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RIFT VALLEY FEVER - MAURITANIA: HUMAN, SUSPECTED, REQUEST FOR INFORMATION
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A ProMED-mail post
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International Society for Infectious Diseases
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Date: Mon 1 Oct 2012
Source: FluTrackers, Al Khaleej report [in Arabic, machine trans., summ. & edited]
http://www.flutrackers.com/forum/showth ... p?t=193286


Fear returned to Mauritania from the emergence of a new epidemic of Rift Valley Fever. This has been noted following information from the Sheikh Zayed Hospital in Nouakchott, yesterday evening [30 Sep 2012], about the death of a [20-year-old] man due to RVF.

The Mauritanian Ministry of Health has delegated a medical mission to the north of the country, where the village where the victim came from is located.

There is also suspicion of RVF as the cause of death of a young woman, yesterday [30 Sep 2012], in the state of Brakna.

--
Communicated by:
Gert van der Hoek
Senior Moderator
FluTrackers
http://flutrackers.com

[RVF in humans may be indicative for the circulation of the virus in livestock, where it may cause mass abortions and high mortality in offspring of ruminants, particularly sheep and goats.

Confirmation of the reported cases in humans and information on the current RVF situation in Mauritania's livestock is anticipated. - Mod.AS

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/3AVt.]

RIFT VALLEY FEVER - MAURITANIA (02): FATALITIES
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A ProMED-mail post
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ProMED-mail is a program of the
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Date: Thu 4 Oct 2012
Source: Flutrackers.com [machine transl., edited]
http://www.flutrackers.com/forum/showth ... post470350


Mauritania -- Rift Valley fever cases
-------------------------------------
Ministers of health, equipment employment, education and transport on late Thursday [4 Oct 2012] afternoon issued a statement on discussions of the Council of Ministers held a few hours earlier. The Minister of Health, Mr. Hamady Ba Housseynou, presented to Cabinet a paper on an outbreak of Rift Valley fever (RFV) in Mauritania. The Minister reported that 7 cases of fever had been recorded in the country causing 4 deaths. 2 of the survivors were recovering and one was still under treatment.

This is not the 1st time that Rift Valley fever has occurred in Mauritania. Cases were recorded in Adrar in 2010. Among the causes of Rift valley fever are high rainfall and lack of ability to cook meat thoroughly. Mr. Hamady Ba Housseynou called on citizens to look out for signs of the disease and to take appropriate action immediately to contain the infection.

The Department of Health says it is ready to intervene at any time. But the situation is much more difficult for cases that occur away from urban areas on account of the difficult in provision the supply of blood that is vital to save the patients' lives.

The current disease situation situation is not unusual and there is no cause for panic. The cases are sporadic and there is no focal epidemic.

--
Communicated by:
Correspondent Gert van der Hoek

[Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but also has the capacity to infect humans. Infection can cause severe disease in both animals and humans. The disease also results in significant economic losses due to death and abortion among RVF-infected livestock. The vast majority of human infections 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. Certain occupational groups such as herders, farmers, slaughterhouse workers and veterinarians are therefore at higher risk of infection. There is some evidence that humans may also become infected with RVF by ingesting the unpasteurized or uncooked milk of infected animals.

Human infections have also resulted from the bites of infected mosquitoes, most commonly the _Aedes_ mosquito. Transmission of RVF virus by hematophagous (blood-feeding) flies is also possible.

To date, no human-to-human transmission of RVF has been documented, and no transmission of RVF to health care workers has been reported when standard infection control precautions have been put in place. There has been no evidence of outbreaks of RVF in urban areas.

The incubation period for RVF varies from 2 to 6 days. The symptoms of RVF usually last from 4 to 7 days, after which time the immune response becomes detectable with the appearance of antibodies and the virus gradually disappears from the blood. 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). The total case fatality rate has varied widely between different epidemics but, overall, has been less than 1 percent in those documented cases. Most fatalities occur in patients who develop the haemorrhagic icterus form. For further information, see: http://www.who.int/mediacentre/factshee ... index.html).

The interactive ProMED/HealthMap of Mauritania can be accessed at: http://healthmap.org/r/3AVt. - Mod.CP]

RIFT VALLEY FEVER - MAURITANIA (03): MOSQUITO VECTOR SPECIES
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Date: Mon 8 Oct 2012
From: Alan Kemp [edited]


We do not have good information about which mosquito vector species are responsible for transmitting Rift Valley fever (RVF) virus to humans. Our best guess is that certain floodwater _Aedes_ species are responsible for inter-epidemic transmission between non-human hosts and that these species ignite the epidemic phase of transmission.

Please note that the term, "the _Aedes_ mosquito" is too generic. It would seem more likely that competent _Culex_ species such as _Culex poicilipes_ in East and West Africa, _Culex pipiens_ var. _molestus_ in Egypt, _Culex tritaeniorhynchus_ in the Arabian Peninsula, and _Culex theileri_ in southern Africa are responsible for introducing RVF virus into the human population. These species are far more numerous and widespread than the floodwater _Aedes_ species during periods of recovering and extensive rainfall and constitute important pest species for humans. Whereas the _Aedes_ vectors will most certainly feed on humans, their ecology does not normally bring them into contact with humans. The one possible exception to this rule is the species implicated in the Saudi Arabian and Mauritanian outbreaks, _Aedes vexans_ subspecies _arabiensis_.

--
Alan Kemp MSc(Med)
Centre for Emerging and Zoonotic Diseases
National Institute for Communicable Diseases
National Health Laboratory Service
South Africa


[ProMED-mail thanks Alan Kemp for providing this information on the mosquito vector species that might be responsible for transmitting Rift Valley fever (RVF) virus to humans in Mauritania and elsewhere. Alan also pointed out that, strictly speaking, mosquitoes should be included among the hematophagous (blood-feeding) flies referred to in the moderator's comment.

