320 (1984). Prevalence of acute conjunctivitis caused by chlamydia, adenovirus, and herpes simplex virus in an ophthalmic casualty department. British Journal of Ophthalmology, 68, 653-655.
Woodland, R. M., Kirton, R. P. & Darougar, S. (1987). Sensitivity of mitomycin-C treated McCoy cells for isolation of
TRANSACTIONS
OF THE ROYAL
Chlamydia trachomatisfrom genital specimens. EuropeanJournal of Clinical Microbiology, 6,653~656.
Received 8 May 1991; revised 16 June 1991; accepted for publication 8 August 1991
SOCIETYOF TROPICAL MEDICINE AND HYGIENE (1992) 86,320
-1 First fatal human case of Rift Valley fever in Madagascar Jacques Morvanl, Jean-Louis Lesbordesz, Pierre E. Rollins, Jean-Claude Moudenl and Jean Roux1 ‘Institut Pasteur, BP. 1274, Tananarive, Madagascar; Xlinique Me’dzcale, H6pital Militaire, Tananarive, Madagascar; 3Institut Pasteur, 25 rue du Dr Roux, 75015 Paris, France Although Rift valley fever (RVF) epizootics have occurred in East and South Africa since the beginning of the century, RVF virus was not known in Madagascar until 1979 when it was isolated from a pool of mosquitoes and subsequently from an uncomplicated human case after a laboratorv accident (MATHIOT et al.. 1984’1. Antigenic analysis using mondclonal antibodies ievealeh that the Madagascar strains were more closely related to the highly pa&ogenic Egyptian epizootic strain (involved in the 1977-1978 outbreak) than to anv other enzootic African strain (SALUZZOet hZ., 1989). 1; spite of the apparent presence of RVF in potential vectors, no RVF outbreak was reported among the susceptible livestock (mainly cattle) and human populations. However in March, 1990, during the rainy season (December to March), a high incidence of abortion in cattle was reported from the east coast of Madagascar surrounding the city of Feverive, and recent RVF virus circulation was confirmed by the presence of immunoglobulin M (IFZM) antibodies in cattle and human. though no virus isilat’lon was made (MORVAN et al., 199’1). Since January 1991, numerous foci of bovine abortion were reported in the central highlands of Madagascar where cattle numbers are high and movements of cattle are frequent (J. Morvan, unpublished data). In February 1991, a 36 year old woman was admitted to the Military Hospital of Antananarivo with a history of fever, jaundice of 2 d duration and sudden onset of neurological symptoms (disorientation and coma). The following day, she died with hepatoencephalonephritis, without haeaminotransferase morrhagic symptoms (aspartate 2700 iu, alanine aminotransferase 20 040 iu, serum creatinine 1750 pmol/litre, prothrombin time 22% , platelets count 194 999imm. haemoelobin 12 ~1. A serum samnle taken upon admission to thi hospital &owed a high Ieke
of RVF specific IgM and RVF virus antigen detected by immunocapture enzyme-linked immunosorbent assay. RVF virus was isolated in Vero cells. A liver biopsy the day before death showed extensive necrosis of liver hepatocytes cells with Councilman bodies and inflammatory cell infiltration. Epidemiological studies showed that the patient had not been directly involved in animal caretaking but she lived 1 km from a cattle farm where an RVF outbreak had been reported. Several strains of RVF were isolated from bovine abortion products and IgM prevalence was very high: lWl1 (90.9%) in recovering aborting females and in 57/172 (36.6%) in other cattle. Using a panel of monoclonal antibodies (kindly provided by J. F. Smith, Virology Division, USAMRIID, USA), the human and bovine isolates were tvped and all were found to be identical. All were recognized by an antinucleocapsid monoclonal antibodv (RlP3E71. like the non-Eavntian African strains but &like the 1599 Madagascar mG;uito isolate (SALUZZOet al., 1989). This result suggest either recent introduction and subsequent epidemic-spread of an African RVF virus. or the uresence of 2 antigenicallv different viruses in the same geographical area. ko oth& human case was reported, but IgM antibodies were detected in some other inhabitants-of the patient’s village 1121166. 7.2%). Mosauitoes were caught during 2 nights h the batieni’s home surroundings ~=2200,-84.S”~ of which were Culex antennatus), but no virus was isolated from these potential vectors. Serological investigation of 135 patients with fever in the same hospital, between January and March 1991, showed onlv one IZM nositive natient. More studies will be done to &aluatgthehuman impact of this outbreak. References Mathiot, C., Ribot, J. J., Clerc, Y., Coulanges, P. & Rasalofonirina. N. (1984). Fievre de la vall6e du Rift et virus Zinaa: un a&ovir& paihogene pour l’homme et l’animal nouv&u pour Madagascar. Archives de l’lnstitut Pasteur de Madagascar, 51,125-134.
Morvan, J., Fontenille, D., Saluzzo, J. F. & Coulanges, I’. 11991).Possible Rift Vallev fever outbreak in man and cattle in Midagascar. Transactioks of the Royal Society of Tropical Medicine and Hygiene, 85, 108. Saluzzo, J.-F., Anderson, G. W:, jr, Smith, J. F., Fonrenille, D. & Coulange!, P. (1989). Biological and antigenic relationship between Rift Valley fever virus strains isolated in Egypt and Madagascar. Transactions of the Royal Society of Tropical Medicine and Hygiene, 83,701,
Received 6 September 1991; revised 9 January 1992; acceptedfor publication 1SJanuary 1992
Woodland, R. M., Kirton, R. P. & Darougar, S. (1987). Sensitivity of mitomycin-C treated McCoy cells for isolation of
TRANSACTIONS
OF THE ROYAL
Chlamydia trachomatisfrom genital specimens. EuropeanJournal of Clinical Microbiology, 6,653~656.
