Re-emergence of yellow fever in Senegal in 1995.

An outbreak of yellow fever (YF) occurred in the central part of Senegal during October 1995. Thirty-one probable cases were detected and 79 cases were confirmed either by IgM ELISA or by virus isolation (30 strains isolated). The case fatality rate was 18.9%. Incidence of the infection was evaluated by a serosurvey in the area. Males 10-29 years old belonging to the Peul ethnic group were more affected. Moreover, 28 YF virus strains were isolated from mosquitoes and larvae pools and vertical transmission of YF virus by Aedes aegypti was also demonstrated for the first time in the field. This outbreak occurred after the major amplification of the wild cycle of YF virus in 1993 in West Africa. This epidemic represented a typical example of intermediate transmission of YF: both humans and wild vertebrates are involved in the virus cycle through wild mosquitoes with semidomestic habits, mainly Ae. furcifer, Ae. luteocephalus, and domestic vector Ae. aegypti. It was controlled by a prompt immunization campaign. The impact of inclusion of YF vaccine in the Expanded Program of Immunization, which has been conducted in Senegal for eight years, is discussed.