On 16 August 2000, the Ministry of Health (MOH), Liberia confirmed an outbreak of
yellow fever (YF) in Grand Cape Mount County Liberia (see map below).
To date, the authorities have detected 29 cases meeting the case definition, including 3
deaths, originating from 2 districts in the county. A report of one case in a third
district has not yet been verified. Laboratory results have confirmed yellow fever
IgM in 1 of 5 clinical samples sent to Institut Pasteur, Abidjan, Côte d'Ivoire, for
testing; virus detection is now underway in this and the other samples.
These cases were detected following training in integrated surveillance for district
surveillance officers in the county. As this training is introduced in the other counties,
the outbreak may prove to be more extensive. Other districts are now beginning to detect
All cases which have been investigated have occurred among unvaccinated persons. The
most recent YF vaccination campaign in the area was conducted in 1999 but was limited to a
single refugee camp. Most of the refugees who were vaccinated in that exercise have left
the area. A nationwide YF vaccination campaign was conducted in 1995, but coverage was
reported to be low, leaving much of the population susceptible.
The population in the Grand Cape Mount County lives in small villages or towns of
approximately 5-10 000 people. There is a lot of movement across the border with Sierra
Leone. The road between Grand Cape Mount County and the capital of Liberia, Monrovia, is
in good condition and there is a considerable amount of traffic to and from Monrovia. If
YF were introduced in Monrovia there would be 1.5 million people at risk.
In response to the outbreak, the MOH, Liberia, WHO, and health sector non-governmental
organizations (NGOs) have agreed to:
- implement a mass vaccination campaign targeting the 150 000 population immediately at
risk. WHO is providing vaccine and autodestruct syringes for this campaign.
- intensify vaccination and surveillance in the affected communities and other districts
not yet known to be affected.
The World Health Organization is also seeking to mobilize support for yellow fever detection and response activities.