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RIFT VALLEY FEVER - SOUTH AFRICA (02): (FREE STATE)
***************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 15 Mar 2010
Source: News 24 [edited]
<http://www.news24.com/Content/SouthAfri ... life_in_FS>


The number of people killed in the Free State since the outbreak of
Rift Valley fever (RVF) has risen to 2, health officials said on
Monday. "A total of 21 human... cases of Rift Valley fever have been
confirmed, all acquired in Free State, with 2 deaths," Deputy
Minister of Health Molefi Sefularo said in a statement. The
department said most of the cases followed direct contact with
RVF-infected livestock. The human cases were farmers, veterinarians
and farm workers. Sefularo said additional suspect cases were
currently being tested.

On Monday [15 Mar 2010], agricultural officials in the Northern Cape
announced they were awaiting RVF test results from 4 districts. "The
Northern Cape provincial government has embarked upon an
all-out-effort to foil the current outbreak of RVF," agriculture MEC
[Member of the Executive Council] Norman Shushu said in a statement.

33 dead lambs
-------------
Shushu said one farm in the Colesberg area reported a confirmed case
of RVF with 4 cattle dead, out of 14 that took ill. Suspected cases
had also emerged around farms near Richmond, Carnavon -- where one
reported 30 dead lambs -- Prieska and Douglas, where farmers had
reported livestock mortalities. "Samples were collected and we are
awaiting the results thereof." Shushu said the Northern Cape has had
no confirmed human cases. A suspected case in Colesberg tested negative.

Provincial veterinary services would update the Red Meat Producers
Organisation in the Northern Cape and the National African Farmers'
Union on the sickness on Monday [15 Mar 2010]. The provincial
agriculture and health departments would launch a public awareness
campaign on RVF. Shushu urged farmers in the affected areas to
immediately vaccinate their animals and avoid opening carcasses they
suspected died from RVF.

Heavy rainfall
--------------
In 2009, the Northern Cape veterinary services reacted to an outbreak
of RVF in the Kakamas area. Some 5000 doses of vaccine were used to
contain the disease at the time. This year RVF was reported in the
Free State after heavy rainfall countrywide in January and February
[2010]. The province reported high mortalities in lambs and abortions
in sheep in the Bultfontein district, as well as parts of Boshoff and
Jacobsdal. In the Eastern Cape the disease was also reported in the
Hofmeyer area.

Rift Valley fever is caused by a virus spread by mosquitoes amongst
sheep, cattle and goats. People can get RVF through contact with the
blood or other body fluids of infected animals.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[As Mod.CP pointed out in his excellent summary of Rift Valley Fever
(ProMED archive no. 20100309.0761), outbreaks of RVF in animals
precede human cases. The establishment of an active animal health
surveillance system to detect new cases is essential in providing
early warning for veterinary and human public health authorities.
Further information can be obtained at:
<http://www.who.int/mediacentre/factshee ... index.html>.

A map of the provinces of South Africa, showing the adjacent
provinces of the Free State and North Cape, can be accessed at:
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at:
<http://healthmap.org/r/00vd>. - Mod.TY]

RIFT VALLEY FEVER - SOUTH AFRICA (03): (FREE STATE, EASTERN CAPE,
NORTHERN CAPE, GAUTENG, MPUMALANGA)
*************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sun 21 Mar 2010
From: Jacqueline Weyer
<jacquelinew@nicd.ac.za>


Rift Valley fever outbreak in South Africa
------------------------------------------
Currently there is an extensive outbreak of Rift Valley fever (RVF)
affecting livestock in South Africa with animal cases reported on
farms predominantly in the Free State Province but also in the
Eastern Cape, Northern Cape, Gauteng and Mpumalanga Provinces.
Considerable rainfall has created conditions favourable for breeding
of the mosquito vectors over much of the country, and preliminary
molecular epidemiological findings suggest that the outbreak involves
spread of one of 2 genotypes of the virus which have emerged locally
over the past few years.

As of 15 Mar 2010, there have been 42 human laboratory-confirmed
cases including 2 deaths, with 37 cases from the Free State Province,
2 cases from the Northern Cape and 3 cases from the Eastern Cape. It
is likely that there are more human cases, given that the typical
infection is mild and persons may not present to health centres or be
tested. Contact with infected animal tissues has been identified as
the likely route of transmission with farmers, farm workers,
veterinarians and assistants, and slaughter men being affected.

All patients, with the exception of the 2 fatal cases have had mild
disease with self-limiting febrile illness and myalgia. The 2 fatal
cases presented with multi-organ failure, notably with severe hepatic
dysfunction and markedly raised hepatic enzymes, and profound
thrombocytopenia and bleeding. Investigations are ongoing to identify
any co-morbidity.

