheria ' ' - Encephalitis: Primary {arthropod-borne GI unspec.) 26 Post-infectious B Hepatitis. Viral: 'pro B - 285 Type A 544 _ Type unspecified 175 Malaria ‘ l9 Measles imbeolal 95 Meningococcal infections: Total 52 Civilian 51 Military x Mumps 60 Pertussis - 23 Rubella (German measles) 86 Tetanus 1 Tuberculosis 524 Tularemia ' Typhoid fever . 7 Typhus favor, tick-borne lfiky. Mt. sported} 57 Venereal diseases: ' Gonorrhea: Civilian 19. 599 Military 42:. Syphilis, primary 8: Randal-y: Civilian “3 Military Rabies in animals Anthrax Bomlism (Alaska 1) Congenital rubella syndrome (Illinais 1i Leprosy 1' (Tax. 1, Calif. 2) Leprospirosis (Mo. 1) Plague (N.MBX. 1) Psirtacosis Rabies in man Poliomyelitis: Total dies, indicating recent YF infect _ Paralytic (Pa. 1) 1974-1578" 121:668 ‘23 ‘0‘ :59 3.573 ' 26'165 fiflfl? - 2‘3 21:650- 1,330 1.915 21 31'532' F63 ' I§v350 IT’SIZ OD - 2!:- 463 551. 768 157629 11.843 19‘ 57 August 3, 1979- - - _ '. MMWR _ ' .' . _ 357- . Yellow Fever-— Continued ' " ' ‘. ' ” _ _ _ ' found in 7 viii-ages and indices 950 ih 2;. potential sites which.- wouid- be expectedto yield '_ ' large numbers of A. aegypti during the rainy season were numerous. in the North Bank - Division, several vi-llageswere positive, ineludin-g one (Mints-h Kunda} with a high Bre— teau index .-(10.4), in. this village YF virus was isolated. from an acutely ili'man-o'n January ' ‘ 10, and 2 isolateswere also recovered- from A. aegypti collected from human .lzra’it,a ' Evidence for sylvatic Y'F transmission was obtained from a survey of monkeys col- lected in MacCarthy island and North Ban-k divisions. 0f 19 Cclobus [radius and Cercopi- thecus aethiops, 16 had serologic evidence 'of Y'F infection. _- 7 ' . - '. . . It 'is believed that during-the. rainy season, human infections were acquired from - ' ' A. Iuteacephalus and possibly other species, as weil as, in certain: localities, A. aegypti, breeding in domestic and peridomest‘ic situations. lri December and-January,however, when the sylvatic'vector populations were markedly reduced, YF'transmi-s-sion continued- in localities with highA. aegypti ihdices, such as in Minteh Kuhda. '. ' . ‘ The YE mass vaccination campaigrr was cempieted' by January 31, When'approxi- mately 546,000 vaccinations. had been given, rep-resenting 95.5% of the population.- ' . Neutralization tests, performed -on prevaccination and. postvacbination serum specimens from 58 individuals, showed a seroconversion rate of 93%. Vaccine lots. returned .to the Pasteur lnstitute in-‘Dakar, Senegal, after field use had retained adequate- potency. - ' Reported b y the Ministry of Health, Banjul, the Medical Research Council, Faja'ra, The Gambia; Office _ de la Recherche Scientifique et Technique Ou tre-mer, Dakar, Senegal; the Warld Health Organization . in the Weekly Epidemiological Record 54: 182, June 8, 1979; VectOr-Borne Diseases Div, Bur of Labo- ratories, Bar of Smallpox Eradication, Viral Diseases Div, Bar of Epidemiology, CDC. - _ - . . . ' - _ Reference I _1. MMWFI 27:520-521, 1978 \- ...
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Yellow Fever - - _ "Angust 3,1979! Vol. 28 '/...

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