Predictive Factors and Risk Mapping for Rift Valley Fever Epidemics in Kenya

Background

To-date, Rift Valley fever (RVF) outbreaks have occurred in 38 of the 69 administrative districts in Kenya. Using surveillance records collected between 1951 and 2007, we determined the risk of exposure and outcome of an RVF outbreak, examined the ecological and climatic factors associated with the outbreaks, and used these data to develop an RVF risk map for Kenya.

Methods

Exposure to RVF was evaluated as the proportion of the total outbreak years that each district was involved in prior epizootics, whereas risk of outcome was assessed as severity of observed disease in humans and animals for each district. A probability-impact weighted score (1 to 9) of the combined exposure and outcome risks was used to classify a district as high (score ≥ 5) or medium (score ≥2 - <5) risk, a classification that was subsequently subjected to expert group analysis for final risk level determination at the division levels (total = 391 divisions). Divisions that never reported RVF disease (score < 2) were classified as low risk. Using data from the 2006/07 RVF outbreak, the predictive risk factors for an RVF outbreak were identified. The predictive probabilities from the model were further used to develop an RVF risk map for Kenya.

Results

The final output was a RVF risk map that classified 101 of 391 divisions (26%) located in 21 districts as high risk, and 100 of 391 divisions (26%) located in 35 districts as medium risk and 190 divisions (48%) as low risk, including all 97 divisions in Nyanza and Western provinces. The risk of RVF was positively associated with Normalized Difference Vegetation Index (NDVI), low altitude below 1000m and high precipitation in areas with solonertz, luvisols and vertisols soil types (p <0.05).

Conclusion

RVF risk map serves as an important tool for developing and deploying prevention and control measures against the disease.     

Rift Valley Fever Virus Seroprevalence in Human Rural Populations of Gabon

Background

Rift Valley fever (RVF) is a mosquito-borne viral zoonosis caused by a phlebovirus and transmitted by Aedes mosquitoes. Humans can also be infected through direct contact with blood (aerosols) or tissues (placenta, stillborn) of infected animals. Although severe clinical cases can be observed, infection with RVF virus (RVFV) in humans is, in most cases, asymptomatic or causes a febrile illness without serious symptoms. In small ruminants RVFV mainly causes abortion and neonatal death. The distribution of RVFV has been well documented in many African countries, particularly in the north (Egypt, Sudan), east (Kenya, Tanzania, Somalia), west (Senegal, Mauritania) and south (South Africa), but also in the Indian Ocean (Madagascar, Mayotte) and the Arabian Peninsula. In contrast, the prevalence of RVFV has rarely been investigated in central African countries.

Methodology/Principal Findings

We therefore conducted a large serological survey of rural populations in Gabon, involving 4,323 individuals from 212 randomly selected villages (10.3% of all Gabonese villages). RVFV-specific IgG was found in a total of 145 individuals (3.3%) suggesting the wide circulation of Rift Valley fever virus in Gabon. The seroprevalence was significantly higher in the lakes region than in forest and savannas zones, with respective rates of 8.3%, 2.9% and 2.2%. In the lakes region, RVFV-specific IgG was significantly more prevalent in males than in females (respectively 12.8% and 3.8%) and the seroprevalence increased gradually with age in males but not in females.

Conclusions/Significance

Although RVFV was suggested to circulate at a relatively high level in Gabon, no outbreaks or even isolated cases have been documented in the country. The higher prevalence in the lakes region is likely to be driven by specific ecologic conditions favorable to certain mosquito vector species. Males may be more at risk of infection than females because they spend more time farming and hunting outside the villages, where they may be more exposed to mosquito bites and infected animals. Further investigations are needed to determine the putative sylvan cycle of RVFV, including the mosquito species and the reservoir role of wild animals in the viral maintenance cycle.     

The Risk of Nosocomial Transmission of Rift Valley Fever

In 2000, we investigated the Rift Valley fever (RVF) outbreak on the Arabian Peninsula—the first outside Africa—and the risk of nosocomial transmission. In a cross-sectional design, during the peak of the epidemic at its epicenter, we found four (0.6%) of 703 healthcare workers (HCWs) IgM seropositive but all with only community-associated exposures. Standard precautions are sufficient for HCWs exposed to known RVF patients, in contrast to other viral hemorrhagic fevers (VHF) such as Ebola virus disease (EVD) in which the route of transmission differs. Suspected VHF in which the etiology is uncertain should be initially managed with the most cautious infection control measures.     