The RVF outbreak has occurred in areas where Crimean-Congo
haemorrhagic fever (CCHF) [a tick-transmitted disease - Mod.CP] is
well documented and considering the overlapping clinical and
clinico-pathological features it is clearly critical to consider this
in the differential diagnosis and management of patients, especially
regarding infection control issues.

CCHF was confirmed in 2 patients in the past week. The 1st case, a
farmer from the Free State Province, was confirmed by RT-PCR and
serology. He presented with an acute febrile illness, myalgia,
haemorrhage with profound thrombocytopenia and transaminitis, and had
a good response to ribavirin treatment. The 2nd patient was from the
Northern Cape with a reported tick bite exposure. CCHF was confirmed
by RT-PCR. This patient passed away.

Intensive health promotion and active case finding is ongoing in the
affected areas as well as areas with the potential for spread of the RVF.

--
Lucille Blumberg
Juno Thomas
Jacqueline Weyer
Petrus Jansen van Vuuren
Patricia Leman
Antoinette Grobbelaar
Alan Kemp
Robert Swanepoel
Janusz Paweska

Special Pathogens and Outbreak Units,
National Institute for Communicable Diseases,
National Health Laboratory Service,
1 Modderfontein road,
Sandringham,
Johannesburg,
South Africa
Jacqueline Weyer
<jacquelinew@nicd.ac.za>

[ProMED-mail is indebted to Jacqueline Weyer and colleagues for
providing this update on the progress of the current outbreak of Rift
Valley fever in South Africa. Previous reports indicated that the
outbreak was confined to the Free State, but human cases have been
recorded now in Eastern Cape and Northern Cape provinces. In addition
animal cases have been recorded in Gauteng and Mpumalanga provinces
and human cases may follow.

Outbreaks of Rift Valley fever are associated characteristically with
persistent heavy rainfall with sustained flooding and the appearance
of large numbers of mosquitoes, the main vector. Localised heavy
rainfall is seldom sufficient to create conditions for an outbreak;
the simultaneous emergence of large numbers of 1st generation
transovarially infected mosquitoes is also required. After virus
amplification in vertebrates, mosquitoes act as secondary vectors to
sustain the epidemic.

Genome analysis has confirmed that this outbreak is associated with
one of the 2 strains of Rift valley fever virus that have emerged
locally in South Africa in recent years. According to Bird et al.
(Journal of Virology, 2007 Mar;81(6):2805-16) Rift Valley fever virus
strains isolated within an epidemic have exhibited little diversity,
whereas those in enzootic settings can be highly diverse. Virus
genetic diversity within epidemics was low (approximately 5 percent)
and primarily involved accumulation of mutations at an average of 2.9
x 10(-4) substitutions/site/year, and with some evidence of sub-unit
reassortment.

Interestingly their Bayesian analysis of Rift Valley fever virus
genetic diversity placed the most recent common ancestor of these
viruses in the late 1800s, the colonial period in Africa, a time of
dramatic changes in agricultural practices and introduction of
nonindigenous livestock breeds.

A map of the provinces of South Africa can be accessed at:
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>.
The HealthMap/ProMED-mail interactive map of South Africa is available at:
<http://healthmap.org/r/00vd>.
- Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (04): (FREE STATE, EASTERN CAPE,
NORTHERN CAPE, GAUTENG, NORTH WEST)
*************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 24 Mar 2010
From: BuaNews online [edited]
<http://www.buanews.gov.za/news/10/10032415451001>


Total of 47 RVF human cases confirmed
-------------------------------------
The National Institute for Communicable Diseases (NICD) has confirmed
5 new human laboratory cases of Rift Valley fever (RVF). This pushes
up the number of confirmed cases to 47. Of the 47 confirmed cases on
Wednesday [24 Mar 2010], 41 cases with 2 deaths were reported in the
Free State, 3 in the Eastern Cape [province] and 3 in the Northern
Cape [province].

"Outbreak investigations by the Departments of Health and
Agriculture, Forestry and Fisheries are ongoing, supported by the
South African Field Epidemiology and Training Programme," said the
Department of Health.

The NICD have also confirmed the spread of RVF in animals in the
North West Province. The department said RVF continues to spread in
sheep, goats and cattle on farms within the Free State, Eastern Cape,
Northern Cape and Gauteng Provinces.

