Abstract
The first confirmed Rift Valley fever outbreak outside Africa was reported in September 2000, in the Arabian Peninsula. As of February 2001, a total of 884 hospitalized patients were identified in Saudi Arabia, with 124 deaths. In Yemen, 1,087 cases occurred, with 121 deaths. Laboratory diagnosis of Rift Valley fever virus (RVFV) infections included virus genetic detection and characterization of clinical specimens by reverse transcription-polymerase chain reaction, in addition to serologic tests and virus isolation. Genetic analysis of selected regions of virus S, M, and L RNA genome segments indicated little genetic variation among the viruses associated with disease. The Saudi Arabia and Yemen viruses were almost identical to those associated with earlier RVF epidemics in East Africa. Analysis of S, M, and L RNA genome segment sequence differences showed similar phylogenetic relationships among these viruses, indicating that genetic reassortment did not play an important role in the emergence of this virus in the Arabian Peninsula. These results are consistent with the recent introduction of RVFV into the Arabian Peninsula from East Africa.
Highlights
The first confirmed Rift Valley fever outbreak outside Africa was reported in September 2000, in the Arabian Peninsula
Virus Antigen, IgM, and IgG Detection in Patient Sera Patient sera were tested for the presence of Rift Valley fever virus (RVFV) or Crimean-Congo hemorrhagic fever virus (C-CHFV) antigen, or immunoglobulin (Ig) M or IgG antibodies reactive with these viruses and Alkhurma virus, a member of the tick-borne encephalitis (TBE) complex that was recently discovered in Saudi Arabia [4]
The four serum samples from the suspected case-patients were tested by antigen-capture enzyme-linked immunosorbent assay (ELISA) with RVFV- or C-CHFV-reactive antibodies; IgM-capture ELISA with RVFV, C-CHFV, or Alkhurma virus–infected cell lysate antigens; IgG ELISA with RVFV, C-CHVF, or Alkhurma virus–infected cell slurry antigen; virus isolation with Vero E6 cells; and reverse transcriptase polymerase chain reaction (RT-PCR) assays for detection of RVFV, C-CHFV, or TBE-complex virus RNA
Summary
The first confirmed Rift Valley fever outbreak outside Africa was reported in September 2000, in the Arabian Peninsula. Analysis of S, M, and L RNA genome segment sequence differences showed similar phylogenetic relationships among these viruses, indicating that genetic reassortment did not play an important role in the emergence of this virus in the Arabian Peninsula. These results are consistent with the recent introduction of RVFV into the Arabian Peninsula from East Africa. On September 10, 2000, the Ministry of Health in Saudi Arabia began to receive reports of unexplained hemorrhagic fever in humans near the Saudi-Yemeni border, with associated animal deaths and abortions.
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