Urban yellow fever epidemic in western Nigeria, 1987

Abstract

A large epidemic of urban yellow fever occurred in April and May 1987 in Oyo State, western Nigeria. The principal vector was Aedes aegypti, breeding in domestic water containers. The 1987 outbreak followed an epidemic of sylvatic yellow fever in eastern Nigeria the previous year, and probably resulted from introduction of the virus by viraemic travellers. The outbreak in Oyo State ended in early July, by which time 805 cases and 416 deaths had been officially notified. However, surveys of 3 villages in the epicentre, a region with over 4 million inhabitants, indicated an infection rate of approximately 20%, a clinical attack rate of 2·9% and a mortality rate of 0·6%, suggesting that the true incidence of cases and deaths far exceeded the official reports. Yellow fever virus was isolated from persons with fully developed yellow fever as well as mild febrile illness. One virus isolate was made from blood of an individual with mild illness, who had received 17D vaccine 5 d earlier; monoclonal antibody analysis showed that the isolate was a wild-type virus. Larval indices of Ae. aegypti were very high; however, low vector competence of the Ae aegypti population may have provided a constraint on spread of the epidemic. In late 1987 a third epidemic appeared in Niger State, northern Nigeria, with 644 reported cases and 149 deaths. The vector(s) involved is (are) unknown.