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Rift Valley Fever
Fever Rift Valley

Rift valley fever is an infectious disease caused by rift valley fever virus, an RNA virus that causes hemorrhagic fever in humans and animals, similar to Ebola, Lassa, Marburg, dengue and yellow fever viruses. Humans become infected via aerosols or by ingesting unpasteurized animal milk or after exposure to infected animal blood, body fluids or tissue or following mosquito or other insect bites.

Images

WIKIDATA, Public Domain
WIKIDATA, Public Domain

Presentation

Most infected individuals remain asymptomatic or develop a mild form of the disease, consisting of fever, muscle and joint pain, weakness, backache, and headache. The clinical picture may resemble meningitis with neck stiffness photophobia, anorexia, and vomiting. Still, symptoms may be difficult to recognize, especially if the epizootic context is unknown and diagnosis may depend on reliable laboratory techniques.

Severe illness consists of ocular disease, meningoencephalitis, and hemorrhagic fever. Ocular symptoms like blurred or decreased vision signify retinal or macular damage, that might spontaneously resolve or become permanent, leading to vision loss. Central nervous system disease manifests as an intense headache, hallucinations, confusion, seizures, lethargy, and coma, with persistence of neurologic deficit, whereas hemorrhagic fever signifies liver damage and manifests as jaundice, melena, hematemesis, menorrhagia, epistaxis or other mucosal hemorrhages, purpuric rash or ecchymosis. 50% of patients with hemorrhagic fever die within one week of symptom onset. Jaundice, neurologic and hemorrhagic forms have a higher incidence of mortality [1] [2]. Central nervous system disease may be followed by permanent neurologic deficits.

Although abortion is the most prominent trait of this disease in animals, pregnant women, newborns, and small children usually are spared from this infection. The reason for this might be that they usually are not exposed to diseased animals and more efforts are made to prevent their exposure to mosquitoes; if other reasons exist, they are yet to be reported.

Rift valley fever (RVF) induces life-long immunity.

Ocular disease becomes apparent 7-21 days after infection and resolves after 10-12 weeks. Encephalitis may be suspected 1-4 weeks after initial general symptoms of the disease appear, while hemorrhages occurring much sooner i.e. 2-4 days following exposure, entail a poor prognosis.

Immune System

  • Generalized Lymphadenopathy

    There is a generalized lymphadenopathy involving the superficial and visceral lymph nodes. These are oedematous with petechial haemorrhages. The spleen may or may not be enlarged with subcapsular haemorrhages. [fao.org]

Entire Body System

  • Fever

    Rift Valley fever in small ruminants, Senegal, 2003. Emerg Infect Dis 2005 ; 11 : 1693 – 700. 8. Rift Valley fever in Kedougou, southeastern Senegal, 2012. Emerg Infect Dis 2014 ; 20 : 504 – 6. 9. [ofid.oxfordjournals.org]

    24 November 2016 Rift Valley Fever in Niger 29 September 2016 Rift Valley fever in Niger 2 August 2016 Rift Valley fever in China 1 November 2012 Rift Valley fever in Mauritania 12 May 2010 Rift Valley fever in South Africa- update 2 4 May 2010 Rift [who.int]

    Freiburg im Breisgau sowie der Landkreise Breisgau… … Deutsch Wikipedia Rift Valley fever — DiseaseDisorder infobox Name = Rift Valley fever | Caption = TEM micrograph of tissue infected with Rift Valley fever virus ICD10 = ICD10|A|92|4|a|90 ICD9 = ICD9 [deacademic.com]

    Bath, Rift Valley Fever, Diseases of Sheep, (469-473), (2008). [doi.org]

  • Veterinarian

    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. [who.int]

    • Veterinarians/veterinarian students. • Volunteers/workers on farms. • Laboratory staff/students. • Health Care Workers. [fitfortravel.nhs.uk]