The virus is transmitted by mosquitoes and causes termination of
gestation and deaths of young livestock. Humans become infected from
contact with infected tissues of livestock and less frequently from
mosquito bites. The department has urged people living in the
affected areas to seek medical attention at their nearest health
facilities should they have any symptoms.

--
Communicated by:
Rabelani Daswa
<rabedaswa@gmail.com>

[Currently there is an extensive outbreak of Rift Valley fever
affecting livestock in South Africa with animal cases reported on
farms predominantly in the Free State Province, but also in the
Eastern Cape, Northern Cape, Gauteng and Mpumalanga Provinces. As of
15 Mar 2010, there had been 42 human laboratory-confirmed cases
including 2 deaths, with 37 cases (2 fatal) in the Free State
Province, 2 cases in the Northern Cape province and 3 cases in the
Eastern Cape province.

The above report indicates that another 5 human cases have been
confirmed: 4 in the Free State and one in Northern Cape province. No
further fatalities have been reported. The outbreak in livestock
remains centered in the Free State province, but has now spread also
into North West province.

As most human cases of Rift Valley fever are relatively mild and of
short duration, no specific treatment is required for these patients.
For the more severe cases, the predominant treatment is general
supportive therapy. Outbreaks of Rift valley fever in animals can be
prevented by a sustained programme of animal vaccination. Both
modified live attenuated virus and inactivated virus vaccines have
been developed for veterinary use. An inactivated vaccine has been
developed for human use. However, this vaccine is not licensed and is
not commercially available.

A map of the provinces of South Africa can be accessed at:
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at:
<http://healthmap.org/r/00vd>. - Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (05): (FREE STATE, EASTERN CAPE,
NORTHERN CAPE, GAUTENG, NORTH WEST)
*************************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Sat 27 Mar 2010
Source: Times Live, SAPA report [edited]
<http://www.timeslive.co.za/local/articl ... lley-fever>


More infected with Rift Valley fever
------------------------------------
A total of 3 more people have been infected with Rift Valley fever
(RVF), bringing the total to 63 of laboratory confirmed human cases,
the Department of Health said. Spokeswoman Charity Bhengu said of the
63 cases of infected people, 54 cases and 2 deaths were in the Free
State, 4 in Eastern Cape and 5 in Northern Cape. "Direct contact with
RVF-infected livestock and/or linked to farms with confirmed animal
cases of RVF, remain the main risk factors for the infection. The
human cases are farmers, veterinarians and farm workers. Additional
suspect cases are currently being tested."

Rift Valley fever is a viral disease that can cause severe illness in
a low proportion of infected humans. The virus is transmitted by
mosquitoes and causes outbreaks of abortion and deaths of young
livestock such as sheep, goats and cattle. "It is important to note
that humans become infected by contact with infected tissues of
livestock and less frequently from mosquito bites," said Bhengu.

So far, 70 000 animals have been vaccinated in the Free State to
contain the spread of the virus, according to the Department of
Agriculture. The outbreak investigations by the Department of Health
and the Department of Agriculture, Forestry and Fisheries were
continuing, supported by the SA Field Epidemiology and Training
Programme (SA-FELTP) and the NICD [National Institute for Communicable
Diseases].

The 1st human victim of the sickness was identified in the Free State
on 13 Feb 2010. Since then, the illness has been primarily clustered
within the Lejweleputswa District and Bultfontein area of the Free
State. Animal infections had rapidly spread to most districts with
spillover into the Eastern Cape, Northern Cape, North West and Gauteng.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The number of human cases of Rift Valley fever in South Africa has
increased to 63 from the 47 reported on Wed 24 Mar 2010 (Rift Valley
fever - South Africa (04): (FS, EC, NC, GT, NW) 20100324.0935). The
number of cases in the Free State has increased from 41 to 54, from 3
to 4 in Eastern Cape province and 3 to 5 in Northern Cape province.
The number of fatalities remains 2, both in Free State province.
Animal cases, but so far no human cases, have been recorded in Gauteng
and North West provinces. The outbreak remains centered in Free State
province and it is to be hoped that the emergency vaccination of some
70 000 animals there may halt the spread of the virus.

The vast majority of human infections with Rift Valley fever virus
result from direct or indirect contact with the blood or organs of
infected animals. The virus can be transmitted to humans through the
handling of animal tissue during slaughtering or butchering, assisting
with animal births, conducting veterinary procedures, or from the
disposal of carcasses or fetuses. The virus infects humans through
inoculation; for example, via a wound from an infected knife or
through contact with broken skin, or through inhalation of aerosols
produced during the slaughter of infected animals. There is some
evidence that humans may also become infected by ingesting the
unpasteurized or uncooked milk of infected animals. Less frequently
human infections may result from the bites of infected mosquitoes.

