@article{fdi:010011863,
  title = {{A}n epidemic of sylvatic yellow fever in the southeast region of {M}aranhao state, {B}razil, 1993-1994 : epidemiologic and entomologic findings},
  author = {{V}asconcelos, {P}.{F}.{C}. and {R}odrigues, {S}.{G}. and {D}{\'e}gallier, {N}icolas and {M}oraes, {M}.{A}.{P}. and {T}ravassos da {R}osa, {J}.{F}.{S}. and {T}ravassos da {R}osa, {E}.{S}. and {M}ondet, {B}ernard and {B}arros, {V}.{L}.{R}.{S}. and {T}ravassos da {R}osa, {A}.{P}.{A}.},
  editor = {},
  language = {{ENG}},
  abstract = {{Y}ellow fever virus transmission was very active in {M}aranhao {S}tate in {B}razil in 1993 and 1994. {A}n investigation was carried out to evaluate the magnitude of the epidemic. {I}n 1993, a total of 932 people was examined for yellow fever from {M}aranhao : 70 were positive serologically, histopathologically, and/or by virus isolation, and another four cases were diagnosed clinically and epidemiogically. {I}n {M}irador (17,565 inhabitants), the incidence was 3.5 per 1,000 people (case fatality rate [number of deaths/number of cases diagnosed] = 16.4%), while in a rural yellow fever risk area (14,659 inhabitants), the incidence was 4.2 and the case-fatality rate was 16,1% (10 of 62). {A} total of 45.2% (28 of 62) asymptomatic infections were registrered. {I}n 1994, 49 serum samples were obtained and 16 cases were confirmed (two by virus isolation, two by seroconversion, and 12 by serology). {N}o fatal cases were reported. {I}n 1993, 936 potential yellow fever vectors were captured in {M}irador and a single strain was isolated from a pool of #{H}aemagogus janthinomys$ (infection rate = 0.16%). {I}n 1994, 16 strains were isolated from 1,318 #{H}g. janthinomys$ (infection rate = 1.34%) and one #{S}abethes chloropterus$ (infection rate = 1.67%). {O}ur results suggest that this was the most extensive outbreak of yellow fever in the last 20 years in {B}razil. {I}t is also clear that the lack of vaccination was the principal reason for the epidemic, which occurred between {A}pril and {J}une, during the rainy season, a period in which the mosquito population in the forest increases. ({R}{\'e}sum{\'e} d'auteur)},
  keywords = {{FIEVRE} {JAUNE} ; {EPIDEMIOLOGIE} ; {TRANSMISSION} ; {VARIATION} {SAISONNIERE} ; {EPIDEMIE} ; {SURVEILLANCE} {ENTOMOLOGIQUE} ; {BRESIL} ; {MARANHAO}},
  booktitle = {},
  journal = {{T}he {A}merican {J}ournal of {T}ropical {M}edicine and {H}ygiene},
  volume = {57},
  numero = {2},
  pages = {132--137},
  ISSN = {0002-9637},
  year = {1997},
  URL = {https://www.documentation.ird.fr/hor/fdi:010011863},
}