Elevated antibodies against rift valley fever virus among humans with exposure to ruminants in Saudi Arabia

In 2000, an outbreak of Rift Valley fever virus (RVFV) occurred in the Kingdom of Saudi Arabia (KSA). Since then there have been sparse efforts to monitor for RVFV reemergence. During 2012, we enrolled 300 individuals with ruminant exposure and 50 age-group matched non-exposed controls in southwestern KSA, in a cross-sectional epidemiological study of RVFV. Sera from the participants were screened with an enzyme-linked immunosorbent assay (ELISA) for anti-RVFV IgG antibodies of which 39 (11.1%) were positive. Sixteen (41.0%) of those 39 were also positive by a plaque reduction neutralization assay (PRNT). The PRNT-positive subjects were further studied with an IgM ELISA and one was positive. No RVFV was detected in the 350 sera using real-time reverse transcription polymerase chain reaction. Contact with cattle (odds ratio [OR] = 3.16, 95% confidence interval [CI] 1.01, 9.90) and a history of chronic medical illness (OR = 6.41, 95% CI 1.75, 23.44) were associated with greater odds of RVFV seropositivity by PRNT. The IgM-positive participant was 36 years of age, and reported multiple risk factors for ruminant contact. Although these findings simply may be vestiges of the 2000 epidemic, KSA's frequent visits from pilgrims and importations of live animals from RVFV-endemic areas suggest that more comprehensive surveillance for imported RVFV virus in ruminants, mosquitoes, and travelers is imperative.