Abstract
Rift Valley fever virus is an emerging mosquito-borne virus that causes infections in animals and human beings in Africa and the Arabian Peninsula. Outbreaks of Rift Valley fever lead to mass abortions in livestock, but such abortions have not been identified in human beings. Our aim was to investigate the cause of miscarriages in febrile pregnant women in an area endemic for Rift Valley fever. Pregnant women with fever of unknown origin who attended the governmental hospital of Port Sudan, Sudan, between June 30, 2011, and Nov 17, 2012, were sampled at admission and included in this cross-sectional study. Medical records were retrieved and haematological tests were done on patient samples. Presence of viral RNA as well as antibodies against a variety of viruses were analysed. Any association of viral infections, symptoms, and laboratory parameters to pregnancy outcome was investigated using Pearson's χ2 test. Of 130 pregnant women with febrile disease, 28 were infected with Rift Valley fever virus and 31 with chikungunya virus, with typical clinical and laboratory findings for the infection in question. 15 (54%) of 28 women with an acute Rift Valley fever virus infection had miscarriages compared with 12 (12%) of 102 women negative for Rift Valley fever virus (p<0·0001). In a multiple logistic regression analysis, adjusting for age, haemorrhagic disease, and chikungunya virus infection, an acute Rift Valley fever virus infection was an independent predictor of having a miscarriage (odds ratio 7·4, 95% CI 2·7-20·1; p<0·0001). This study is the first to show an association between infection with Rift Valley fever virus and miscarriage in pregnant women. Further studies are warranted to investigate the possible mechanisms. Our findings have implications for implementation of preventive measures, and evidence-based information to the public in endemic countries should be strongly recommended during Rift Valley fever outbreaks. Schlumberger Faculty for the Future, CRDF Global (31141), the Swedish International Development Cooperation Agency, the County Council of Västerbotten, and the Faculty of Medicine, Umeå University.
Highlights
Rift Valley fever is an emerging mosquito-borne infection caused by Rift Valley fever virus, with outbreaks in Africa and more recently in the Arabian Peninsula
We found a significant association between acute Rift Valley fever virus infection and miscarriage
Of 162 patients whose samples were stored for analysis, 130 pregnant women were included in the study. 32 patients were excluded from the analysis: one deceased pregnant woman, seven non-pregnant women, and 24 men, some analyses were done on their samples
Summary
Rift Valley fever is an emerging mosquito-borne infection caused by Rift Valley fever virus (genus Phlebovirus, family Bunyaviridae), with outbreaks in Africa and more recently in the Arabian Peninsula. The infection is characterised by a high case-fatality rate in young animals and causes mass abortions in cattle, goats, and sheep. Rift Valley fever presents in most cases as a mild illness with influenza-like symptoms. Infections during pregnancy pose a considerable threat to the mother and fetus. Emerging vector-borne infections by agents such as Zika virus, West Nile virus, Japanese encephalitis virus, Venezuelan equine encephalitis virus, malaria, brucellosis, and dengue can induce fetal malformation, miscarriage, or premature birth in human beings.[2,3,4,5,6,7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
