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Table 2 Characteristics and alternative diagnoses of Rift Valley Fever manifestations

From: The challenging management of Rift Valley Fever in humans: literature review of the clinical disease and algorithm proposal

RVF manifestations Time of onset Frequency Lethality Sequelae Differential infectious diagnoses
Influenza-like syndrome 2 to 6 days of incubation 50–90% of infected people Prolonged asthenia Arboviruses, influenza virus, HIV (primary infection)
Rickettsia spp., Coxiella burnetii, Salmonella spp., bacterial sepsis
Malarial parasites
Acute hepatitis Day 2–21 1–2% of symptomatic cases High in icteric hepatitis None EBV, CMV, HIV, hepatitis viruses A, B, C, D, E, arboviruses (yellow fever, dengue, chikungunya)
Mycoplasma, Leptospirosa spp., Coxiella burnetii, Brucella, Bartonella, Babesia, Pneumococcus, Clostridium perfringens
Malarial parasites
Hemorrhagic fever Day 2–14 (day 2–4) 1–25% of symptomatic cases 25–65% None Hemorrhagic viral fevers, Leptospira spp.
Ocular signs Day 4–20 0.5–15% of symptomatic cases Reduced or lost vision Measles, rubella, influenza, CMV, HSV, VZV, West Nile, chikungunya, dengue and various encephalitis viruses
Rickettsia spp., Borrelia burgdorferi, Treponema pallidum
Acute encephalitis Day 2–10 < 1% of symptomatic cases 50% Neurologic disorders Enteroviruses, measles, mumps, rubella, influenza, rabies viruses, arboviruses (West-Nile, dengue, regional encephalitis), HIV
Listeria, Rickettsia, Treponema pallidum, Brucella, Borrelia, Leptospirosa spp., Chlamydia, Mycoplasma, ±bacterial meningitis (meningococcal, pneumococcal)
Plasmodium falciparum, Trypanosoma spp., Toxoplasma gondii, Echinococcus, Cryptococcus, Histoplasma capsulatum
Delayed encephalitis Day 4– 60 1–5% of symptomatic cases < 50% Neurologic disorders
  1. HIV human immunodeficiency virus, EBV Epstein Barr virus, CMV cytomegalovirus, HSV herpes simplex viruses, VZV varicella zoster virus