The interactive ProMED/HealthMap of Mauritania can be accessed at http://healthmap.org/r/3AVt. - Mod.CP]

RIFT VALLEY FEVER - MAURITANIA (04): (NOUAKCHOTT), ALERT
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
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Date: Wed 24 Oct 2012
Source: Al Akhbar ("The news") [in French, trans. & summarised Mod.CP, edited]
http://fr.alakhbar.info/5132-0-Mauritan ... sable.html.


According to a statement by the Minister of Health, Dr. Ould Cheikh Baye M'Khaittrat, 13 deaths have been reported among 30 human cases of Rift Valley fever virus infection in Mauritania. The Minister stated that: "The indications are that the outbreak, which has occurred over a wide area, has begun to moderate after affecting a total of 30 people. The Minister stated also that some rumours circulating to the contrary are ill-founded. "The health authorities have taken all necessary measures to contain the outbreak," he stated. He added that meat should be cooked thoroughly before consumption, and milk should always be boiled before use, especially in areas where animal disease had been observed.

He stated that no new cases of Rift Valley fever virus infection had been reported for 5 days over the whole country, including Nouakchott. He added that: "The Department of Health is implementing measures to contain the virus and eradicate the disease. The Rift Valley fever situation is not now alarming because the rainy season, which is one of the factors favouring the spread of the disease, has ended."

After confirmation of the existence of the epidemic in animals, the Ministry of Rural Development obtained blood samples from 26 people and submitted the samples for analysis to the National Institute of Public Health; 9 samples tested positive for Rift Valley fever virus infection; 9 were negative, and the remainder are still being examined.

--
Communicated by:
a correspondent from the Sahara

[Rift Valley fever (RVF) is a viral zoonosis that primarily affects animals but also has the capacity to infect humans. Infection can cause severe disease in both animals and humans. The disease also results in significant economic losses due to death and abortion among RVF-infected livestock. The vast majority of human infections 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. Certain occupational groups such as herders, farmers, slaughterhouse workers and veterinarians are, therefore, at higher risk of infection. There is some evidence that humans may also become infected with RVF by ingesting the unpasteurized or uncooked milk of infected animals.

On 4 Oct 2012, the Mauritanian Ministry of Health reported that 7 human cases of Rift Valley fever had been recorded in the country, resulting in 4 deaths; 2 of the survivors were recovering, and one was still under treatment. The extent of the outbreak in livestock has not been reported. Although the number of human cases has risen to 30 with 13 deaths, it is considered that the outbreak is declining because of the prevailing weather conditions.

However, this coming weekend marks the festival of Eid Al Adha, also known as Eid El Kebir. Many sheep will be slaughtered as part of the festival rituals around the country. Past experience has shown (e.g. in Egypt in 1977 and 1978) that during the slaughtering procedures, blood aerosols may expose attending humans to RVF infection.

Nouakchott is the capital and the largest city of Mauritania. The city is the administrative and economic centre of Mauritania. The interactive ProMED/HealthMap of Mauritania can be accessed at: http://healthmap.org/r/3OL_. - Mod.CP]

Rift Valley fever in Mauritania
01.11.2012 - WHO

The Ministry of Health (MoH) in Mauritania declared an outbreak of Rift Valley Fever (RVF) on 4 October 2012. From 16 September 2012 (the date of onset of the index case) to 30 October 2012, a total of 34 cases, including 17 deaths have been reported from 6 regions. The last case was notified on the 27 October 2012 from Magta Lahjar in the Brakna region. The 6 regions include Assaba, Brakna, Hodh Chargui, Hodh Gharbi, Tagant and Trarza. All the cases had history of contact with animals.

In humans, 25 samples tested positive by ELISA and PCR at the National Reference Laboratory of the National Institute of Public Health Research (INRS) in Nouakchott and at the Institut Pasteur in Dakar. In the animal population, analysis conducted by the National Veterinary Research Laboratory shows virus circulation in several regions of the country.

A multi-sector task force has been jointly established by the MOH and the Ministry of Rural Development to respond to this outbreak. WHO and partners, including the Food and Agriculture Organization (FAO), are working within the task force to strengthen epidemiological surveillance in both human and animal health, strengthen capacity in case management at health care facilities, strengthen health measures in slaughterhouses, and raise awareness among farmers.

A multi-sector investigation team has been deployed to conduct a detailed outbreak investigation among humans and animals in the affected areas. An international team of experts will be deployed to provide technical assistance from 3 to 10 November 2012.

Mauritania experienced an outbreak of RVF in 2010.

With regard to this outbreak, WHO does not recommend any travel or trade restrictions be applied.

Gruß
Birgitt

On 30 August, the Ministry of Health in Niger notified WHO of unexplained deaths among humans, along with deaths in livestock in the Tahoua region of Niger. On 23 September, human and animal specimens were tested at the Institut Pasteur de Dakar (IPD) and were reported positive for Rift Valley Fever (RVF) virus by PCR and for specific IgM antibodies confirming the first outbreak of RVF in Niger. Initially the outbreak was centered in the north west of the country in areas bordering Mali, in particular around Tassara and Tchintabaraden in the Tahoua Region, however suspected cases of RVF have recently been identified in new areas to the north and south of Tchintabaraden.

From 8 August to 21 November, 266 suspected human cases including 32 deaths have been reported from Abalak, Keita, Madaoua, Tilia, Tassara, Tahoua department and Tchintabaraden in the Tahoua Region. From 8 August to 18 November, 196 specimens were tested and 17 patients were confirmed positive by RVF PCR and/or serological identification of IgM antibodies.

Rift Valley Fever in Niger

Grüsse
Alexander