14 July 2008After an outbreak of Rift Valley Fever (RVF) in Madagascar that has already caused 20 human deaths as well as affecting livestock, two United Nations agencies have stepped in to help treat and control the disease. Since January RVF has been reported in both animals and humans in more than 20 out of the 119 districts of Madagascar, primarily in the north, south and central highlands. By the end of June Madagascar’s Ministry of Health had reported a total of 520 human-suspected cases related to RVF, including 20 deaths. Laboratory tests have confirmed 84 human cases so far. The UN Food and Agriculture Organization (FAO) and the UN World Health Organization (WHO) have helped Malagasy authorities develop an Emergency Response Plan, which includes providing disease management for affected livestock herds and human populations at risk, reinforcing livestock disease surveillance and improving reporting systems and laboratory diagnostics. Transmitted by mosquitoes, RVF is a dangerous disease that affects both livestock – including sheep, goats, cattle and camels – and humans, but is usually well-established in animal populations by the time the first human cases are observed. Humans become infected through mosquito bites or direct contact with infected material and liquids such as animal blood during slaughtering, while the uncooked milk of infected animals can also pose a risk. No cases of human-to-human transmission have ever been reported. While some infected people experience no detectable symptoms, others develop flu-like fever, muscle pain, headaches, joint pain, vomiting, loss of appetite and sensitivity to light. In more severe cases patients can also experience lesions in their eyes, neurological problems, liver impairment and haemorrhagic fever symptoms including widespread bleeding. FAO and WHO have received a total of $376,000 from the UN Central Emergency Response Fund (CERF) to support the emergency plan, but the two agencies are appealing to international donors to help extend the programme to areas not yet covered, aiming to cover all populations at risk.