Date: Tue 13 Oct 2015
Source: Rapide Info [in French, trans. ProMed CopyEd.LMI, edited]
<http://rapideinfo.net/node/8105>

An official document confirms the deaths of 8 people from Rift Valley fever.

Rift Valley fever (RVF), a disease that primarily affects animals but can also infect humans, has killed 8 people in Mauritania since September [2015], according to a new report released on Saturday [10 Oct 2015] by the World Health Organization (WHO).

"From the beginning, the assessment made by the government (of Mauritania), which ensures transparency, confirmed 8 deaths out of 25 suspected cases," WHO representative in Nouakchott Jean-Pierre Baptiste, explained to the AFP.

The Mauritanian government sent the report to WHO on Friday [9 Oct 2015]. The Mauritanian authorities in charge of this case could not be reached for further information on Saturday [10 Oct 2015].

Mr. Baptiste praised "the strong mobilization of the government for the management of patients suspected of having Rift Valley fever in all affected regions."

The Mauritanian government said that the central and southeast regions were mainly affected by the disease.

During an interview on Friday [9 Oct 2015], the Mauritanian Health Minister, Ahmed Ould Jelvoune, reassured people, declaring that "his government had full control of the situation in the country."

Rift Valley fever, named after the Kenyan region where it was identified in 1931, killed 17 people in Mauritania in 2012.

This disease is transmitted by mosquitoes, and, according to WHO, in the vast majority of cases, the infection occurs in humans as a result of direct or indirect contact with the blood or organs of infected animals.

WHO said that there was no treatment, but potential vaccines are in development.
================
[The report above adds additional information that was not included in the previous RFV report from Mauritania (ProMED-mail archive no. 20151007.3694282), including human case numbers.

As ProMed Mod.AB noted: "Rift Valley fever (RVF) is a major zoonotic disease caused by a virus of the genus _Phlebovirus_ of the family _Bunyaviridae_. The virus affects different animal species (buffaloes, camels, cattle, goats, and sheep) and can pass to humans either by direct contact through blood or body fluids during slaughter or ingestion of contaminated meat or indirectly through arthropod biting, especially by arthropods of the genus _Aedes_.

"The disease was confirmed in Mauritania in the early 2000s, and, since then, it has reappeared recurrently; the most recent epidemic dates back to 2012-2013."

It is still not clear whether epidemiological investigations have been conducted in farm animals, which are the main reservoirs and amplifiers of RVF virus.

Rift Valley fever (RVF) outbreaks very often involve significant numbers of ill and dead small ruminant animals. It is odd that no small ruminant animal cases are mentioned, unless the animals had been vaccinated previously and are immune. RVF virus can persist for a long time in some areas, maintained in _Aedes_ vector mosquitoes that deposit eggs in seasonally-flooded areas, where those eggs are transovarially infected with the virus. Adult female mosquitoes coming from infected eggs can transmit the virus during their 1st blood meals. Eradicating the virus from these areas is not possible with current technology.

Maps of Mauritania can be accessed at
<http://www.mapsofworld.com/mauritania/maps/map-of-mauritania.jpg> and
<http://healthmap.org/promed/p/51>. - ProMed Mod.TY]
Date: Sun 4 Oct 2015
Source: Rapideinfo, Mauritanian News Agency (AMI) report [in French, trans. ProMed Mod.AB, edited]
<http://rapideinfo.net/node/7838>

The Ministry of Health published on Sunday night [4 Oct 2015] a press release, a copy of which was received by the Mauritanian News Agency (AMI), stating that the health situation is under control and well attended. The full text of this press release follows:

"The Ministry of Health has been informed by its local services on [14 Sep 2015] of the death of a suspected case of hemorrhagic fever in Magtaa Lahjar Health Center in Tourguelil Town, Moudjeria district [Tagant region].

A multidisciplinary team from the Ministry of Health went immediately to the area and conducted investigations on cases and contact tracing. The patient was admitted at the Magtaa Lahjar health center, and samples were collected from him and sent to the Pasteur Institute in Dakar for biological analysis, which confirmed a recent infection with Rift Valley fever [RVF] virus. The same day, a joint team of the health and livestock ministries crisscrossed the localities of Moudjeria district and carried out education sessions to sensitize people about the risks of viral haemorrhagic fevers and ways to protect themselves, while searching for potential cases and following the contacts.