Public Health Benefits from Livestock Rift Valley Fever Control: A Simulation of Two Epidemics in Kenya

EcoHealth - In controlling Rift Valley fever, public health sector optimises health benefits by considering cost-effective control options. We modelled cost-effectiveness of livestock RVF control...     

A Mathematical Model of Rift Valley Fever with Human Host

Rift Valley Fever is a vector-borne disease mainly transmitted by mosquito. To gain some quantitative insights into its dynamics, a deterministic model with mosquito, livestock, and human host is formulated as a system of nonlinear ordinary differential equations and analyzed. The disease threshold [Formula: see text] is computed and used to investigate the local stability of the equilibria. A sensitivity analysis is performed and the most sensitive model parameters to the measure of initial disease transmission [Formula: see text] and the endemic equilibrium are determined. Both [Formula: see text] and the disease prevalence in mosquitoes are more sensitive to the natural mosquito death rate, d(m). The disease prevalence in livestock and humans are more sensitive to livestock and human recruitment rates, [Formula: see text] and [Formula: see text], respectively, suggesting isolation of livestock from humans is a viable preventive strategy during an outbreak. Numerical simulations support the analytical results in further exploring theoretically the long-term dynamics of the disease at the population level.     

Factors Associated with Severe Human Rift Valley Fever in Sangailu,Garissa County,Kenya

BackgroundMosquito-borne Rift Valley fever virus (RVFV) causes acute, often severe, disease in livestock and humans. To determine the exposure factors and range of symptoms associated with human RVF, we performed a population-based cross-sectional survey in six villages across a 40 km transect in northeastern Kenya.Conclusions/SignificanceOur results demonstrate that a significant proportion of the population in northeastern Kenya has been infected with RVFV. Village and certain animal husbandry activities were associated with more severe disease. Older age, male gender, herder occupation, killing and butchering livestock, and poor visual acuity were useful markers for increased RVFV infection. Formal vision testing may therefore prove to be a helpful, low-technology tool for RVF screening during epidemics in high-risk rural settings.     

Seroprevalence of Sheep and Goat Pox,Peste Des Petits Ruminants and Rift Valley Fever in Saudi Arabia

Sheep and goat pox, peste des petits ruminants and Rift Valley fever are important diseases of small ruminant livestock. Sheep and goat pox, along with peste des petits ruminants, are endemic throughout most of Africa, Asia and the Middle East. Whereas Rift Valley fever is endemic in Africa, outbreaks in the Middle East have been reported over the past decade, including the Arabian Peninsula. Saudi Arabia is a major importer of livestock, and understanding the prevalence of these viral infections would be useful for disease control. In this study, sera from sheep and goats were collected from 3 regions in Saudi Arabia. They were evaluated for antibodies specific to sheep and goat pox, peste des petits ruminants and Rift Valley fever by virus neutralization assays. To the best of our knowledge, this is the first study to evaluate the seroprevalence of these viruses in sheep and goats.     

Paleolimnology of mid-elevation lakes in the Kenya Rift Valley

Three small lakes of the Kenya Highlands have been subject to intermittent paleoenvironmental investigation for more than 50 years. In this report, the stratigraphic, core-based history of Lake Naivasha (elev. 1 890 m) is extended backward to 20 000 B.P. and is related to less complete 30 000-year core stratigraphies from nearby lakes Nakuru and Elmenteita. The paleolimnological reconstructions, primarily diatom-based, include geochemical parameters and the first ostracode stratigraphies from tropical Africa. The analyses from all three lakes converge on a history of low and fluctuating water levels over approximately the past 4 500 years, preceded by a major Holocene high stand (ca. 10 000-6 000 B.P.) and a brief earlier rise centered on 12 500 B.P. The lakes were mostly very low during the late Pleistocene (13 000–30 000 B.P.), though modestly elevated levels may have occurred early in this time period. The ostracode record, comprising at least 15 species, was relatively continuous in the Nakuru core but was restricted to sharply demarcated regions in cores from the other lakes.     