    Any animal suspected of having Rift Valley Fever should be reported to the State Veterinarians or USDA Area Veterinarian in Charge immediately. Prevention Human and animal vaccines exist for those areas where Rift Valley Fever is endemic. [thecattlesite.com]

    Participants received most their information about RVF from social networks and the mass media, rather than the health system or veterinarians. [ncbi.nlm.nih.gov]

  • Pain

    When the virus infects humans, the symptoms are usually mild (flu-like fever, muscle pain, joint pain, and headache). But in 8 to 10 percent of people, the infection can lead to blindness, hemorrhagic fever, or death. [earthobservatory.nasa.gov]

    Our data reveal an identifiable clinical syndrome suggestive of severe RVF, characterized by fever, large-joint arthralgia, and gastrointestinal complaints and later followed by jaundice, right upper-quadrant pain, and delirium, often coinciding with [ncbi.nlm.nih.gov]

    Symptoms include fever, muscle pain and headache. A small percentage of patients get ocular disease or brain inflammation. Neither Nipah virus infection or Rift Valley fever have vaccines. [mnn.com]

    Humans experience flu-like symptoms, which may include fever, weakness, weight loss, dizziness, headache, nausea, vomiting, and muscle and joint pain. About 1% of those infected experience more severe symptoms. [floridahealth.gov]

    Mild symptoms include hemorrhagic fever, muscle pains and headaches whereas severe symptoms range from loss of sight within weeks of infection to brain inflammation, which can lead to headaches and seizures. ... [allafrica.com]

  • Inflammation

    Serial blood samples from these men were analyzed for a series of biomarkers specific for various aspects of human pathophysiology including inflammation, endothelial function and coagulopathy. [ncbi.nlm.nih.gov]

    These symptoms include: retinal inflammation, brain inflammation, or hemorrhagic fever. Onset of hemorrhagic fever results in 50% mortality in about 3-6 days after infection of the host. [floridahealth.gov]

    A small percentage of patients get ocular disease or brain inflammation. Neither Nipah virus infection or Rift Valley fever have vaccines. [mnn.com]

    Mild symptoms include hemorrhagic fever, muscle pains and headaches whereas severe symptoms range from loss of sight within weeks of infection to brain inflammation, which can lead to headaches and seizures. ... [allafrica.com]

    The most common complication associated with RVF is inflammation of the retina (a structure connecting the nerves of the eye to the brain). As a result, approximately 1% - 10% of affected patients may have some permanent vision loss. Q. [mosquitocontrol.org]

  • Falling

    CONCLUSIONS: Limiting the importation of infected ruminants beginning one month prior to the Greater Bairam festival (on years in which the festival falls between the months of July and October: 2014-2022) might be a feasible way of mitigating future [ncbi.nlm.nih.gov]

    In Ethiopia during the same period, the heavy rain fall and attendant flooding affected Southern and South Eastern parts of the country bordering Somalia and Kenya. [austinpublishinggroup.com]

    Shutterstock June 3, 2018 As rain continues to fall in Kenya, national and county governments must put measures in place to prevent a Rift Valley fever outbreak. [theconversation.com]

    Fall, Mamadou Ciss, Momar T. [doi.org]

    RVF in camels Camels do not normally show any clinical signs following RVF infections and fall into the inapparent infection group. They have a brief period of viraemia. [fao.org]

Gastrointestinal

  • Overeating

    Using Satellites to Track Rift Valley Fever Rift Valley Fever (RVF), at least in the African country of Kenya, has been well known for over 60 years. [odysseyofthemind.com]

    Most of this rainfall fell over RVF endemic areas in this region. [pnas.org]

    A persistent virus Alongside this work, the researchers studied the dynamics of virus transmission over some 20 years. [cirad.fr]

    “Areas of continental Africa also appear to be at elevated risk and have been over the past 6–9 months,” Linthicum said. But just because conditions are primed does not mean there will be an outbreak. [earthobservatory.nasa.gov]

