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WHO - Rift Valley fever in South Africa- update (May 4, 2010, edited) - An imported case in Germany.

Giuseppe

Emeritus
WHO - Rift Valley fever in South Africa- update (May 4, 2010, edited)

[Source: World Health Organization, <cite cite="http://www.who.int/csr/don/2010_05_04a/en/index.html">WHO | Rift Valley fever in South Africa- update</cite>. Edited.]

Rift Valley fever in South Africa- update

4 May 2010


As of 27 April 2010, German health authorities reported a laboratory confirmed case of Rift Valley Fever (RVF) in a traveller returning to Germany after a trip to South Africa from 17 March to 8 April 2010.

The case, along with three travel companions, visited rural areas and game reserves along the coast of Eastern Cape and Western Cape provinces.

On 7 April 2010, the case developed symptoms including fever, headache and a rash (exanthema). Almost concurrently a similar illness was reported in her travel companions.

German health authorities are currently investigating the circumstances around infection in the confirmed case.

As of 3 May 2010, the Department of Health of South Africa has reported 172 cases, including 15 deaths since the beginning of the outbreak in Free State Province, Eastern Cape Province, Northern Cape Province, Western Cape, and North West Province.

While it is reported that most of these cases have had direct contact with RVF-infected livestock and/or are epidemiologically linked to farms with confirmed animal cases of RVF, there are a number of cases in which the route of transmission is currently unknown.

Exposure to infected mosquitoes in these cases cannot be currently ruled out.

The Government of South Africa has implemented public health control measures which include development of key risk reduction messages for at risk population and health worker guidelines for case identification and reporting, laboratory investigations, clinical case management, hospital infection control and the public health measures for prevention and control and animal vaccination in non-affected areas.

WHO advises no international travel restriction to or from South Africa.

However, WHO recommends that visitors to South Africa, especially those intending to visit farms and/or game reserves, avoid coming into contact with animal tissues or blood, avoid drinking unpasteurized or uncooked milk or eating raw meat. All travellers should take appropriate precautions against mosquito bites (use of mosquito nets, insect repellents).

Travel medicine professionals and travel medicine services should be aware of the current RVF situation in South Africa in order to provide advice and care accordingly.


For more information

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Re: WHO - Rift Valley fever in South Africa- update (May 4, 2010, edited) - An imported case in Germany.

http://www.reuters.com/article/idUSTRE6434FY20100504

[snip]

A female German tourist who visited game reserves was confirmed as having the disease upon return from South Africa last month, the WHO said in a statement. Three other travelers fell ill with similar symptoms but all four have recovered
 
Re: WHO - Rift Valley fever in South Africa- update (May 4, 2010, edited) - An imported case in Germany - NOT.

Re: WHO - Rift Valley fever in South Africa- update (May 4, 2010, edited) - An imported case in Germany - NOT.

Umm, wow. Bad testing. Rickettsia (spotted fever) confirmed, and RVF ruled out. And yes, we have another case where soptted fever was mistaken for hemorrhagic fever.

http://promedmail.org/pls/apex/f?p=..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,82665

Archive Number 20100511.1537
Published Date 11-MAY-2010
Subject PRO/AH/EDR> Rift Valley fever - South Africa (17): tourist, NOT


RIFT VALLEY FEVER - SOUTH AFRICA (17): TOURIST, NOT
***************************************************
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: Tue 11 May 2010
From: Stephan Gunther [edited]
<stephan.gunther@gmx.net>


Acute illness in a German tourist on returning from South Africa,
update on laboratory findings
-----------------------------------------------------------------------------------------------
The Bernhard-Nocht-Institute (BNI), Hamburg, and the
Robert-Koch-Institute Berlin, Germany, recently released a
preliminary report on a German tourist with acute illness after
returning from South Africa (ProMED-mail Archive Number
20100505.1450, 5 May 2010).

An acute-phase blood sample tested positive for Rift Valley fever
(RVF) virus-specific IgM and IgG at BNI, and therefore it was
considered likely that the case-patient acquired infection with RVF
virus while travelling in South Africa. Additional laboratory
analyses, conducted both in Germany and in South Africa, however,
could not confirm this preliminary diagnosis.

Testing of a 2nd, convalescent serum sample at BNI did not reveal an
increase in anti-RVF virus antibody titres indicating that the
antibodies are not related to the illness following the travel to
South Africa. The serum samples, which were sent to and investigated
at the Special Pathogens Unit, National Institute for Communicable
Diseases of the National Health Laboratory Service (SPU NICD-NHLS),
Sandringham, South Africa, tested negative for RVF virus-specific
antibodies in different tests, including ELISA and virus neutralizing assays.

While the reason for the discrepant findings remains unclear, in 3
laboratories, including BNI and SPU NICD-NHLS, seroconversion to
Rickettsia-specific IgM and IgG was detected, indicating recent
infection with _Rickettsia_ sp. We conclude from these new findings
that the acute illness in the case-patient after returning from South
Africa was caused by infection with _Rickettsia_ and not with RVF virus
.

--
Prof. Stephan Gunther
Department of Virology
Bernhard-Nocht-Institute for Tropical Medicine
Bernhard-Nocht-Str. 74, 20359 Hamburg, Germany
<guenther@bni.uni-hamburg.de>

Prof. Janusz T. Paweska
Special Pathogens Unit
National Institute for Communicable Diseases of the National Health
Laboratory Service
Private Bag X4, Sandringham-Johannesburg, 2131
Modderfontein Road 1, Gauteng, South Africa
<januszp@nicd.ac.za>

[ProMED-mail thanks Professors Stephan Gunther and Janusz Paweska for
providing this information concerning the revised diagnosis of the
acute illness suffered by a tourist recently returned to Germany from
a visit to South Africa.

This incident may provide some reassurance for visitors to South
Africa that the probability of contracting Rift Valley fever virus
during recreational travel in that country is low. Nonetheless
visitors should avoid contact with diseased livestock and protect
themselves from mosquito bites. Likewise diagnostic services in
Europe should remain vigilant
. - Mod.CP]
 
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