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

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. 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. 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. 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

Prevalence of Rift Valley fever by age groups.

<p>The trend line indicates gradual increase of sero-positivity with age.</p

Main stages in the process of crowdsourcing vector surveillance.

<p>Illustration of the five main steps when crowdsourcing for community knowledge and experiences to predict or approximate densities and distribution of outdoor-biting mosquitoes.</p

Study areas.

<p>Map showing the three villages where the study was conducted (Kivukoni, Minepa and Mavimba) in rural Ulanga district, southeastern Tanzania.</p

Comparison of mosquito catches in areas classified by communities as having high, medium or low mosquito densities in dry season and wet season.

<p>Median nightly mosquito catches in areas marked by community members as having high mosquito densities, medium densities or low densities in all villages during wet season (upper panel), and dry season (lower panel). Data segregated by taxa, but combined over 12 months. The error bars in this graph represent the inter-quartile ranges, i.e. 25^th percentile and 75^th percentile on either side of the median nightly catch. Data for the wet season included months of December, January, February, March, April and May, while the dry season data included June, July, August, September, October and November.</p