    However, increased understanding of the molecular biology of the virus over the last few years has led to recent advances in vaccine design and has enabled the development of more-potent prophylactic measures to combat infection. [ncbi.nlm.nih.gov]

  • Vomiting

    Affected animals show: Fever (40-42°C) Anorexia, depression and weakness in adult cattle and lambs, Mucopurulent nasal discharge in sheep and goats, Vomiting, Diarrhea in cattle, Vomiting and jaundice in sheep, Sometimes haemorrhagic diarrhoea in lambs [lrd.spc.int]

    Humans experience flu-like symptoms, which may include fever, weakness, weight loss, dizziness, headache, nausea, vomiting, and muscle and joint pain. About 1% of those infected experience more severe symptoms. [floridahealth.gov]

    Vomiting and diarrhoea may involve melaena and haematochezia. Tachycardia, cyanosis, petechiation, haemorrhage and clotting defects are haematological consequences of RVF. [web.archive.org]

    With no specific treatment or effective human vaccine, Rift Valley fever can cause blindness and severe hemorrhaging, leading the victim to vomit blood or even bleed to death. [voanews.com]

    Anorexia, injected conjunctivae, nasal discharges, vomiting and other signs are seen but are generally less severe than in young animals. Abortion is a feature, as is diarrhoea. [fao.org]

  • Abdominal Pain

    Affected animals are listless and reluctant to move or feed and may show signs of abdominal pain. Mortality in young lambs is high (90%–100%), and animals usually die within 2–3 days. [msdvetmanual.com]

    pain, photosensitivity, anorexia, excessive salivation and decreased milk production. [en.wikivet.net]

  • Loss of Appetite

    Sensitivity to light, neck stiffness, vomiting and loss of appetite are also common. [iamat.org]

    Some develop neck stiffness, sensitivity to light, loss of appetite and vomiting, in the early diagnosing process these symptoms can often be confused with meningitis. [thesun.co.uk]

    Some patients develop neck stiffness, sensitivity to light, loss of appetite and vomiting; in these patients the disease, in its early stages, may be mistaken for meningitis. [web.archive.org]

  • Nausea

    Humans experience flu-like symptoms, which may include fever, weakness, weight loss, dizziness, headache, nausea, vomiting, and muscle and joint pain. About 1% of those infected experience more severe symptoms. [floridahealth.gov]

Cardiovascular

  • Tachycardia

    Tachycardia, cyanosis, petechiation, haemorrhage and clotting defects are haematological consequences of RVF. The respiratory disease of RVF is non-specific: Purulent nasal discharge, epistaxis, tachypnoea and dyspnoea. [web.archive.org]

Liver, Gall & Pancreas

  • Jaundice

    The necrotic changes induce jaundice and a stage is reached when the liver has a bronze appearance as the congestion, necrotic areas and icterus develop. At later stages the liver will be completely yellow with jaundice. [fao.org]

    Our data reveal an identifiable clinical syndrome suggestive of severe RVF, characterized by fever, large-joint arthralgia, and gastrointestinal complaints and later followed by jaundice, right upper-quadrant pain, and delirium, often coinciding with [ncbi.nlm.nih.gov]

    Jaundice, neurologic and hemorrhagic forms have a higher incidence of mortality. Central nervous system disease may be followed by permanent neurologic deficits. [symptoma.com]

    Affected animals show: Fever (40-42°C) Anorexia, depression and weakness in adult cattle and lambs, Mucopurulent nasal discharge in sheep and goats, Vomiting, Diarrhea in cattle, Vomiting and jaundice in sheep, Sometimes haemorrhagic diarrhoea in lambs [lrd.spc.int]

    In older animals, the liver is enlarged and inflamed, with many foci of necrosis which are bronzed and jaundiced. The gall bladder may also be distended and haemorrhagic. [web.archive.org]

Eyes

  • Photophobia

    The clinical picture may resemble meningitis with neck stiffness photophobia, anorexia, and vomiting. [symptoma.com]

