"Agence France Presse reports today that officials of the International Federation of Red Cross and Red Crescent Societies say that the epidemic of hemorrhagic fever [tentatively diagnosed as Rift Valley Fever] is "out of control". The Red Cross puts the epidemic toll at "more than 450", although members of the Kenyan parliament announced in a press conference that 5 thousand have died from both the epidemic and starvation. The Red Cross says the disease can be transmitted through "breathing", as well as by handling infected animals and mosquito bites. The Red Cross statement said "We have to establish the magnitude of the thing and still we are unsure precisely what we are dealing with. We are sure there is Rift Valley fever, but is that all? We are seeing some strange phenomena and there may be something else out there." It called for a helicopter operation to reach inaccessible areas, vaccination of livestock, and supply of masks, gloves, and disinfectants for the disposal of corpses."--Dorothy B. Preslar < dpreslar@fas.org> "[We have seen no basis for the truth of the Kenyan parliamentarians' claim for five thousand human deaths, but if one adds the >450 deaths (which could be any number >450) to the number of dead from other causes, 5,000 might not be an unreasonable number. During the 1977-78 RVF epidemic in Egypt, Harry Hoogstraal noted that members of his research team developed antibody titres as a result of merely observing a sick animal being bled out and butchered, presumably from having been infected through the aerosol formed from the blood splash. Experimentally, aerosols of RVF virus are highly infectious for laboratory mice and could be a source of infections for veterinarians, slaughterhouse workers, laboratory workers, and people slaughtering sick and dying livestock. There is certainly a most urgent need for more transport and supplies. Whether putrefying carcasses form a continuing risk is unlikely, other than regards general public hygiene, but human corpses in the epidemic zone are being buried promptly by relatives; this has made it difficult for the field team to obtain tissue samples. This situation has continued for well more than a month. Rather than state the obvious, excuse us for pointing out to students everywhere that the national epidemiologic and medical reactions to this emergency are not what we would call "classical". The initial official response was slow to non-existent until the election results were in. We do not know what is being done now, how many cases have occurred in Somalia, whether RVF virus arose autochthonously, or even what the Kenyan body counts are. Clearly, this is a complex microbiological morass. We only know that the laboratory work at the NIV, Johannesburg, has been first class and that CDC has confirmed Bob Swanepoel's findings.- Mods.MHJ/CHC]" .--promed@usa.healthnet.org From our correspondent in Kenya: "Here's an interesting fact -- tell me if you have seen this: I have been surprised at the number of carcasses of livestock that are left virtually untouched to rot in situ. I mentioned this at one of the villages, and the elder said that the hyenas and the vultures won't eat them ... anyway, today, I was doing some planning with the MSF-Belgium people, and they sent a sanitation/engineer up to Garissa to work with us. I mentioned this in passing while we were discussing the disposal of the animal carcasses, and he said that it was funny that in the last Ebola cleanup he did last year, he noticed that the monkey carcasses were not eaten [scavenged] either. Blue tongue has been identified from some of the sheep samples sent to Vet Labs in Kabete. I saw the most unusual presentations in a couple of camel herds ... complete ballooning of the head and upper neck only, death by asphyxia, eyes very swollen, and huge mucoid membranous sloughs in mouth covering some nasty ulcers. No foot involvement. From what the DVO says, he and the vets who work with him have never seen anything like this ... It is a virus soup out there!"-- Martin Hugh-Jones <mehj2020@vt8200.vetmed.lsu.edu> ON promed@usa.healthnet.org