title: A need for One Health approach - lessons learned from outbreaks of Rift Valley fever in Saudi Arabia and Sudan.
abstract: BACKGROUND
  Rift Valley fever (RVF) is an emerging viral zoonosis that impacts human and animal health. It is transmitted from animals to humans directly through exposure to blood, body fluids, or tissues of infected animals or via mosquito bites. The disease is endemic to Africa but has recently spread to Saudi Arabia and Yemen. Our aim was to compare two major outbreaks of RVF in Saudi Arabia (2000) and Sudan (2007) from a One Health perspective.
  
  
  METHODS
  Using the terms 'Saudi Arabia', 'Sudan', and 'RVF', articles were identified by searching PubMed, Google Scholar, and web pages of international organizations as well as local sources in Saudi Arabia and Sudan.
  
  
  RESULTS
  The outbreak in Saudi Arabia caused 883 human cases, with a case fatality rate of 14% and more than 40,000 dead sheep and goats. In Sudan, 698 human cases of RVF were recognized (case fatality, 31.5%), but no records of affected animals were available. The ecology and environment of the affected areas were similar with irrigation canals and excessive rains providing an attractive habitat for mosquito vectors to multiply. The outbreaks resulted in livestock trade bans leading to a vast economic impact on the animal market in the two countries. The surveillance system in Sudan showed a lack of data management and communication between the regional and federal health authorities, while in Saudi Arabia which is the stronger economy, better capacity and contingency plans resulted in efficient countermeasures. Studies of the epidemiology and vectors were also performed in Saudi Arabia, while in Sudan these issues were only partly studied.
  
  
  CONCLUSIONS
  We conclude that a One Health approach is the best option to mitigate outbreaks of RVF. Collaboration between veterinary, health, and environmental authorities both on national and regional levels is needed.
authors: Department of Epidemiology and Diseases Control, Public Health Institute, Federal Ministry of Health, Khartoum, Sudan ; Department of Clinical Microbiology, Infectious Diseases, Umeå University, Umeå, Sweden ; Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
authors: Osama Ahmed
authors: OA
authors: Hassan
authors: Department of Clinical Microbiology, Infectious Diseases, Umeå University, Umeå, Sweden.
authors: Clas
authors: C
authors: Ahlm
authors: Department of Clinical Microbiology, Virology, Umeå University, Umeå, Sweden.
authors: Magnus
authors: M
authors: Evander
keywords: One Health; Rift Valley fever; Saudi Arabia; Sudan; climate; mosquito; outbreak; trade ban