Rift Valley Fever Virus Infection in Golden Syrian Hamsters

Rift Valley fever virus (RVFV) is a formidable pathogen that causes severe disease and abortion in a variety of livestock species and a range of disease in humans that includes hemorrhagic fever, fulminant hepatitis, encephalitis and blindness. The natural transmission cycle involves mosquito vectors, but exposure can also occur through contact with infected fluids and tissues. The lack of approved antiviral therapies and vaccines for human use underlies the importance of small animal models for proof-of-concept efficacy studies. Several mouse and rat models of RVFV infection have been well characterized and provide useful systems for the study of certain aspects of pathogenesis, as well as antiviral drug and vaccine development. However, certain host-directed therapeutics may not act on mouse or rat pathways. Here, we describe the natural history of disease in golden Syrian hamsters challenged subcutaneously with the pathogenic ZH501 strain of RVFV. Peracute disease resulted in rapid lethality within 2 to 3 days of RVFV challenge. High titer viremia and substantial viral loads were observed in most tissues examined; however, histopathology and immunostaining for RVFV antigen were largely restricted to the liver. Acute hepatocellular necrosis associated with a strong presence of viral antigen in the hepatocytes indicates that fulminant hepatitis is the likely cause of mortality. Further studies to assess the susceptibility and disease progression following respiratory route exposure are warranted. The use of the hamsters to model RVFV infection is suitable for early stage antiviral drug and vaccine development studies.     

Modeling the Spatial Spread of Rift Valley Fever in Egypt

Rift Valley fever (RVF) is a severe viral zoonosis in Africa and the Middle East that harms both human health and livestock production. It is believed that RVF in Egypt has been repeatedly introduced by the importation of infected animals from Sudan. In this paper, we propose a three-patch model for the process by which animals enter Egypt from Sudan, are moved up the Nile, and then consumed at population centers. The basic reproduction number for each patch is introduced and then the threshold dynamics of the model are established. We simulate an interesting scenario showing a possible explanation of the observed phenomenon of the geographic spread of RVF in Egypt.     

Curcumin Inhibits Rift Valley Fever Virus Replication in Human Cells

Rift Valley fever virus (RVFV) is an arbovirus that is classified as a select agent, an emerging infectious virus, and an agricultural pathogen. Understanding RVFV-host interactions is imperative to the design of novel therapeutics. Here, we report that an infection by the MP-12 strain of RVFV induces phosphorylation of the p65 component of the NFκB cascade. We demonstrate that phosphorylation of p65 (serine 536) involves phosphorylation of IκBα and occurs through the classical NFκB cascade. A unique, low molecular weight complex of the IKK-β subunit can be observed in MP-12-infected cells, which we have labeled IKK-β2. The IKK-β2 complex retains kinase activity and phosphorylates an IκBα substrate. Inhibition of the IKK complex using inhibitors impairs viral replication, thus alluding to the requirement of an active IKK complex to the viral life cycle. Curcumin strongly down-regulates levels of extracellular infectious virus. Our data demonstrated that curcumin binds to and inhibits kinase activity of the IKK-β2 complex in infected cells. Curcumin partially exerts its inhibitory influence on RVFV replication by interfering with IKK-β2-mediated phosphorylation of the viral protein NSs and by altering the cell cycle of treated cells. Curcumin also demonstrated efficacy against ZH501, the fully virulent version of RVFV. Curcumin treatment down-regulated viral replication in the liver of infected animals. Our data point to the possibility that RVFV infection may result in the generation of novel versions of host components (such as IKK-β2) that, by virtue of altered protein interaction and function, qualify as unique therapeutic targets.     

Concentration of Rift Valley Fever and Chikungunya Viruses by Precipitation

Simple and efficient methods for concentrating Rift Valley fever (RVF) virus and chikungunya (CHIK) virus are described. Ammonium sulfate, potassium sulfate, or alcohol was used as a precipitating agent and the precipitate was resuspended to volumes suitable for further processing and purification. The methods permitted concentration of live RVF virus and CHIK virus about 100-fold with negligible losses of virus. RVF virus retained a high level of infectivity with potassium aluminum sulfate and alcohol, but CHIK virus retained a higher infectivity level with ammonium sulfate than with potassium aluminum sulfate. The data indicate that serum plays an important role in the concentration of both viruses, at least when the sulfate methods are used.     

