Rapid Field Response to a Cluster of Illnesses and Deaths - Sinoe County, Liberia, April-May, 2017.

On April 25, 2017, the Sinoe County Health Team (CHT) notified the Liberia Ministry of Health (MoH) and the National Public Health Institute of Liberia of an unknown illness among 14 persons that resulted in eight deaths in Sinoe County. On April 26, the National Rapid Response Team and epidemiologists from CDC, the World Health Organization (WHO) and the African Field Epidemiology Network (AFENET) in Liberia were deployed to support the county-led response. Measures were immediately implemented to identify all cases, ascertain the cause of illness, and control the outbreak. Illness was associated with attendance at a funeral event, and laboratory testing confirmed Neisseria meningitidis in biologic specimens from cases. The 2014-2015 Ebola virus disease (Ebola) outbreak in West Africa devastated Liberia's already fragile health system, and it took many months for the country to mount an effective response to control the outbreak. Substantial efforts have been made to strengthen Liberia's health system to prevent, detect, and respond to health threats. The rapid and efficient field response to this outbreak of N. meningitidis resulted in implementation of appropriate steps to prevent a widespread outbreak and reflects improved public health and outbreak response capacity in Liberia.

Rapid Laboratory Identification of Neisseria meningitidis Serogroup C as the Cause of an Outbreak - Liberia, 2017.

On April 25, 2017, a cluster of unexplained illness and deaths among persons who had attended a funeral during April 21-22 was reported in Sinoe County, Liberia (1). Using a broad initial case definition, 31 cases were identified, including 13 (42%) deaths. Twenty-seven cases were from Sinoe County (1), and two cases each were from Grand Bassa and Monsterrado counties, respectively. On May 5, 2017, initial multipathogen testing of specimens from four fatal cases using the Taqman Array Card (TAC) assay identified Neisseria meningitidis in all specimens. Subsequent testing using direct real-time polymerase chain reaction (PCR) confirmed N. meningitidis in 14 (58%) of 24 patients with available specimens and identified N. meningitidis serogroup C (NmC) in 13 (54%) patients. N. meningitidis was detected in specimens from 11 of the 13 patients who died; no specimens were available from the other two fatal cases. On May 16, 2017, the National Public Health Institute of Liberia and the Ministry of Health of Liberia issued a press release confirming serogroup C meningococcal disease as the cause of this outbreak in Liberia.