Received 8 May 1991; revised 16 June 1991; accepted for publication 8 August 1991
SOCIETYOF TROPICAL MEDICINE AND HYGIENE (1992) 86,320
-1 First fatal human case of Rift Valley fever in Madagascar Jacques Morvanl, Jean-Louis Lesbordesz, Pierre E. Rollins, Jean-Claude Moudenl and Jean Roux1 ‘Institut Pasteur, BP. 1274, Tananarive, Madagascar; Xlinique Me’dzcale, H6pital Militaire, Tananarive, Madagascar; 3Institut Pasteur, 25 rue du Dr Roux, 75015 Paris, France Although Rift valley fever (RVF) epizootics have occurred in East and South Africa since the beginning of the century, RVF virus was not known in Madagascar until 1979 when it was isolated from a pool of mosquitoes and subsequently from an uncomplicated human case after a laboratorv accident (MATHIOT et al.. 1984’1. Antigenic analysis using mondclonal antibodies ievealeh that the Madagascar strains were more closely related to the highly pa&ogenic Egyptian epizootic strain (involved in the 1977-1978 outbreak) than to anv other enzootic African strain (SALUZZOet hZ., 1989). 1; spite of the apparent presence of RVF in potential vectors, no RVF outbreak was reported among the susceptible livestock (mainly cattle) and human populations. However in March, 1990, during the rainy season (December to March), a high incidence of abortion in cattle was reported from the east coast of Madagascar surrounding the city of Feverive, and recent RVF virus circulation was confirmed by the presence of immunoglobulin M (IFZM) antibodies in cattle and human. though no virus isilat’lon was made (MORVAN et al., 199’1). Since January 1991, numerous foci of bovine abortion were reported in the central highlands of Madagascar where cattle numbers are high and movements of cattle are frequent (J. Morvan, unpublished data). In February 1991, a 36 year old woman was admitted to the Military Hospital of Antananarivo with a history of fever, jaundice of 2 d duration and sudden onset of neurological symptoms (disorientation and coma). The following day, she died with hepatoencephalonephritis, without haeaminotransferase morrhagic symptoms (aspartate 2700 iu, alanine aminotransferase 20 040 iu, serum creatinine 1750 pmol/litre, prothrombin time 22% , platelets count 194 999imm. haemoelobin 12 ~1. A serum samnle taken upon admission to thi hospital &owed a high Ieke
of RVF specific IgM and RVF virus antigen detected by immunocapture enzyme-linked immunosorbent assay. RVF virus was isolated in Vero cells. A liver biopsy the day before death showed extensive necrosis of liver hepatocytes cells with Councilman bodies and inflammatory cell infiltration. Epidemiological studies showed that the patient had not been directly involved in animal caretaking but she lived 1 km from a cattle farm where an RVF outbreak had been reported. Several strains of RVF were isolated from bovine abortion products and IgM prevalence was very high: lWl1 (90.9%) in recovering aborting females and in 57/172 (36.6%) in other cattle. Using a panel of monoclonal antibodies (kindly provided by J. F. Smith, Virology Division, USAMRIID, USA), the human and bovine isolates were tvped and all were found to be identical. All were recognized by an antinucleocapsid monoclonal antibodv (RlP3E71. like the non-Eavntian African strains but &like the 1599 Madagascar mG;uito isolate (SALUZZOet al., 1989). This result suggest either recent introduction and subsequent epidemic-spread of an African RVF virus. or the uresence of 2 antigenicallv different viruses in the same geographical area. ko oth& human case was reported, but IgM antibodies were detected in some other inhabitants-of the patient’s village 1121166. 7.2%). Mosauitoes were caught during 2 nights h the batieni’s home surroundings ~=2200,-84.S”~ of which were Culex antennatus), but no virus was isolated from these potential vectors. Serological investigation of 135 patients with fever in the same hospital, between January and March 1991, showed onlv one IZM nositive natient. More studies will be done to &aluatgthehuman impact of this outbreak. References Mathiot, C., Ribot, J. J., Clerc, Y., Coulanges, P. & Rasalofonirina. N. (1984). Fievre de la vall6e du Rift et virus Zinaa: un a&ovir& paihogene pour l’homme et l’animal nouv&u pour Madagascar. Archives de l’lnstitut Pasteur de Madagascar, 51,125-134.
Morvan, J., Fontenille, D., Saluzzo, J. F. & Coulanges, I’. 11991).Possible Rift Vallev fever outbreak in man and cattle in Midagascar. Transactioks of the Royal Society of Tropical Medicine and Hygiene, 85, 108. Saluzzo, J.-F., Anderson, G. W:, jr, Smith, J. F., Fonrenille, D. & Coulange!, P. (1989). Biological and antigenic relationship between Rift Valley fever virus strains isolated in Egypt and Madagascar. Transactions of the Royal Society of Tropical Medicine and Hygiene, 83,701,
Received 6 September 1991; revised 9 January 1992; acceptedfor publication 1SJanuary 1992