New studies of post-Pleistocene human skeletal remains from the Rift Valley,Kenya

Prehistoric human crania from Bromhead's Site, Willey's Kopje, Makalia Burial Site, Nakuru, and other localities in the Eastern Rift Valley of Kenya are reassessed using measurements and a multivariate statistical approach. Materials available for comparison include series of Bushman and Hottentot crania, South and East African Negroes, and Egyptians. Up to 34 cranial measurements taken on these series are utilized to construct three multiple discriminant frameworks, each of which can assign modern individuals to a correct group with considerable accuracy. When the prehistoric crania are classified with the help of these discriminants, results indicate that several of the skulls are best grouped with modern Negroes. This is especially clear in the case of individuals from Bromhead's Site, Willey's Kopje, and Nakuru, and the evidence hardly suggests post-Pleistocene domination of the Rift and surrounding territory by “Mediterranean” Caucasoids, as has been claimed. Recent linguistic and archaeological findings are also reviewed, and these seem to support application of the term Nilotic Negro to the early Rift populations.     

Inter-epidemic Acquisition of Rift Valley Fever Virus in Humans in Tanzania

Background

In East Africa, epidemics of Rift Valley fever (RVF) occur in cycles of 5–15 years following unusually high rainfall. RVF transmission during inter-epidemic periods (IEP) generally passes undetected in absence of surveillance in mammalian hosts and vectors. We studied IEP transmission of RVF and evaluated the demographic, behavioural, occupational and spatial determinants of past RVF infection.

Methodology

Between March and August 2012 we collected blood samples, and administered a risk factor questionnaire among 606 inhabitants of 6 villages in the seasonally inundated Kilombero Valley, Tanzania. ELISA tests were used to detect RVFV IgM and IgG antibodies in serum samples. Risk factors were examined by mixed effects logistic regression.

Findings

RVF virus IgM antibodies, indicating recent RVFV acquisition, were detected in 16 participants, representing 2.6% overall and in 22.5% of inhibition ELISA positives (n = 71). Four of 16 (25.0%) IgM positives and 11/71 (15.5%) of individuals with inhibition ELISA sero-positivity reported they had had no previous contact with host animals. Sero-positivity on inhibition ELISA was 11.7% (95% CI 9.2–14.5) and risk was elevated with age (odds ratio (OR) 1.03 per year; 95% CI 1.01–1.04), among milkers (OR 2.19; 95% CI 1.23–3.91), and individuals eating raw meat (OR 4.17; 95% CI 1.18–14.66). Households keeping livestock had a higher probability of having members with evidence of past infection (OR = 3.04, 95% CI = 1.42–6.48) than those that do not keep livestock.

Conclusion

There is inter-epidemic acquisition of RVFV in Kilombero Valley inhabitants. In the wake of declining malaria incidence, these findings underscore the need for clinicians to consider RVF in the differential diagnosis for febrile illnesses. Several types of direct contact with livestock are important risk factors for past infection with RVFV in this study’s population. However, at least part of RVFV transmission appears to have occurred through bites of infected mosquitoes.     

Trends in waterbird numbers in the southern Rift Valley of Kenya

Bennun, L. & Nasirwa, O. 2000. Trends in waterbird numbers in the southern Rift Valley of Kenya. Ostrich 71 (1 & 2): 220–226.

Each January since 1991, volunteer teams have counted waterbirds at major wetlands in the southern Kenyan Rift Valley. There has been consistent coverage at Lakes Naivasha, Elmenteita, Nakuru and (since 1992) Bogoria. These lakes are shallow and, except for Bogoria, fluctuate greatly in extent; all but Naivasha are saline. Lake levels were moderately high in 1991–1993 but have been generally low since. Flamingo totals for the three saline lakes combined were more than one million from 1992–1994, but roughly halved each year since then. Greater Flamingos Phoenicopterus ruber made up between 0.7 and 4.1% of total flamingo numbers; other waterbirds made up between 2.7 and 10.2% of the overall total. Lakes Naivasha, Elmenteita and Nakuru together hold most of the non-flamingo waterbirds in the southern Rift; to compare trends for other species, we pooled totals for these sites. Significant, or near-significant, declines were evident for grebes, pelicans, cormorants, storks, gulls, rallids, kingfishers, terns and raptors. No group showed an overall increasing trend. At Dandora, a smaller site with stable water levels, these groups showed large annual fluctuations but no obvious declines. In most waterbird groups where numbers decreased, the probable cause was sustained low lake levels at Lake Nakuru; numbers at Lake Naivasha remained stable. Exceptions were rallids, kingfishers and raptors, where numbers steadily declined at Naivasha. There is a need to investigate local environmental causes of these changes for kingfishers and raptors, and to assess possible loss of breeding sites for rallids.     