    The disease is typically mild with patients showing flu-like symptoms and photophobia (sensitivity to light). Recovery often occurs in seven days and is uneventful. [thecattlesite.com]

    The disease is characterized by sudden onset of high fever, severe headache, myalgia, arthralgia, and photophobia in humans [1]. [microbewiki.kenyon.edu]

    Some patients also have stiffness of the neck, photophobia and vomiting. Most people recover spontaneously within two days to a week. The incubation period is two to six days. [healio.com]

    Human symptoms of this disease range from photophobia and headaches to retinitis and encephalitis ( 18, 19 ). [doi.org]

  • Blurred Vision

    These lesions are usually associated with blurred vision and/or mild to severe vision loss, which may or may not resolve during convalescence. [infectionlandscapes.org]

Musculoskeletal

  • Myalgia

    The usual presentation is of sudden onset fever, myalgia, biphasic behaviour and gastrointestinal disease. [web.archive.org]

    The disease is characterized by sudden onset of high fever, severe headache, myalgia, arthralgia, and photophobia in humans [1]. [microbewiki.kenyon.edu]

    The symptoms of uncomplicated infections may include fever, headache, generalized weakness, dizziness, weight loss, myalgia and back pain. Some patients also have stiffness of the neck, photophobia and vomiting. [healio.com]

    The usual presentation is of sudden onset fever, myalgia, biphasic behaviour and gastrointestinal disease. [4] Diagnosis Following infection viraemia is often high (though short lived) so the virus can be easily detected in the blood shortly after. [en.wikivet.net]

  • Arthralgia

    Our data reveal an identifiable clinical syndrome suggestive of severe RVF, characterized by fever, large-joint arthralgia, and gastrointestinal complaints and later followed by jaundice, right upper-quadrant pain, and delirium, often coinciding with [ncbi.nlm.nih.gov]

    The disease is characterized by sudden onset of high fever, severe headache, myalgia, arthralgia, and photophobia in humans [1]. [microbewiki.kenyon.edu]

    The mild disease course typically presents as an influenza-like illness with abrupt onset of fever, mylagia and arthralgia, and headache. [infectionlandscapes.org]

    Systemic reaction parameters include fever, chills, headache, malaise, myalgia, arthralgia, sore throat, gastric upset, dizziness, photophobia and skin rash. [google.ch]

Skin

  • Petechiae

    On necropsy, in the viraemic stage, widespread petechiae and ecchymoses on serous surfaces and organs will be seen and extravasated blood present in the body cavities. [web.archive.org]

    The symptoms may include jaundice, hematemesis, melena, a purpuric rash, petechiae and bleeding from the gums. Hemorrhagic fever frequently progresses to frank hemorrhages, shock and death (case fatality rate of up to 50%). [healio.com]

    In all animals, the spleen and peripheral lymph nodes are enlarged and edematous and may show petechiae. [msdvetmanual.com]

    On post mortem during the viraemic stage, widespread petechiae and ecchymoses on serous surfaces and organs will be seen and present in the body cavities. [en.wikivet.net]

  • Insect Bite

    • Practice good insect bite avoidance measures back to top [fitfortravel.nhs.uk]

    Humans become infected via aerosols or by ingesting unpasteurized animal milk or after exposure to infected animal blood, body fluids or tissue or following mosquito or other insect bites. [symptoma.com]

    More details on insect bite prevention. There is no preventive medication or vaccine against Rift Valley Fever. [iamat.org]

    The transmission of RVF is primarily by the bites of the mosquitoes of several species. Man acquires the infection from the infected animals and insect bites. [austinpublishinggroup.com]

  • Skin Rash

    She delivered baby of 3.2 kg with skin rash, palpable liver and spleen. The two samples from the mother and neonate were found to be positive for RVF-IgM. This report demonstrate that, RVF can be vertically transmitted. [ncbi.nlm.nih.gov]

