Yellow fever vaccination and pregnancy: a four-year prospective study.

During an outbreak of yellow fever (YF) in Nigeria in 1986-1987, women at various stages of pregnancy were vaccinated against YF, either because those pregnancies were not known at the time or because they requested vaccination out of fear of acquiring the disease. This offered an opportunity to assess the safety and efficacy of YF vaccine in pregnant women and the effect of this vaccine on their newborn children. Pre-vaccination and post-vaccination serum samples from the vaccinated pregnant women were tested by enzyme-linked immunosorbent assay and by neutralization tests for antibody to YF virus. The results showed that the antibody responses of these pregnant women were much lower than those of YF-vaccinated, non-pregnant women in a comparable control group. Follow-up of these women and their newborn children for 3-4 years showed no abnormal effect that could be attributed to the YF vaccine, which suggests that vaccination of pregnant women, particularly during a YF epidemic, may not be contraindicated.

Urban yellow fever epidemic in western Nigeria, 1987.

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.

Expanded Programme on Immunization in Nigeria.

A brief description is given of the Expanded Programme on Immunization in Nigeria, which emphasizes the use of fixed facilities with outreach extension.