Two separate smallpox outbreaks, each associated with exposure at the sick-bed and at the funeral ceremony of a smallpox victim, occurred in Sierra Leone in 1968. The first epidemic was comprised of 12 cases in 5 villages, while the second involved 146 cases in 38 villages. The immunity levels of both communities were similar. Both index cases were presumed to be members of secret societies, which significantly influenced the course of each outbreak. The greater accessibility of the first population to control measures, and the greater exposure of susceptible villagers in the second epidemic, may account for the difference in size of the two outbreaks.
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