Application of polar-orbiting, meteorological satellite data to detect flooding of Rift Valley Fever virus vector mosquito habitats in Kenya

Measurements of green-leaf vegetation dynamics recorded by the advanced very high resolution radiometer instruments onboard National Oceanic and Atmospheric Administration satellites 7 and 9 were used to derive ground moisture and rainfall patterns in Kenya and monitor resultant flooding of mosquito larval habitats (dambos) likely to support Rift Valley Fever virus vector mosquitoes (Aedes and Culex spp.). Satellite-derived data from mid-1981 to December 1988 have been analysed with corresponding rainfall, flooding and vector population data as they relate to Rift Valley Fever virus ecology. Single (7 x 7 km) and multiple grid-cell image analysis (200 x 300 km) in small localized areas and large geographical regions, respectively, of vegetation data were used to quantify the potential for flooding of mosquito breeding habitats. The ability to detect accurately parameters, such as ground moisture, that determine flooding could provide local officials with sufficient warning to allow for implementation of specific mosquito control measures before a disease outbreak.     

Correlative Gene Expression to Protective Seroconversion in Rift Valley Fever Vaccinates

Rift Valley fever Virus (RVFV), a negative-stranded RNA virus, is the etiological agent of the vector-borne zoonotic disease, Rift Valley fever (RVF). In both humans and livestock, protective immunity can be achieved through vaccination. Earlier and more recent vaccine trials in cattle and sheep demonstrated a strong neutralizing antibody and total IgG response induced by the RVF vaccine, authentic recombinant MP-12 (arMP-12). From previous work, protective immunity in sheep and cattle vaccinates normally occurs from 7 to 21 days after inoculation with arMP-12. While the serology and protective response induced by arMP-12 has been studied, little attention has been paid to the underlying molecular and genetic events occurring prior to the serologic immune response. To address this, we isolated RNA from whole blood of vaccinated calves over a time course of 21 days before and after vaccination with arMP-12. The time course RNAs were sequenced by RNASeq and bioinformatically analyzed. Our results revealed time-dependent activation or repression of numerous gene ontologies and pathways related to the vaccine induced immune response and its regulation. Additional bioinformatic analyses identified a correlative relationship between specific host immune response genes and protective immunity prior to the detection of protective serum neutralizing antibody responses. These results contribute an important proof of concept for identifying molecular and genetic components underlying the immune response to RVF vaccination and protection prior to serologic detection.     

Immunogenicity and efficacy of a chimpanzee adenovirus-vectored Rift Valley Fever vaccine in mice

Background

Rift Valley Fever (RVF) is a viral zoonosis that historically affects livestock production and human health in sub-Saharan Africa, though epizootics have also occurred in the Arabian Peninsula. Whilst an effective live-attenuated vaccine is available for livestock, there is currently no licensed human RVF vaccine. Replication-deficient chimpanzee adenovirus (ChAd) vectors are an ideal platform for development of a human RVF vaccine, given the low prevalence of neutralizing antibodies against them in the human population, and their excellent safety and immunogenicity profile in human clinical trials of vaccines against a wide range of pathogens.

Methods

Here, in BALB/c mice, we evaluated the immunogenicity and efficacy of a replication-deficient chimpanzee adenovirus vector, ChAdOx1, encoding the RVF virus envelope glycoproteins, Gn and Gc, which are targets of virus neutralizing antibodies. The ChAdOx1-GnGc vaccine was assessed in comparison to a replication-deficient human adenovirus type 5 vector encoding Gn and Gc (HAdV5-GnGc), a strategy previously shown to confer protective immunity against RVF in mice.

Results

A single immunization with either of the vaccines conferred protection against RVF virus challenge eight weeks post-immunization. Both vaccines elicited RVF virus neutralizing antibody and a robust CD8⁺ T cell response.

Conclusions

Together the results support further development of RVF vaccines based on replication-deficient adenovirus vectors, with ChAdOx1-GnGc being a potential candidate for use in future human clinical trials.