title: Severe Rift Valley fever may present with a characteristic clinical syndrome.
abstract: Rift Valley fever (RVF) virus is an emerging pathogen that is transmitted in many regions of sub-Saharan Africa, parts of Egypt, and the Arabian peninsula. Outbreaks of RVF, like other diseases caused by hemorrhagic fever viruses, typically present in locations with very limited health resources, where initial diagnosis must be based only on history and physical examination. Although general signs and symptoms of human RVF have been documented, a specific clinical syndrome has not been described. In 2007, a Kenyan outbreak of RVF provided opportunity to assess acutely ill RVF patients and better delineate its presentation and clinical course. 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 hemorrhagic manifestations. Further characterization of a distinct RVF clinical syndrome will aid earlier detection of RVF outbreaks and should allow more rapid implementation of control.
authors.affiliation: Department of Medicine, Immunology, and Pathology, University of Texas Medical Branch, Galveston, TX, USA.
authors.forename: Summerpal S
authors.initials: SS
authors.lastname: Kahlon
authors.forename: Clarence J
authors.initials: CJ
authors.lastname: Peters
authors.forename: James
authors.initials: J
authors.lastname: Leduc
authors.forename: Eric M
authors.initials: EM
authors.lastname: Muchiri
authors.forename: Samuel
authors.initials: S
authors.lastname: Muiruri
authors.forename: M Kariuki
authors.initials: MK
authors.lastname: Njenga
authors.forename: Robert F
authors.initials: RF
authors.lastname: Breiman
authors.forename: A Clinton
authors.initials: AC
authors.lastname: White
authors.forename: Charles H
authors.initials: CH
authors.lastname: King
mesh_terms: D000328:Adult; D004196:Disease Outbreaks; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012295:Rift Valley Fever / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology