Rift valley fever differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2]Associate Editor(s)-in-Chief: Aakash Hans, MD[3]

Overview[edit | edit source]

The majority of differential diagnoses for Rift valley fever arise from other diseases which are prevalent in travelers and present with fever. All these disease would share a similar history of recent travel to an endemic area, followed by development of fever and body aches. A few of these diseases are listed below.

Differential Diagnosis[edit | edit source]

• Malaria
  • The disease presents with fever like Rift valley fever, but the major difference is the pattern of fever in malaria. The fever recurs every 3-4 days in malaria while no such patterns are seen in RVF.
  • Malaria is common in African countries, so paying attention to the time and onset of fevers can be useful in distinguishing between the two diseases.^[1] The vast majority of cases of malaria occur in children under the age of 5 years.^[2]
• Typhoid fever
  • Typhoid usually has a pattern of step-ladder form of fever, meaning the temperature rises with each passing day.^[3]
  • The patient also complaints of bowel abnormalities along with fever. Individuals report either constipation or diarrhea along with fever.
  • A rash is seen on the chest, known as rose-spots in patients with Typhoid.
• Crimean-Congo hemorrhagic fever
  • It is a tick-borne viral disease of both wild animals and domestic animals, affecting humans.^[4]
  • The virus belongs to the Bunyaviridae family, which is commonly found in Africa.
  • Risk factors include handling body fluids of infected humans or animals.
• Ebola virus disease
  • It is caused by a virus belonging to the Filoviridae family.^[5]
  • It should be suspected in febrile indivisuals who have done the following within a time span 3 weeks before fever :
    • Traveled to an area of a country where the disease had recently occurred.
    • Have had contact with body fluids like blood and other secretions of animals or humans infected with the disease.
• Dengue
  • Patients with dengue also complain of fever but have greater joint pains than in Rift valley fever.^[6]
  • A characteristic feature of dengue fever is retro-orbital pain.
  • Dengue has a longer incubation period of 7 days, followed by a week of febrile phase, 1-2 days of the critical phase and 3-5 days of the recovery phase.
• Yellow fever
  • It is a rare disease caused by mosquitos found in South America and Africa.^[7]
  • There are vaccines for travelers traveling to these areas.
  • The disease is usually a self limiting febrile illness but may lead to cardiac, renal and hepatic complications.
• Lassa fever
  • The disease is usually seen in West Africa.^[8]
  • It is transmitted by rats and risk factors include handling food materials infected with rat feces or contact with infected humans.
  • The incubation period ranges from 2-21 days and most of the people do not report any symptoms.
  • Common symptoms are fever, throat pain, headache, swelling of the face, vomiting and diarrhea.
• Chikungunya
  • It is caused by the Aedes aegypti mosquito and is commonly seen in African and Asian countries.^[9]
  • The course of the disease is self limiting and involves fever, headaches and generalized body pain.
• Q fever
  • Q fever is caused by infection by a bacteria called Coxiella burnetii.^[10]
  • The bacteria is usually found in domestic animals such as sheep, goats, cats and ticks also.
  • Risk factors include drinking raw milk, breathing in contaminated dust or droplets.
  • Acute infection is characterised by fever, pneumonia and hepatitis. Chronic infections presents with cardiac, musculoskeletal or vascular symptoms.
• Zika virus
  • Patients exposed to the virus develop illness 3-12 days after being exposed.^[11]
  • Symptoms include headache,rash,fever and back pain.
  • Symptoms last for the next 4-7 days with most of patients having a full recovery.
• Marburg virus disease
  • Marburg virus is the pathogen responsible for the disease.^[12]
  • Infection in humans is caused due to exposure to mines and caves where Rousettus bats can be found.
  • Once the virus is transmitted from animals to humans, further spread is usually human-to-human and results from contact with bodyfluids.
  • Hypotension, metabolic disorders, immunosuppression and coagulopathy are the initial symptoms.

References[edit | edit source]

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