Rift Valley fever

Rift Valley fever
Classification and external resources

TEM micrograph of tissue infected with Rift Valley fever virus
ICD-10 A92.4
ICD-9 066.3
MeSH D012295
Rift Valley Fever virus
Virus classification
Group: Group V ((-)ssRNA)
Family: Bunyaviridae
Genus: Phlebovirus
Species: Rift Valley Fever virus

Rift Valley Fever (RVF) is a viral zoonosis (affects primarily domestic livestock, but can be passed to humans) causing fever. It is spread by the bite of infected mosquitoes, typically the Aedes or Culex genera. The disease is caused by the RVF virus, a member of the genus Phlebovirus (family Bunyaviridae). The disease was first reported among livestock in Kenya around 1915, but the virus was not isolated until 1931. RVF outbreaks occur across sub-Saharan Africa, with outbreaks occurring elsewhere infrequently (but sometimes severely - in Egypt in 1977-78, several million people were infected and thousands died during a violent epidemic. In Kenya in 1998, the virus claimed the lives of over 400 Kenyans. In September 2000 an outbreak was confirmed in Saudi Arabia and Yemen). On 19 Oct 2011, the first confirmed human case of Rift Valley fever contracted in Zimbabwe was reported in a Caucasian female traveler who returned to France after a 26-day stay in Marondera, Mashonaland East Province during July and August, 2011.[1]

Contents

Clinical signs and diagnosis

In humans the virus can cause several syndromes. Usually sufferers have either no symptoms or only a mild illness with fever, headache, myalgia and liver abnormalities. In a small percentage of cases (< 2%) the illness can progress to hemorrhagic fever syndrome, meningoencephalitis (inflammation of the brain), or affecting the eye. Patients who become ill usually experience fever, generalized weakness, back pain, dizziness, and weight loss at the onset of the illness. Typically, patients recover within 2–7 days after onset.

Approximately 1% of human sufferers die of the disease. Amongst livestock the fatality level is significantly higher. In pregnant livestock infected with RVF there is the abortion of virtually 100% of fetuses. An epizootic (animal disease epidemic) of RVF is usually first indicated by a wave of unexplained abortions.

Other signs amongst livestock include vomiting and diarrhoea, respiratory disease, fever, lethargy, anorexia and sudden death in young animals.[2]

Diagnosis relies on viral isolation from tissues, or serological testing with an ELISA.[2]

Animal vaccination

Several animal vaccines have been made to protect against RVF infection. The first one to be developed was a live vaccine. When administered to mice, the results were promising; this vaccine provided immunity for 3 years. However, a problem was encountered: administration to pregnant ewes on many occasions led to abortion. Since then, attenuated vaccines have been developed. Although they are protective and do not cause adverse effects, these results are only achieved after multiple inoculations. The fact that multiple doses are required may prove problematic, especially in areas where RVF is endemic.

2006/07 outbreak in Kenya & Somalia

In November 2006, a Rift Valley fever outbreak occurred in Kenya. The victims are from the North Eastern Province and Coast Province of Kenya, which have received heavy rain in recent months, causing floods and creating breeding grounds for mosquitoes which spread the virus of the fever from infected livestock to humans.

By 7 January 2007, about 75 people have died and another 183 infected.[3] The outbreak has forced the closure of livestock markets in the North Eastern Province, affecting the economy of the region.[4]

The outbreak was subsequently reported to have moved into Maragua and Kirinyaga districts of Central Province of Kenya.[5]

On 20 January 2007 the outbreak was reported to have crossed into Somalia from Kenya and killed 14 people in the Lower Jubba region.[6]

As of 23 January 2007 cases had started to crop at the Kenyan capital Nairobi. An estimated large number of businesses were supposedly suffering large losses as customers were shunning the common meat joints for the popular Nyama Choma (Roast meat), as it was believed to be spreading the fever.

In December 2006 and again in January 2007, Taiwan International Health Action (TaiwanIHA) began operating missions in Kenya [1] consisting of medical experts assisting laboratory training and health facility personnel, and included donations of supplies such as mosquito sprays. The United States Centers for Disease Control has also set up an assistance mission and laboratory in Kenya.

