Rift valley fever


  • Viral illness caused by RVF virus, a bunyaviridae
  • Primarily infects domesticated animals; cattle, sheep, buffalo, etc.
  • Outbreaks related to unusually heavy rainfall and flooding
  • Found mostly in eastern and southern Africa where domesticated animals are raised
    • Can be found in most of Africa
    • Recent outbreaks in Saudi Arabia and Yemen (first outside African continent)
  • Outbreaks cause major economic impact with livestock death


  • Mosquitos, most commonly Aedes, are a reservoir and vector for RVF virus
    • Able to live with the virus and pass on to offspring, virus remains viable in eggs
    • Bite livestock and humans to cause infection
    • Increased rainfall increases mosquito numbers and is associated with outbreaks
  • Humans are most commonly infected through direct contact of blood or other bodily fluids of infected livestock
    • Slaughter, veterinary procedures, obstetrical procedures
  • No documented human to human transmission
  • Aerosolized transfer has occurred in laboratory settings

Clinical Features

  • Incubation period of 2-6 days


  • No symptoms or flu-like illness (fever, myalgias, joint pain, headache)
  • Early disease can be mistaken for meningitis with occasional neck stiffness and sensitivity to light
  • Resolves within 1 week


  • Occular form- 0.5-2% of patients
    • Mild disease form + retinal lesions, blurred and decreased vision
    • Retinal lesions occur 1-3 weeks after disease onset and last 10-12 weeks
    • 50% of patients with macular lesions will develop permanent vision loss
  • Meningoencephalitis form- <1% of patients
    • Severe headache, memory loss, hallucinations, confusion, vertigo, seizures, coma, and late neurological complications
    • Onset is 1-4 weeks after mild symptoms
    • Residual severe neurological deficits are common
  • Hemorrhagic fever form- <1% of patients
    • Jaundice is first sign due to liver dysfunction
    • Hemorrhage (vomit, stool, gums, menorrhagia), purpuric rash, echymosis
    • Onset is 2-4 days after illness, death in 3-6 days
    • Most fatalities from RVF, 50% fatality rate

Differential Diagnosis

Fever in traveler


  • Pursue other possible causes of fever
  • IgM ELISA, viral detection, and RT-PCR can be used to diagnose acute infection. IgG ELISA for previous infection.


  • Mild: requires no intervention (self limited_
  • Severe
    • Supportive Care
      • Pain control
        • DO NOT use ASA in hemorrhagic form
    • IVFs
    • Blood Component Transfusion - consider in hemorrhagic shock


  • Inactivated vaccine has been developed for humans
    • Not licensed and not commercially available
    • Experimental use on veterinary and lab workers
  • Approved vaccines for livestock


  • Isolation precautions: standard, contact, and consider droplet
  • Admit if severe form suspected, likely ICU
    • Consult ID
    • Consult ophthalmology for ocular form

See Also

External Links