KYASANUR FOREST DISEASE (KFD)

Synonym : Monkey disease

Type of zoonosis : Metazoonosis type IV
Etiology
• KFD is caused by Kyasanur forest disease virus (KFDV). Single stranded RNA virus
belongs to the genus Flavivirus, family Flaviviridae.
Reservoir and incidence
• Porcupines, rat, mice, squirrels, forest birds and small mammals act as reservoir hosts
for KFDV.
• Monkeys act as amplifier host.
• Man and cattle are accidental hosts.
• KFD is limited to Karnataka state. KFD antibody also found in man and animals in
the Kutch and Saurashtra Peninsula and sporadically from other parts of India.
• Recently, a virus very similar to KFD virus known as Alkhurma. Haemorrhagic Fever
virus (AHFV) was discovered in Saudi Arabia. KFDV and AHFV share 89%
sequence homology.
• People with recreational or occupational exposure to rural or outdoor settings (eg:
Hunters, campers, forest workers, farmers) are potentially at risk for infection.
• Outbreaks of KFD in human beings residing by the side of the forest occur generally
in dry months (January to June) when field workers go to forests more frequently.
This period is also coinciding with increased tick activity.
Transmission
• By contact with an infected animal, such as sick or recently dead monkey.
• By bite of an infected tick nymphs (Haemaphysalis spinigera).
• The adult Heamaphysalis spinigera ticks feed on large wild or domestic animals, and
then fell down on the ground. The larvae and nymph attach themselves to humans,
various small mammals of the forest, as well as birds and monkeys and transmit the
virus.
• The virus has also been isolated from H.turturis, in the nymphs of which the agent
can survive throughout the year, and from six other species of Haemaphysalis, and
also from several species of lxodes.
 Clinical signs in monkeys
• KFD infecion of South Indian macaque (Macaca radiata) develop diarrhoea,
bradycardia, hypotension and eventually leads to death.
• Maximum mortality among two spp. Of monkeys-
The grey langur – Presbytis entellus, and
The bonnet macaque –Macaca radiata.
Clinical signs in man
• The incubation period ranges from 3 to 8 days.
• KFD has sudden onset with fever, cephalalgia, myalgia, anorexia and insomnia. On
the third or fourth day, the patient tends to experience diarrhoea and vomiting.
• Severe prostration, papulovesicular lesions on the palate are developed.
• Less frequently symptoms of coughing and abdominal pain.
• The fever lasts for 6 to 11 days. After a febrile period of 9 to 21 days, a significant
proportion of the patients undergo a second phase of pyrexia that lasts for 2 to 12
days, usually with neurologic symptoms such as stiffness of the neck, mental
confusion, tremors and abnormal reflexes.
• Haemorrhagic manifestations in agricultural workers who are poor and malnourished.
• Convalescence is prolonged. A small proportion of patients develop coma or
bronchopneumonia prior to death.
• The case fatality rate is approximately 5% to 10%.
Diagnosis
• Blood and paired sera should be collected.
• Serologic diagnosis by complement fixation, haemagglutination
inhibition, neutralization tests and ELISA using paired sera.
 • Serologic diagnosis is more difficult if the patient has been previously exposed to
another Flavivirus.
Treatment
• Supportive therapy and clinical management are important, include maintenance of
hydration and prevention of bleeding disorders.
Prevention and control
• Individual human protection against ticks is very much important, such as protective
clothing and the use of repellents.
Vaccination
• A formalin-inactivated chick embryo fibroblast tissue culture vaccine is used for
immunization. But the presence of antibodies to other Flaviviruses, especially the
West Nile virus, seems to interfere with the vaccine’s efficacy.
• In mice, it is reported that 70 to 100% protection against large doses of KFD virus for
at least 18 months with single inoculation of a live vaccine based on an attenuated
strain of Langat virus.
• Tick control measures to be followed in KFD prevalent areas.
• Control Tick population
• Wear light coloured cloths in Jungle to spot ticks & avoid their bite
• Stop deforestation.
• Education of villagers and forest workers