title: Severe Human Illness Caused by Rift Valley Fever Virus in Mauritania, 2015.
abstract: BACKGROUND
  Rift Valley Fever epizootics are characterized by numerous abortions and mortality among young animals. In humans, the illness is usually characterized by a mild self-limited febrile illness, which could progress to more serious complications.Objectives. The aim of the present prospective study was to describe severe clinical signs and symptoms of Rift Valley Fever in southern Mauritania.
  
  
  METHODS
  Suspected cases were enrolled in Kiffa (Assaba) and Aleg (Brakna) Hospital Centers from September 1 to November 7, 2015, based on the presence of fever, hemorrhagic or meningoencephalitic syndromes, and probable contact with sick animals. Suspected cases were confirmed by enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase-polymerase chain reaction (RT-PCR).
  
  
  RESULTS
  There were thirty-one confirmed cases. The sex ratio M/F and the average age were 2.9 and 25 years old [range, 4-70 years old], respectively. Mosquito bites, direct contact with aborted or dead animals, and frequent ingestion of milk from these animals were risk factors observed in all patients. Hemorrhagic and neurological manifestations were observed in 81% and 13% of cases, respectively. The results of laboratory analysis showed high levels of transaminases, creatinine, and urea associated with thrombocytopenia, anemia, and leukopenia. All patients who died (42%) had a hemorrhagic syndrome and 3 of them had a neurological complication. Among the cured patients, none had neurologic sequelae.
  
  
  CONCLUSIONS
  The hemorrhagic form was the most common clinical manifestation of RVF found in southern Mauritania and was responsible for a high mortality rate. Our results justify the implementation of a continuous epidemiological surveillance.
authors.affiliation: Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier de Kiffa , Assaba , Mauritania.
authors.forename: Boushab Mohamed
authors.initials: BM
authors.lastname: Boushab
authors.affiliation: Institut National d'Hépato-Virologie de Nouakchott, Faculté de Médecine , Mauritania.
authors.forename: Fatima Zahra
authors.initials: FZ
authors.lastname: Fall-Malick
authors.affiliation: Service de Médecine Interne du Centre Hospitalier National de Nouakchott, Faculté de Médecine , Mauritania.
authors.forename: Sidi El Wafi
authors.initials: SE
authors.lastname: Ould Baba
authors.affiliation: Laboratoire du Centre Hospitalier National de Nouakchott, Faculté de Médecine , Mauritania.
authors.forename: Mohamed Lemine
authors.initials: ML
authors.lastname: Ould Salem
authors.affiliation: Organisation Mondiale de la Sante , Mauritania.
authors.forename: Marie Roseline Darnycka
authors.initials: MR
authors.lastname: Belizaire
authors.affiliation: Médecine Interne, Centre Hospitalier , Aleg, Brakna , Mauritania.
authors.forename: Hamade
authors.initials: H
authors.lastname: Ledib
authors.affiliation: Service de Médecine Interne et Maladies Infectieuses, Centre Hospitalier de Kiffa , Assaba , Mauritania.
authors.forename: Mohamed Mahmoud
authors.initials: MM
authors.lastname: Ould Baba Ahmed
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Institut de Recherche pour le Développement, Aix-Marseille Université , Marseille , France.
authors.forename: Leonardo Kishi
authors.initials: LK
authors.lastname: Basco
authors.affiliation: Institut National de Recherche en Santé Publique , Nouakchott , Mauritania.
authors.forename: Hampaté
authors.initials: H
authors.lastname: Ba
keywords: Assaba; Brakna; Mauritania; Rift valley fever; severe human illness.