Rift Valley Fever: scientific pathways toward public health prevention and response.

Abstract

As humankind strides into the second decade of the 21st century, we can take pride in advances that have enhanced the lives of many around the world. The planet is a very different place from what it was during the 19th century. The connectivity experienced through global travel and communications was unthinkable then, when technology was about to affect nearly every facet of life. And yet, scourges that infested the industrial world at that time, then nearly disappeared during the early 1900s, in the industrialized world, like cholera and typhoid fever, 1– 3 continue to rage in Africa and Asia 4– 7 in these modern times. Despite technologic advancements, these diseases are classic indicators of inadequate infrastructure, showing persisting societal failures. While the “classic” diseases continue to rage, new highly fatal diseases have emerged or reappeared during the 21st century, such as severe acute respiratory syndrome (SARS), 8, 9 Nipah virus encephalitis, 10 and avian influenza 11 with adverse global or regional public health and economic impact. These events have shown how ecologic changes brought on by factors associated with increasing human population size, like massive consumption of natural resources and encroachment on environments, have brought animals (and the pathogens that infect them) in close contact with immunologically naive humans. Once introduced into humans, those pathogens that are transmitted from human to human can spread with lightning speed by global and regional commercial markets and travel. Advancing technologies are creating exciting possibilities for prevention and control of emerging infectious diseases. They include: far-reaching and constantly improving communications tools, including use of mobile text messaging resulting in improved surveillance approaches, 12 and state-of-the-art satellite imagery and mapping capacity to forecast and detect ecologic changes and climate anomalies relevant to disease prevalence. 13, 14 In addition, monitoring of animal and insect vector mobility and geographic distributions and, development of highly sensitive diagnostic tools for use in human, animal, and vector surveillance are enhancing the ability to detect new pathogens or changes in reservoir patterns for known pathogens. These new capacities will dramatically affect the ability to detect early, and, ultimately to forecast in advance, the emergence of disease threats so that effective measures can be taken to avert or minimize the public health impact. Rift Valley Fever (RVF) is an illustrative model for assessing the impact of climate and ecology on its periodic reemergence and spread, as well as for the potential that modern technologies and public health advancements can contribute to disease forecasting, prevention, and control. 12 Rift Valley