By the end of January, 2007, some 148 people had died since the outbreak began in December.

As at 14 March 2007, the Kenyan government declared RVF as having diminished drastically after spending an estimated 2.5 Million in Vaccine and deployment costs, It also lifted the ban on cattle movement in the affected areas.

As of 2 November 2007, 125 cases including 60 deaths have been reported from more than 10 localities of White Nile, Sinnar, and Gezira states in Sudan. Young adult males are predominantly affected. More than 25 human samples have been found positive for RVF by PCR or ELISA.[7]

2010 South Africa Outbreak

As of 8 April 2010, the Ministry of Health South Africa has reported 87 human cases infected with Rift Valley Fever (RVF), including two deaths in Free State, Eastern Cape and Northern Cape provinces.[8] Most of these cases reported direct contact with RVFV-infected livestock and or linked to farms with confirmed animal cases of RVF. The human cases are: farmers, veterinarians and farm workers. All cases were confirmed with RVF by test conducted at the National Institute of Communicable Diseases (NICD) in Johannesburg, South Africa.

There is an ongoing outbreak of Rift Valley Fever Virus (RVFV) infection affecting sheep, goats, cattle and wildlife on farms within Free State, Eastern Cape, Northern Cape, Western Cape, Mpumalanga, North West, Gauteng provinces. As of 29 March 2010, approximately 78 farms reported laboratory-confirmed animal cases, with extensive livestock deaths.

Outbreak investigations by the Department of Health and the Department of Agriculture, Forestry and Fisheries are ongoing, and are being supported by the South African Field Epidemiology and Training Programme (SA-FELTP) and NICD. The Department of Health and the Department of Agriculture are taking measures to enhance disease surveillance among cattle and in managing the control of the disease outbreak.

Sporadic cases of RVF infection in animals have been documented in South Africa in recent years. The last major outbreak of the disease in humans occurred between 1974–76, where an estimated 10,000 to 20,000 cases were affected.[9]

Use as a biological weapon

Rift Valley fever was one of more than a dozen agents that the United States researched as potential biological weapons before the nation suspended its biological weapons program in 1969.[10][11]

References

  1. ^ G. Vesin: RIFT VALLEY FEVER, HUMAN - FRANCE: ex ZIMBABWE (MASHONALAND EAST) FIRST REPORT, ProMED, a program of the International Society for Infectious Diseases, http://www.promedmail.org, Date: Wed 19 Oct 2011.
  2. ^ a b Rift Valley Fever reviewed and published by WikiVet, accessed 12 October 2011.
  3. ^ "At least 75 people die of Rift Valley Fever in Kenya". International Herald Tribune. 7 January 2007. http://www.iht.com/articles/ap/2007/01/07/africa/AF-GEN-Kenya-Rift-Valley-Fever.php. 
  4. ^ "Kenya: Schools Disrupted As Deadly Fever Hits Incomes". IRIN. 11 January 2007. http://www.reliefweb.int/rw/RWB.NSF/db900SID/LZEG-6XCNZ7?OpenDocument. 
  5. ^ "Nairobi at risk of RVF infection". The Standard (Kenya). 22 January 2007. http://www.eastandard.net/hm_news/news.php?articleid=1143963928. 
  6. ^ "14 die after Rift Valley Fever breaks out in southern Somalia". Shabelle Media Network, Somalia. 20 January 2007. http://www.shabelle.net/news/ne2114.htm. 
  7. ^ "Deadly fever spreads Kenya Panic". BBC. 26 January 2007. http://news.bbc.co.uk/2/hi/africa/6301417.stm. 
  8. ^ http://www.promedmail.org/pls/apex/f?p=2400:1001:4602376937374923::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82136
  9. ^ http://www.who.int/csr/don/2010_03_30a/en/index.html
  10. ^ "Chemical and Biological Weapons: Possession and Programs Past and Present", James Martin Center for Nonproliferation Studies, Middlebury College, April 9, 2002, accessed November 14, 2008.
  11. ^ USDA-APHIS and CDC: National Select Agent Registry, http://www.selectagents.gov/Select%20Agents%20and%20Toxins%20List.html, September 19, 2011.

External links