Update on unexplained cluster of deaths – Liberia

10 May 2017

On 25 April 2017, the Ministry of Health of Liberia notified WHO and partners of a cluster of sudden deaths of unknown aetiology in Sinoe County. The event began on 23 April 2017 when an 11-year-old child was admitted to hospital presenting with diarrhoea, vomiting and mental confusion after attending a funeral on 22 April 2017.

As of 9 May 2017, a total of 31 cases including 13 deaths have been reported.

The Ministry of Health of Liberia (MOH) responded quickly to the cluster using the emergency management and laboratory infrastructure it developed during the Ebola outbreak alongside WHO, and other public health partners. The Liberian MOH sent blood, urine, and plasma samples to the US Centers for Disease Control and Prevention (CDC) for testing of infectious diseases and environmental toxins.

On 8 May, WHO was informed by Liberia’s MOH that samples from four of the deceased patients had tested positive for meningitis C (Neisseria menigitidis). Although these most recent reports point to meningitis as the probable cause of illness and death in these patients, the investigation is still ongoing to determine if this bacteria is responsible for other reported illnesses in this cluster.

While awaiting full toxicology reports, the Liberian MOH is exploring whether vaccination against meningitis is an appropriate course of action. WHO supports the ongoing epidemiological and laboratory investigations to identify the aetiological agent of this cluster of cases to guide additional control measures.

Since it was notified of the cluster of sudden deaths, WHO has worked closely with Liberian Ministry of Health and other partners in areas of overall coordination, surveillance, contact tracing, case management, social mobilization, community engagement, laboratory investigation, and infection prevention and control.

Below:

01 - WHO Liberia staff review packaging information for specimens from victims who died after attending a wake and funeral on 21/22 April. These additional specimens were shipped on 12 May for investigations in Europe and Africa. 

02 - WHO staff package the samples. Earlier samples have been analyzed in Liberia, and at @CDC and @institutpasteur laboratories with support of @MSF. Meningococcal disease is suspected. Other causes to be ruled out.

Photo credit: WHO/P. Glee

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