The detection of current suspected cases led to hospitalization, isolation and case management at the hospitals. Their condition is evolving favorably, and monitoring of contacts in Nouakchott and in the interior of the country is underway. Note that all these cases have never been in contact or made trips to countries affected by Ebola virus disease. Samples for analysis were immediately made and sent to the Pasteur Institute in Dakar.

Given this situation, the Ministry of Health has promptly taken the following measures:
- Meeting of the monitoring committee
- Monitoring and strengthening of epidemiological surveillance with daily reporting and count of weekly cases
- Sending field missions for awareness
- Extension of operational guidelines for case management at health structures
- Development and dissemination of audiovisual spots in the 4 main languages.

Remember that usually during the winter periods, sporadic cases of hemorrhagic fever occur and are well supported by our health facilities with a favorable evolution.

The Ministry of Health brings to the attention of the people that all necessary measures have been taken and that the situation is under control and well attended."
====================
[Rift Valley fever (RVF) is a major zoonotic disease caused by a virus of the genus _Phlebovirus_ of the family _Bunyaviridae_. The virus affects different animal species (buffaloes, camels, cattle, goats, and sheep) and can pass to humans either by direct contact through blood or body fluids during slaughter or ingestion of contaminated meat or indirectly through arthropod biting, especially by arthropods of the genus _Aedes_.

The disease was confirmed in Mauritania in the early 2000s and, since then, it has reappeared recurrently; the most recent epidemic dates back to 2012-2013.

The case raised by the Mauritanian Information Agency (AMI) announced a new episode of the disease that has already caused one death and led to several suspected cases, the numbers of which are not mentioned in the communique of the Health Minister. It is not clear whether epidemiological investigations have been conducted in farm animals, which are the main reservoirs of the RVF virus.

Maps of Mauritania can be seen at <http://www.mapsofworld.com/mauritania/maps/map-of-mauritania.jpg> and <http://healthmap.org/promed/p/14540>. Moudjeria is a town and a district in south-central Mauritania, located in Tagant region. The region is divided into 3 districts: Moudjeria, Tichit, and Tidjikja (<https://goo.gl/6uCOZk>). - ProMed Mod.AB]

Rift Valley fever (RVF) outbreaks very often involve significant numbers of ill and dead small ruminant animals. It is odd that no small ruminant animal cases are mentioned, unless the animals had been vaccinated previously and are immune. RVF virus can persist for a long time in some areas, maintained in _Aedes_ vector mosquitoes that deposit eggs in seasonally-flooded areas, where those eggs are transovarially infected with the virus. Adult female mosquitoes coming from infected eggs can transmit the virus during their 1st blood meals. Eradicating the virus from these areas is not possible with current technology. - ProMed Mod.TY]
Date: 5 Sep 2015
Source: Bawabatii [in Arabic, trans. ProMED Mod.MM, edited]
<http://www.bawabatii.com/news19909.html>

The Mauritanian government has admitted to the existence of dengue fever in the country, especially in Nouakchot area, and has taken some measures to control it, including vector control (intensified mosquito insecticide spraying campaigns), which started last Friday and included the provision of mosquito bed nets and increasing the number of health personnel in emergency units.
===================
[Dengue fever/dengue haemorrhagic fever (DF/DHF) is an acute viral febrile illness caused by infection with any of 4 related positive-strand RNA viruses of the genus _Flavivirus_, dengue viruses (DENV) 1, 2, 3, or 4, and is now considered the fastest growing vector-borne disease in Africa, especially the coastal areas and threatening to spread inward.

For the last 2 years, Mauritania has witnessed outbreaks of dengue fever/dengue haemorrhagic fever, and a lot of debate has arisen in the media about whether this fever is endogenous or imported.

ProMED-MENA would appreciate receiving additional information about the current dengue fever outbreak from knowledgeable resources. - ProMED Mod.MM]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/51>.]
Date: Thu 1 Nov 2012
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
<http://www.who.int/csr/don/2012_11_01/en/index.html>
-------------------------------
The Ministry of Health (MoH) in Mauritania declared an outbreak of Rift Valley fever (RVF) on 4 Oct 2012. From 16 Sep 2012 (the date of detection of the index case) to 30 Oct 2012, a total of 34 cases, including 17 deaths have been reported from 6 [of the 12 regions of Mauritania]. The last case was notified on 27 Oct 2012 from Magta Lahjar in the Brakna region. The 6 regions include Assaba, Brakna, Hodh Chargui, Hodh Gharbi, Tagant, and Trarza. All the cases had history of contact with animals.

