Yellow fever in Trinidad and Tobago 1978-1980: epidemiological aspects

Between 1978-1979 an epidemic of yellow fever occurred in Trinidad in two phases. Eight cases occurred in December 1978-March 1979 and 10 cases occured in August-September 1979. Seven died, giving a case fatality rate of 39 per cent . All cases were male aged 16-58 years (median 22.5). Seventeen had been exposed in forests where the virus was active and none had records of being vaccinated. The high level of clinical and virological surveillance that existed made it likely that all or nearly all the cases were ascertained. Intense immunization, health education and vector control efforts also mitigated against a larger epidemic.

Laboratory diagnosis of yellow fever infections in humans, alouatta monkeys and haemagogus mosquitoes in Trinidad, 1978-1980

The yellow fever epidemic in Trinidad began with an epizootic in alouatta monkeys in November, 1978. Activity was detected by virus isolation from Alouatta monkeys and from Haemagogus mosquitoes between this date and July 1980. First reports of monkey deaths centered around the Guayaguayare forests of South Trinidad, following which the epizootic spread west to the Moruga area, and north through the Biche Forest reserve, eventually reaching the north-west Chaguaramas peninsula. Surveillance of febrile persons attending clinics and hospitals was intensified and 18 confirmed cases were identified, from 14 of whom yellow fever virus was isolated. In four cases, diagnoses were made on the basis of liver pathology only. Paired sera were obtained from 10 of 11 persons who survived, and in each case serological conversions were obtained by haemagglutination inhibition and mouse neutralization tests. Yellow Fever virus was isolated from 16 of 32 Alouatta monkeys and from 19 of 174 pools of Haemagogus mosquitoes. Two systems were used for virus isolation: the Aedes cell line AP-61 and suckling mice. The former proved to be more sensitive, detecting virus in 11.7 per cent of 725 specimens inoculated whereas suckling mice detected virus in 7.9 per cent of 724 specimens. In 11 instances virus was detected in an animal or mosquito pool by AP-61 but not initially by mouse inoculation whereas the converse was true in only one case.