    During the 2007 outbreak in Sudan, a 29-year-old pregnant woman presented in early labor with symptoms suggestive of RVF and delivered a baby weighing 3.2 kg with skin rash, palpable liver, and spleen. [frontiersin.org]

    Systemic reaction parameters include fever, chills, headache, malaise, myalgia, arthralgia, sore throat, gastric upset, dizziness, photophobia and skin rash. [google.ch]

Face, Head & Neck

  • Epistaxis

    The respiratory disease of RVF is non-specific: Purulent nasal discharge, epistaxis, tachypnoea and dyspnoea. Fever, lymphadenopathy, depression and lethargy usually accompany infection. Hepatitis may cause consequent photosensitisation. [web.archive.org]

    […] disease manifests as an intense headache, hallucinations, confusion, seizures, lethargy, and coma, with persistence of neurologic deficit, whereas hemorrhagic fever signifies liver damage and manifests as jaundice, melena, hematemesis, menorrhagia, epistaxis [symptoma.com]

Neurologic

  • Headache

    The virus also infects humans, commonly causing malaise, fever and headaches; in epidemics in North Africa, encephalitis and death have also occurred. [epi.ufl.edu]

    Mild symptoms include hemorrhagic fever, muscle pains and headaches whereas severe symptoms range from loss of sight within weeks of infection to brain inflammation, which can lead to headaches and seizures. ... [allafrica.com]

    Most infected individuals remain asymptomatic or develop a mild form of the disease, consisting of fever, muscle and joint pain, weakness, backache, and headache. [symptoma.com]

    On March 9, 2016, a male butcher from Kabale District, Uganda, aged 45 years, reported to the Kabale Regional Referral Hospital with fever, fatigue, and headache associated with black tarry stools and bleeding from the nose. [ncbi.nlm.nih.gov]

    The mild symptoms may include: fever, muscle pains, and headaches which often last for up to a week. [en.wikipedia.org]

  • Confusion

    Symptoms include respiratory issues and mental confusion. Rift Valley fever was first identified in 1931 in sheep farmers in Kenya and has since been found in outbreaks mostly throughout Africa. [mnn.com]

    Central nervous system disease manifests as an intense headache, hallucinations, confusion, seizures, lethargy, and coma, with persistence of neurologic deficit, whereas hemorrhagic fever signifies liver damage and manifests as jaundice, melena, hematemesis [symptoma.com]

    Some develop neck stiffness, sensitivity to light, loss of appetite and vomiting, in the early diagnosing process these symptoms can often be confused with meningitis. [thesun.co.uk]

    Clinical features include intense headache, loss of memory, hallucinations, confusion, disorientation, vertigo, convulsions, lethargy and coma. Neurological complications can appear later (> 60 days). [web.archive.org]

    Confusion, loss of memory, convulsions, hallucination and headache are common features of this syndrome. Coma can also ensue. Mortality associated with this syndrome is also low, but chronic neurologic deficit often persists and can be quite severe. [infectionlandscapes.org]

  • Neck Stiffness

    The clinical picture may resemble meningitis with neck stiffness photophobia, anorexia, and vomiting. [symptoma.com]

    Sensitivity to light, neck stiffness, vomiting and loss of appetite are also common. [iamat.org]

    Most cases are mild, and involve non-specific symptoms including fever, muscle and joint pain, and headache; neck stiffness and vomiting may also occur. [virology.ws]

    Some develop neck stiffness, sensitivity to light, loss of appetite and vomiting, in the early diagnosing process these symptoms can often be confused with meningitis. [thesun.co.uk]

    Some patients develop neck stiffness, sensitivity to light, loss of appetite and vomiting; in these patients the disease, in its early stages, may be mistaken for meningitis. [web.archive.org]

Workup

Laboratory techniques used in order to establish the diagnosis include reverse transcriptase-polymerase chain reaction (RT-PCR) [3] [4], virus isolation in cell cultures [5], enzyme-linked immunoassay (ELISA) to detect viral antigens [6] [7], immunoglobulin IgM and IgG [8] and real-time reverse transcription-loop-mediated isothermal amplification assays (RT-LAMP) [9] [10], a new, highly specific and sensitive diagnostic test. Samples should be handled with caution and processed in specialized facilities, as they might be a bio- hazard. The virus is isolated from serum, liver, spleen or brain tissue. Rapid virus identification in severe cases is extremely important as patients need special management.