While most human cases of Rift Valley fever are relatively mild, a
small percentage of patients develop a much more severe form of the
disease. This usually appears as one or more of 3 distinct syndromes:
ocular (eye) disease (0.5-2 percent of patients), meningoencephalitis
(less than 1 percent) or haemorrhagic fever (less than 1 percent).
According to the World Health Organisation there has been no evidence
of outbreaks of Rift valley fever in urban areas.

A map of the provinces of South Africa can be accessed at:
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>.
The Lejweleputswa region of the Free State can be located via the map at:
<http://www.sa-venues.com/maps/freestate_relief.htm>.
The HealthMap/ProMED-mail interactive map of South Africa is available at:
<http://healthmap.org/r/00vd>.
- Mod.CP]

Rift Valley fever in South Africa
30.03.2010 - WHO

As of 27 March 2009, the Ministry of Health South Africa has reported 63 human cases infected with Rift Valley Fever (RVF), including two deaths in Free State, Eastern Cape and Northern Cape provinces. 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. (see link below)

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. (see link below)

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.

RIFT VALLEY FEVER - SOUTH AFRICA (06): (WESTERN CAPE)
*****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Mon 29 Mar 2010
Source: Times Live, SAPA report [edited]
<http://www.timeslive.co.za/local/articl ... stern-Cape>


Rift Valley fever has spread to Western Cape [province], with a
veterinarian presumably infected and 14 animals dead, the provincial
Departments of Agriculture and Health said on Monday [29 Mar 2010].
The man presumably got infected while conducting post-mortem
examinations on 2 dead cows, Department of Health spokeswoman Helene
Rossouw said in a statement.

Department of agriculture spokesman Wouter Kriel said the 2 Jersey
cattle died near the border of the Northern and Western Cape. 12
Merino lambs died on a farm east of Beaufort West.

"Their post mortem findings were typical for Rift Valley fever.
Samples from both these cases were found positive for Rift Valley
fever virus by the Onderstepoort Veterinary Institute on Friday [26
Mar 2010]."

Rossouw said the vet's symptoms included fever, severe headache,
muscle aches and extreme eye pain with sensitivity to light. Blood
samples had been taken to verify the cause of these symptoms. The man
was under medical supervision at home, and his condition was stable.

A total of 63 people had been confirmed infected countrywide so far.
According to the national Health Department, out of the 63, 54 cases
and 2 deaths were from the Free State. There were 4 cases in the
Eastern Cape and 5 cases in the Northern Cape.

Kriel advised sheep and cattle farmers not to let their stock graze in
wet, low-lying areas with large mosquito populations. "The use of
insecticidal and insect repellent remedies might be considered for
valuable stock. As this is a viral disease, no specific treatment is
available." Kriel said his department had ordered a further 40 000
doses of live Rift Valley fever vaccine to be used in the next weeks.

In November last year [2009], 90 000 doses of vaccine were
administered by private veterinarians in the Swartland, West Coast and
Ceres areas.

--
Communicated by:
ProMED-mail Corr.SB

[The Rift Valley fever outbreak in South Africa has now spread to
include Western Cape province, involving livestock and a veterinarian
[diagnosis still to be confirmed]. The outbreak centered on Free State
province now involves Gauteng, Eastern Cape, Northern Cape and North
West provinces. An initial report of involvement of Mpumalanga
province has not been confirmed subsequently.

A map of the provinces of South Africa can be accessed at:
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at:
<http://healthmap.org/r/00vd>. - Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (08 ) MULTI-PROVINCE
****************************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Wed 31 Mar 2010
Source: South African Government Information, Department of Health
report [edited]
<http://www.info.gov.za/speeches/2010/10033113551001.htm>


3 more people have been infected with Rift Valley fever (RVF) this
morning [31 mar 2010], bringing the total to 69 laboratory confirmed
human cases since the 1st incident on 13 Feb 2010; 2 deaths have been
reported, both from the Free State. [Now 82 cases/5 deaths -- see [2]
below].

The National Institute of Communicable Disease (NICD) reported this
morning [31 Mar 2010] that of the 69 cases of infected people, 58
cases and 2 deaths are from Free State, 4 in Eastern Cape, and 7 in
Northern Cape.
Direct contact with RVF-infected livestock and/or linked to farms with
confirmed animal cases of RVF, remain the main risk factor for the
infection. The human cases are farmers, veterinarians, and farm
workers. Additional suspect cases are currently being tested.

