title: Yellow fever outbreak, Imatong, southern Sudan.
abstract: In May 2003, the World Health Organization received reports about a possible outbreak of a hemorrhagic disease of unknown cause in the Imatong Mountains of southern Sudan. Laboratory investigations were conducted on 28 serum samples collected from patients in the Imatong region. Serum samples from 13 patients were positive for immunoglobulin M antibody to flavivirus, and serum samples from 5 patients were positive by reverse transcription-polymerase chain reaction with both the genus Flavivirus-reactive primers and yellow fever virus-specific primers. Nucleotide sequencing of the amplicons obtained with the genus Flavivirus oligonucleotide primers confirmed yellow fever virus as the etiologic agent. Isolation attempts in newborn mice and Vero cells from the samples yielded virus isolates from five patients. Rapid and accurate laboratory diagnosis enabled an interagency emergency task force to initiate a targeted vaccination campaign to control the outbreak.
authors.affiliation: World Health Organization Collaborating Center for Arbovirus and Viral Hemorrhagic Fever Reference and Research, Nairobi, Kenya. conyango@nairobi.mimcom.net
authors.forename: Clayton O
authors.initials: CO
authors.lastname: Onyango
authors.forename: Victor O
authors.initials: VO
authors.lastname: Ofula
authors.forename: Rosemary C
authors.initials: RC
authors.lastname: Sang
authors.forename: Sanson L
authors.initials: SL
authors.lastname: Konongoi
authors.forename: Abourahmane
authors.initials: A
authors.lastname: Sow
authors.forename: Kenin M
authors.initials: KM
authors.lastname: De Cock
authors.forename: Peter M
authors.initials: PM
authors.lastname: Tukei
authors.forename: Fredrick A
authors.initials: FA
authors.lastname: Okoth
authors.forename: Robert
authors.initials: R
authors.lastname: Swanepoel
authors.forename: Felicity J
authors.initials: FJ
authors.lastname: Burt
authors.forename: Norman C
authors.initials: NC
authors.lastname: Waters
authors.forename: Rodney L
authors.initials: RL
authors.lastname: Coldren
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000831:Animals, Newborn; D000914:Antibodies, Viral / Q000097:blood; D001681:Biological Assay; D001921:Brain / Q000821:virology; D002648:Child; D002675:Child, Preschool; D002522:Chlorocebus aethiops; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D051379:Mice; D008875:Middle Aged; D012367:RNA, Viral / Q000737:chemistry / Q000235:genetics; D020133:Reverse Transcriptase Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D016036:Seroepidemiologic Studies; D013397:Sudan / Q000453:epidemiology; D014709:Vero Cells; D015004:Yellow Fever / Q000453:epidemiology* / Q000821:virology; D015005:Yellow fever virus / Q000302:isolation & purification*
chemical_list: D000914:Antibodies, Viral; D012367:RNA, Viral