 The epidemic began in Nigeria and Cameroon, and spread to Ghana, Ivory Coast and Senegal by 1997.Cases were reported in Cotonou, Benin where mobs attacked individuals accused of the penis theft and authorities ordered security forces to curb the violence, following the deaths of five people by vigilantes.Later reports of outbreak suggest a spread beyond West Africa, including the coverage of episodes in Khartoum, Sudan in September 2003; Banjul, Gambia in October 2003; and Kinshasa, DR Congo in 2008.