Outbreak investigations by the Department of Health and the Department
of Agriculture, Forestry and Fisheries are ongoing, supported by the
South African Field Epidemiology and Training Programme (SA-FELTP) and
the NICD.

Affected farms are primarily clustered within Free State (initially in
Lejweleputswa District, Bultfontein area); however animal cases of RVF
have been confirmed in all districts with spill over into Eastern
Cape, Northern Cape, and Gauteng. The Department of Agriculture in
Free State has started the vaccination of animals, to contain the
spread of the virus. RVF is a viral disease that can cause severe
illness in a small proportion of infected humans. The virus is
transmitted by mosquitoes and causes outbreaks of abortion and deaths
of young livestock (sheep, goats and cattle). It is important to note
that humans become infected from contact with infected tissues of
livestock and less frequently from mosquito bites. The disease occurs
throughout Africa and Madagascar when exceptionally heavy rains favour
the breeding of the mosquito vectors.

Clinical features in humans
---------------------------
Typically illness is asymptomatic or mild in the vast majority of
infected persons, and severe disease would be expected to occur in
less than 1 percent of infected persons.

Key symptoms
------------
- The incubation period (interval from infection to onset of symptoms)
for RVF varies from two to six days
- Sudden onset of flu-like fever and/or muscle pain
- Some patients develop neck stiffness, sensitivity to light, loss of
appetite and vomiting
- Symptoms of RVF usually last from 4-7 days, after which time the
immune response becomes detectable with the appearance of antibodies
and the virus gradually disappears from the blood.

Severe form of RVF in humans includes
- Vision disturbances
- Intense headache, loss of memory, hallucinations, confusion,
disorientation, vertigo, convulsions, lethargy and coma
- Haemorrhagic fever.

The public living in the affected areas is encouraged to seek medical
attention at their nearest Health facilities, should they have any of
the symptoms above.

Preventive measures
------------------
- While there is no specific treatment, the majority of persons
affected will recover completely. People should avoid contact with the
tissues of infected animals, refrain from drinking unpasteurised milk
and prevent mosquito bites to avoid becoming infected
- Farmers and veterinarians should wear protective clothing when
handling sick animals or their tissues. There is no routine vaccine
available for humans.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: Sat 3 Apr 2010
Source: Saturday Star, South African Press Association (SAPA) report [edited]
<http://www.thestar.co.za/index.php?fArticleId=5415554>


So far 5 people have died and 82 others countrywide are infected with
Rift Valley fever, the Ministry of Health said yesterday [Fri 2 Apr
2010]. Nine [sic] new infections have been detected since the virus
[disease] broke out on 13 Feb 2010.

Free State was the worst hit [province] with 4 deaths and 66
infections, followed by the Northern Cape with 1 death and 10 people
infected.

Rift Valley fever virus is transmitted by mosquitoes and causes
abortion in and deaths of young livestock. Farmers, veterinarians, and
farm workers are mostly affected. Direct contact with infected animals
remains the main risk factor for the infection, the department stated.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The 1st report indicates the number of human cases increased from 63
to 69 between 27 and 31 Mar 2010. The 2nd report indicates that by 2
Apr 2010 the number of human cases had risen to 82 and the number of
fatalities had increased from 2 to 5 during this period.

These figures indicate that the outbreak first detected in
mid-February 2010 is now spreading rapidly although still restricted
manly to Free State province.

The last major outbreak of RVF on the interior plateau of South Africa
occurred in 1974-76 during prolonged heavy rains, causing 10 000 to 20
000 human cases. Since then, sporadic outbreaks and human infections
have been documented within KwaZulu-Natal, the Kruger National Park,
Limpopo, Gauteng, North West, and Northern Cape Provinces.

For detailed information go to the South African National Institute
for Communicable Diseases website at
<http://www.nicd.ac.za/outbreaks/rvf/rvf_outbreak.htm>
or refer to the commentaries in the preceding ProMED-mail posts listed below.

A map of the provinces of South Africa can be accessed at
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>.
The HealthMap/ProMED-mail interactive map of South Africa is available
at <http://healthmap.org/r/00vd>. - Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (09): MULTI-PROVINCE
***********************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 7 Apr 2010
Source: AllAfrica.com [edited]
<http://allafrica.com/stories/201004070649.html>


The National Institute for Communicable Diseases (NICD) has confirmed
5 new human laboratory cases of Rift Valley fever (RVF). This pushes
up the number of confirmed cases to 87. Of the 87 confirmed cases, 68
cases and 4 deaths are from the Free State, 7 [cases] from the
Eastern Cape, 11 cases and 2 deaths from the Northern Cape and one
[case] from the North West province.