In humans, 25 samples tested positive by ELISA and PCR at the National Reference Laboratory of the National Institute of Public Health Research (INRS) in Nouakchott [the capital city of Mauritania] and at the Institut Pasteur in Dakar. In the animal population, analysis conducted by the National Veterinary Research Laboratory shows virus circulation in several regions of the country.

A multi-sector task force has been jointly established by the MOH and the Ministry of Rural Development to respond to this outbreak. WHO and partners, including the Food and Agriculture Organization (FAO), are working within the task force to strengthen epidemiological surveillance in both human and animal health, strengthen capacity in case management at health care facilities, strengthen health measures in slaughterhouses, and raise awareness among farmers.

A multi-sector investigation team has been deployed to conduct a detailed outbreak investigation among humans and animals in the affected areas. An international team of experts will be deployed to provide technical assistance from 3 to 10 Nov 2012.

Mauritania experienced an outbreak of RVF in 2010. With regard to this outbreak, WHO does not recommend any travel or trade restrictions be applied.
=====================
[Rift Valley fever (RVF) is a viral zoonosis that primarily affects livestock but also has the capacity to infect humans. Infection can cause severe disease in both animals and humans. The disease also results in significant economic losses due to death and abortion among RVF-infected livestock. The vast majority of human infections result from direct or indirect contact with the blood or organs of infected animals. The virus can be transmitted to humans through the handling of animal tissue during slaughtering or butchering, assisting with animal births, conducting veterinary procedures, or from the disposal of carcasses or fetuses. Certain occupational groups such as herders, farmers, slaughterhouse workers, and veterinarians are, therefore, at higher risk of infection. There is some evidence that humans may also become infected with RVF by ingesting the unpasteurized or uncooked milk of infected animals. Human infections can also result occasionally from the bites of infected _Aedes_ spp. mosquitoes. Human-to-human transmission of RVF has been not been documented.

On 24 Oct 212 the Mauritanian Ministry of Health reported 30 human cases of Rift Valley fever infection, 13 of whom died. As of 1 Nov 2012 the number of confirmed cases has risen to 34, and the number of deaths to 17. It was suggested in the previous report that the outbreak was in decline now because the rainy season, which is one of the factors favouring the spread of the disease, has ended. However, no information has been provided, then or now, concerning the progress and extent of the outbreak in the animal population.

The HealthMap/ProMED-mail interactive map of Mauritania can be accessed at <http://healthmap.org/r/3AVt> and a map of the regions of Mauritania at <http://www.unicef.org/har2010/images/HAR10_Map_Mauritania.jpg>. - ProMed Mod.CP]
Date: Thu, 1 Nov 2012 18:33:23 +0100
http://www.who.int/csr/don/2012_11_01/en/index.html

The Ministry of Health (MoH) in Mauritania declared an outbreak of Rift Valley Fever (RVF) on 4 October 2012. From 16 September 2012 (the date of onset of the index case) to 30 October 2012, a total of 34 cases, including 17 deaths have been reported from 6 regions. The last case was notified on the 27 October 2012 from Magta Lahjar in the Brakna region. The 6 regions include Assaba, Brakna, Hodh Chargui, Hodh Gharbi, Tagant and Trarza. All the cases had history of contact with animals.

In humans, 25 samples tested positive by ELISA and PCR at the National Reference Laboratory of the National Institute of Public Health Research (INRS) in Nouakchott and at the Institut Pasteur in Dakar. In the animal population, analysis conducted by the National Veterinary Research Laboratory shows virus circulation in several regions of the country.

A multi-sector task force has been jointly established by the MOH and the Ministry of Rural Development to respond to this outbreak. WHO and partners, including the Food and Agriculture Organization (FAO), are working within the task force to strengthen epidemiological surveillance in both human and animal health, strengthen capacity in case management at health care facilities, strengthen health measures in slaughterhouses, and raise awareness among farmers.

A multi-sector investigation team has been deployed to conduct a detailed outbreak investigation among humans and animals in the affected areas. An international team of experts will be deployed to provide technical assistance from 3 to 10 November 2012.

Mauritania experienced an outbreak of RVF in 2010.

With regard to this outbreak, WHO does not recommend any travel or trade restrictions be applied.

With best regards,
WHO Communications team
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