Smallpox in the Republic of Guinea, West Africa. I. History and epidemiology

Breman, J.G.; Alécaut, A.B.; Lane, J.M.

American Journal of Tropical Medicine and Hygiene 26(4): 756-764

1977


ISSN/ISBN: 0002-9637
PMID: 329701
Accession: 068526388

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Abstract
Smallpox was probably introduced into Guinea and into the rest of West and Central Africa after 700 A.D. when Islamic invaders began their western and southern penetrations. Specific references to the disease along the "Guinea coast" are found in documents published as early as 1664. Periodic epidemics of smallpox occurred in Guinea at 10 yr intervals since records began being kept in 1925 by the League of Nations. The epidemic interval decreased to 5-7 yr in the 1950's. An annual attack rate of 19.4 reported cases/100,000 occurred in Guinea throughout this century before the beginning of the regional West and Central African Smallpox Eradication and Measles Control Program in Dec. 1967. The overall case fatality rate was 9.4%. The real annual incidence was at least 20 times the reported incidence. The case occurred mainly in dry season months. From Dec. 1967-Jan. 1969, persons less than 15 comprised 57.3% of the cases. Females with smallpox predominated over males, 56.9%:43.1%. Of those affected, 96% lived in villages of less than 1000. Sierra Leone and Guinea had the 2 highest variola attack rates in the world in 1967. The most severely affected areas were in the northern districts of Sierra Leone and the southwestern regions of Guinea. These countries have close geographic and cultural ties, and several importations of smallpox from Sierra Leone into Guinea were identified.