The Departments of Health and Agriculture, Forestry and Fisheries,
supported by the South African Field Epidemiology and Training
Programme (SA-FELTP) and NICD continue to respond to the outbreak.
"Laboratory, epidemiology and surveillance interventions, health
promotion interventions, environmental health measures, and
management of confirmed cases are being prioritised," said the
Department of Health.

Direct contact with RVF-infected livestock or farms linked to
confirmed animal cases of RVF remain the main risk factor for the
infection. The human cases are farmers, veterinarians and farm
workers. Additional suspect cases are currently being tested.

Affected farms are primarily clustered within the Free State, and the
Department of Agriculture in the province has started the vaccination
of animals to contain the spread of the virus. The Eastern Cape,
Gauteng, Northern Cape and North West provinces have also reported
RVF among animals.

The virus is transmitted by mosquitoes and causes termination of
gestation and deaths of young livestock. Humans become infected from
contact with infected tissues of livestock and less frequently from
mosquito bites. The department has urged people living in the
affected areas to seek medical attention at their nearest health
facilities should they have any symptoms.

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[The outbreak remains centered in Free State province. The number of
human cases has increased from the 82 cases recorded on Fri 3 Apr
2010 to 87 and the number of human deaths from 5 to 6. The additional
death was recorded in Northern Cape province. The number of human
cases remains low in comparison with previous outbreaks, but the
number of deaths is unusual, since Rift Valley fever in humans is
generally a mild infection.

For detailed information on Rift Valley fever in South Africa, go to
the South African National Institute for Communicable Diseases
website at: <http://www.nicd.ac.za/outbreaks/rvf/rvf_outbreak.htm>,
or refer to the commentaries in the preceding ProMED-mail posts
listed below. A map of the provinces of South Africa can be accessed
at <http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/r/00vd>. - Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (10)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 8 Apr 2010
Source: News24 [edited]
<http://www.news24.com/SouthAfrica/News/ ... d-20100408>


Rift Valley fever fears 'unfounded'
-----------------------------------
Veterinarians have moved to allay the public's fears of possible Rift
Valley fever infection as the outbreak spreads across the country.
"There is no threat, no fear," Angela Zucca of the Kenilworth
Veterinarian Hospital told News24 on Thursday [8 Apr 2010]. Zucca,
who has been with the hospital for 7 years, said she had never
witnessed a case of cross contamination while working at the
hospital. "That only happens when a place is dirty," she said adding
that the hospital was sanitised thoroughly.

The risk of exposure to members of the public is further lowered by
the fact that animals infected in outbreaks such as this one are
usually not treated by private vets, said Dr Gary Buhrmann, Boland
chief state veterinarian. "State veterinarians are usually
responsible for a large bulk of the cases," he told News24. He urged
members of the public to remain calm, as they were "not really at risk."

In the Western Cape -- the latest province to report infections after
the outbreak started in the Free State, spread to the Eastern Cape
and the Northern Cape -- 3 farms in Beaufort West have reported Rift
Valley fever infections, Buhrmann said. Infected animals there were
dying at a rate of 5 - 10 percent, he said.

Beaufort West state veterinarian Dr Jaco Pienaar, who is recovering
from what he believes to be Rift Valley fever (he is waiting for
laboratory confirmation), reiterated Buhrmann's assertions. He said
although the risk remained high for people who come into contact with
the bodily fluids of infected animals, he had never heard of a human
to human infection case and infection through mosquito bites was yet
to be proven. Pienaar was infected while performing a post mortem on
an infected cow.

"I'm feeling a lot better now," Pienaar said although his eyes were
still hurting. Sensitivity to light is one of the symptoms of Rift
Valley fever in humans. According to the National Institute for
Communicable Diseases other symptoms include flu-like symptoms, neck
stiffness, vomiting and loss of appetite.

As of Thursday [8 Apr 2010], there were 100 confirmed cases of human
Rift Valley fever infections in the country, 77 of them in the Free
State. A total of 7 people have died from the disease.

[Byline: Hlengiwe Mnguni]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Since the previous report from South Africa, dated 7 Apr 2010, the
number of confirmed human cases has increased from 87 to 100 and the
number of deaths from 6 to 7.