Immunological viral antigen detection methods include agar gel immunodiffusion and immunostaining on impression smears or on cryostat sections of liver, spleen, and brain, while histopathological examination reveals specific characteristics [11] [12]. Sandwich ELISA for antigen detection (sAg-ELISA) is a new technique to identify the disease and it is less dangerous to laboratory personnel [13] [14].

Antibody detection methods include hemagglutination-inhibition, complement fixation, indirect immunofluorescence which aim to prove seroconversion and virus neutralization test which is considered to be the gold standard [11] [8].

Treatment

Treatment Treatment typically includes supportive care and the use of experimental antiviral drugs. At this time the United States does not have a licensed human or animal vaccine. [floridahealth.gov]

This resolves without treatment over a week. Treatment Most cases resolve without treatment. Severe illness needs hospital intensive care support. There is no specific treatment against the virus. [fitfortravel.nhs.uk]

Treatment No treatment is available. Control Modified live and inactivated vaccines are available. Live vaccination is only recommended in non-pregnant animals due to its ability to cause abortion and neurological deficits in lambs. [web.archive.org]

The patient developed multiorgan dysfunction and gradually recovered with continuous renal replacement therapy and a short regimen of methylprednisolone treatment. [ncbi.nlm.nih.gov]

Prognosis

Encephalitis may be suspected 1-4 weeks after initial general symptoms of the disease appear, while hemorrhages occurring much sooner i.e. 2-4 days following exposure, entail a poor prognosis. [symptoma.com]

D’Agati and Ibrahim Batal, Donor APOL1 high-risk genotypes are associated with increased risk and inferior prognosis of de novo collapsing glomerulopathy in renal allografts, Kidney International, 10.1016/j.kint.2018.06.024, (2018). Sanaa M. [doi.org]

Etiology

Suspected VHF in which the etiology is uncertain should be initially managed with the most cautious infection control measures. [ncbi.nlm.nih.gov]

Etiology RVF is caused by RVF virus which belongs to the family Bunyaviridae and the genus Phlebovirus. [austinpublishinggroup.com]

By early December 2016, accumulating disease data suggested that the outbreak of Rift Valley Fever was of modest size, and plans to explore other etiologies were formulated. References: WHO: Disease Outbreak News, 29 September 2016. [cdc.gov]

ETIOLOGIC DIAGNOSIS: Bunyaviral hepatitis and cholecystitis CAUSE: Rift Valley fever virus (RVFV) (phlebovirus) CONDITION: Rift Valley Fever GENERAL DISCUSSION: · Zoonotic disease of Africa that results in abortion storms, neonatal mortality and hepatic [askjpc.org]

That this “top 10” list of agricultural diseases on the move includes, exclusively, conditions of viral etiology is not coincidental. [doi.org]

Epidemiology

Author information 1 Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland. [ncbi.nlm.nih.gov]

Further screening was done by title and abstract focusing on studies reporting the epidemiology of RVF including ecology and risk factors as well as molecular diversity, spatial–temporal epidemiology, and risk modeling. [web.archive.org]

[…] overview for 2016 Publication Rift Valley fever - Annual Epidemiological Report for 2016 Publication Communicable Disease Threats Report, 10-16 June 2018, week 24 Publication Rift valley fever - Annual Epidemiological Report for 2015 Publication Rift [ecdc.europa.eu]

Pathophysiology

Serial blood samples from these men were analyzed for a series of biomarkers specific for various aspects of human pathophysiology including inflammation, endothelial function and coagulopathy. [ncbi.nlm.nih.gov]

