Severe presentations of Rift Valley Fever in Madagascar

The authors describe clinical and epidemiologic characteristics of severe presentations of Rift valley fever (RVF) during the 2008 epidemic in Madagascar. The diagnosis was confirmed by RVF virus polymerase chain reaction (PCR), or detection of specifics antibodies by Elisa. Sixteen cases of severe RVF were recorded. The sex-ratio was 7/1 and median age was 32 years (20/59 years). The risk factors of infection were: contact with infected animals or their meat (n=8), and travelling to a risk area (n=2). Hemorrhagic, neurological, and ocular manifestations were observed respectively in 87.5%, 43.8% and 6.3% of cases. All patients who died (n=4) presented with a hemorrhagic form of the disease. The hemorrhagic form was the most frequent presentation of RVF and was responsible for a high level of mortality. Epidemiologic surveillance must be implemented.