A map of the provinces of South Africa can be accessed
at <http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/r/00vd>. - Mod.CP]

RIFT VALLEY FEVER - SOUTH AFRICA (11)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 14 Apr 2010
Source: SAWDIS, Daily Dispatch [edited]
<http://saweatherobserver.blogspot.com/2 ... alley.html>


Seven Eastern Cape people have now contracted Rift Valley fever
(RVF), which has already claimed the lives of 9 people in the country
and infected 111 others. The 7 in the province include farmers, a
veterinarian and his assistant, and farm workers from Hofmeyer and
Middleburg. "There has been an inter-governmental approach adopted
and an outbreak response team activated," provincial Department of
Health spokesperson Siyanda Manana said yesterday [Tue 13 Apr 2010].

The 7 are among 111 people confirmed to have been infected
countrywide since the disease broke out in February 2010. Those
confirmed to have died from the fever include 5 from the Free State
and 4 from the Northern Cape," National Health spokesperson Charity
Bengu said.

She said that 81 people from the Free Sate had been infected, 7 from
the Eastern Cape, 22 cases from the Northern Cape and one from the
North West. Bengu said that direct contact with RVF-infected
livestock and/or links to farms with confirmed animal cases remained
the main risk factor for infection.

The virus is transmitted by mosquitoes and occurs throughout Africa
and Madagascar when exceptionally heavy rain favours the breeding of
the mosquitoes.

Meanwhile, the test results for a patient who died at East London's
St Dominic's Hospital last week have come back negative for a
suspected viral haemorrhagic fever (VHF). VHF is not related to Rift
Valley Fever. The patient, whose details have not been released,
arrived at the hospital on Thursday [8 Apr 2010] evening exhibiting
signs of a VHF. The hospital immediately isolated him as a
precautionary measure.

[Byline: Ntando Makhubu]

--
Communicated by:
ProMED-mail <promed@promedmail.org>

[Since the previous report from South Africa, dated 9 Apr 2010, the
number of confirmed human cases has increased from 100 to 120 and the
number of deaths from 7 to 9. The disease (in humans) remains
confined to the Free Sate, Eastern Cape, Northern Cape and North West
provinces. Those infected have been people working with livestock,
suggesting that mosquito-borne transmission is not a major factor in
transmission of infection in this outbreak. For detailed information
on Rift Valley fever in South Africa, go to the South African
National Institute for Communicable Diseases website at:
<http://www.nicd.ac.za/outbreaks/rvf/rvf_outbreak.htm>.

This report indicates further that the case of suspected viral
haemorrhagic fever described in ProMED-mail post: "Viral hemorrhagic
fever - South Africa: (Eastern Cape) RFI 20100414.1204" is no longer
considered to be suffering from a viral haemorrhagic fever.

A map of the provinces of South Africa can be accessed at
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/r/00vd>. - Mod.CP]

Südafrika - Rift Valley-Fieber
19.04.2010

Das Rift Valley-Fieber breitet sich seit Februar bei Farmtieren in den Provinzen Eastern Cape, Northern Cape, North-West and Gauteng aus. Es wurden auch mehr als 100 Erkrankungen beim Menschen bestätigt. Die Übertragung auf den Menschen erfolgt in der Regel durch direkten oder indirekten Kontakt mit erkrankten Tieren (z.B. beim Schlachten), Verzehr von deren ungegartem Fleisch oder unpasteurisierter Milch, aber auch durch Stiche infizierter Mücken. Reisende sollten sich vor tag- und nachtaktiven Mücken schützen und direkten Kontakt mit Schlachtvieh bzw. dessen rohen Produkten meiden. / Quelle: crm

RIFT VALLEY FEVER (12) - SOUTH AFRICA (12)
******************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Wed 21 Apr 2010
Source: BuaNews, Government Communication and Information System report
[edited]
<http://www.buanews.gov.za/news/10/10042115251003>


The National Institute of Communicable Disease (NICD) has confirmed 3 more
cases of Rift Valley fever (RVF) pushing up the number of confirmed cases
to 143. Of these, 95 are from the Free State, 37 from the Northern Cape, 8
from the Eastern Cape, and one from the North West. Since the 1st incident
on 13 Feb 2010, 9 patients have died -- 5 in the Free State and 4 in the
Northern Cape.

The Department of Health said the majority of cases have had mild flu-like
symptoms and have not developed complications. "The risk of disease is to
persons having direct contact with blood or tissues of infected animals and
the majority of people affected have been persons working on farms,
veterinary workers, and slaughtermen," the department said on Wednesday [21
Apr 2010]. The department added that the disease is generally seen on farms
and not in the cities other than related to the occasional informal
slaughter of infected animals. "The eating of well-cooked meat poses no
risk, nor does the drinking of pasteurized milk. It is likely that the
number of animal cases and therefore human cases will decrease as the
weather gets cooler."

