Rift Valley fever: an uninvited zoonosis in the Arabian peninsula

Rift Valley fever (RVF) is an acute viral disease, affecting mainly livestock but also humans. The virus is transmitted to humans through mosquito bites or by exposure to blood and bodily fluids. Drinking raw, unpasteurized milk from infected animals can also transmit RVF. Routine vaccination of livestock in Africa has been prohibitively expensive, leading to endemicity of RVF in most African countries. Reports in September 2000 first documented RVF occurring outside of Africa in the Kingdom of Saudi Arabia and Yemen. Prior to this outbreak, the potential for RVF spread into the Arabian Peninsula had already been exemplified by a 1977 Egyptian epidemic. This appearance of RVF outside the African Continent might be related to importation of infected animals from Africa. In the most recent outbreak patients presented with a febrile haemorrhagic syndrome accompanied by liver and renal dysfunction. By the end of the outbreak, April 2001 statistics from the Saudi Ministry of Health documented a total of 882 confirmed cases with 124 deaths. Both the severity of disease and the relatively high 14% death rate might be a consequence of underreporting of less severe disease. Travellers to endemic areas may be at risk of acquiring the disease if exposed to animals or their body fluids directly or through mosquito bites. Special education regarding both modes of transmission and the geographical distribution of this disease needs to be given to travellers at risk.