Prevention

“Animal vaccination and mosquito control could even prevent major outbreaks, if initiated ahead of time. There is a window of opportunity, but once outbreaks begin, it’s too late for these preventative actions.” [climate.gov]

We posit that there is a critical need for new approaches to RVF control that will prevent or at least reduce future morbidity and economic stress. [doi.org]

Overall knowledge score on RVF was found to be a significant predictor of good preventive practice of the disease (OR = 1.073, 95% CI = 1.047-1.101). [ncbi.nlm.nih.gov]

Knowledge generated by the project will guide prevention strategies to effectively reduce the risk of transmission. [idrc.ca]

References

  1. Laughlin L, Meegan J, Strausbaugh L. Epidemic Rift Valley fever in Egypt: Observations of the spectrum of human illness. Trans. R. Soc. Trop. Med. Hyg. 1979;73:630–633.
  2. Madani T, Al-Mazrou Y, Al-Jeffri M, et al. Rift Valley fever epidemic in Saudi Arabia: Epidemiological, clinical, and laboratory characteristics. Clin. Infect. Dis. 2003;37:1084–1092.
  3. Garcia S, Crance J, Billecocq A, et al. Quantitative real-time PCR detection of Rift Valley fever virus and its application to evaluation of antiviral compounds. J. Clin. Microbiol. 2001;39:4456–4461.
  4. Ibrahim M, Turell M, Knauert F, Lofts R. Detection of Rift Valley fever virus in mosquitoes by RT-PCR. Mol. Cell. Probes 1997;11:49–53.
  5. Anderson G, Saluzzo J, Ksiazek T, et al. Comparison of in vitro and in vivo systems for propagation of Rift Valley fever virus from clinical specimens. Res. Virol. 1989;140:129–138.
  6. Meegan J, Le Guenno B, Ksiazek T, et al. Rapid diagnosis of Rift Valley fever: A comparison of methods for the direct detection of viral antigen in human sera. Res. Virol. 1989;140:59–65.
  7. Niklasson B, Grandien M, Peters C, Gargan T. Detection of Rift Valley fever virus antigen by enzyme-linked immunosorbent assay. J. Clin. Microbiol. 1983;17:1026–1031.
  8. Swanepoel R, Struthers J, Erasmus M, et al. Comparison of techniques for demonstrating antibodies to Rift Valley fever virus. J. Hyg. 1986;97:317–329.
  9. Le Roux C, Kubo T, Grobbelaar A, van Vuren P, Weyer J, Nel L. Development and evaluation of a real-time reverse transcription-loop-mediated isothermal amplification assay for rapid detection of Rift Valley fever virus in clinical specimens. J. Clin. Microbiol. 2009;47:645–651.
  10. Peyrefitte C, Boubis L, Coudrier D, et al. Real-time reverse-transcription loop-mediated isothermal amplification for rapid detection of Rift Valley fever virus. J. Clin. Microbiol. 2008;46:3653–3659.
  11. Gerdes G. Rift Valley Fever. In: Manual of diagnostic yeasts and vaccines for terrestrial animals (mammals, birds and bees), Office International des Epizooties, Paris, 2004;185–194.
  12. Swanepoel R, Coetzer J. Rift Valley fever. In: Coetzer J, Tustin R.C. (Eds.), Infectious diseases of livestock, Oxford University Press Southern Africa, Cape Town, 2004;1037–1070.
  13. van Vuren P, Paweska J. Laboratory safe detection of nucleocapsid protein of Rift Valley fever virus in human and animal specimens by a sandwich ELISA. J. Virol. Meth. 2009;157:15–24.
  14. Pepin M, Bouloy M, Bird B, Kemp A, Paweska J. Rift valley fever virus (Bunyaviridae:Ohlebovirus): an update on pathogenesis, molecular epidemiology, vectors, diagnostics and prevention. Vet Res. 2010;41(6): 61.
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