An animal vaccination programme on farms and suspected areas has been
implemented by the Department of Agriculture, Forestry and Fisheries to
protect livestock.

On Tuesday [20 Apr 2010], the NICD also assured visitors coming to South
Africa for the FIFA [International Federation of Association Football]
World Cup that they are not at risk of contracting the disease, unless they
handle infected carcasses on farms or handle raw meat from infected
animals. "There is no risk to visitors to Game Parks as the disease
typically only affects ruminants such as sheep, cattle, and goats," NICD
deputy director Lucille Blumberg said at the time.

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[Since the previous ProMED-mail report from South Africa, dated Wed 14 Apr
2010, the number of confirmed human cases has increased from 120 to 143,
whereas the number of deaths remains at 9. The disease (in humans) remains
confined to the Free Sate, Eastern Cape, Northern Cape, and North West
provinces. Those infected have been people working with livestock,
suggesting that mosquito borne transmission is not a major factor in
transmission of infection in this outbreak. Consequently visitors attending
the FIFA World Cup football matches in South Africa in June 2010 should not
be at particular risk.

A map of the provinces of South Africa can be accessed at
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/r/00vd>. - Mod.CP]

Deutschland - Rift Valley-Fieber (importiert)
27.04.2010

Eine 50-jährige Touristin, die für ca. 25 Tage in Südafrika (Eastern Cape) gereist ist, ist Ende April an Rift Valley-Fieber erkrankt. Der Verlauf ist unkompliziert. Mückenschutz sowie Nahrungsmittelhygiene beachten. Außerdem sollten Reisende in Endemiegebieten den Kontakt zu erkrankten Tieren meiden, sowie Besuche von Viehmärkten und Schlachthöfen unterlassen. / Quelle: crm

RIFT VALLEY FEVER - SOUTH AFRICA (13)
*************************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: Thu 29 Apr 2010
Source: Xinhua News Agency [edited]
<http://news.xinhuanet.com/english2010/h ... 271692.htm>


One more person has died of Rift Valley fever, driving the overall
death toll of the disease in South Africa since 13 Feb 2010, to 12,
the country's authorities announced on Wednesday [28 Apr 2010]. The
South African National Institute for Communicable Diseases (NICD)
said the latest death had occurred in the Western Cape Province. The
person was from the Oudtshoorn area, an official with the NICD said.
This was the 1st Rift Valley fever death in the Western Cape in the
current outbreak.

The disease has affected thousands of farm animals and 150 people in
the Free State, Northern Cape, Eastern Cape, and North West
provinces, according to the South African Press Association (SAPA).
In humans, the disease was mostly associated with people who had
direct contact with blood or tissues of infected animals, SAPA
reported. The majority of those affected were people working on
farms, veterinary workers, and workers in abattoirs. The fever is
associated with mild, flu-like symptoms. [While most human cases are
relatively mild, a small percentage of patients develop a much more
severe form of the disease. This usually appears as one or more of 3
distinct syndromes: ocular (eye) disease (0.5-2 percent of patients),
meningoencephalitis (less than 1 percent) or haemorrhagic fever (less
than 1 percent). - Mod.CP]

--
Communicated by:
HealthMap Alerts via ProMED-mail
<promed@promedmail.org>

[Since the last report dated 21 Apr 2010 the number of cases has
increased from 143 to 150, and the number of fatalities from 9 to 12.
The death recorded above is the 12th overall and the 1st in Western
Cape province, the others having occurred in the Free State and
Northern Cape province.

A map of the provinces of South Africa can be accessed at
<http://www.sa-venues.com/maps/south-afr ... vinces.htm>. The
HealthMap/ProMED-mail interactive map of South Africa is available at
<http://healthmap.org/r/00vd>. - Mod.CP]

Südafrika - Rift Valley-Fieber
03.05.2010

Bei dem Ausbruch von Rift Valley-Fieber in Südafrika hat sich die Anzahl der Todesfälle auf 12 erhöht. Insgesamt erkrankten bisher 150 Menschen aus den Provinzen Free State, Northern Cape, Eastern Cape und Nordwest Provinz. Die Übertragung auf den Menschen erfolgt in der Regel durch direkten oder indirekten Kontakt mit erkrankten Tieren (z.B. beim Schlachten), Verzehr von deren ungegartem Fleisch oder unpasteurisierter Milch, aber auch durch Stiche infizierter Mücken. Reisende sollten sich vor tag- und nachtaktiven Mücken schützen und direkten Kontakt mit Schlachtvieh bzw. dessen rohen Produkten meiden. / Quelle: crm