Kyasanur Forest Disease

 

Ms. Pallavi Jambhulkar*

Nursing Tutor, VSPM Madhuribai Deshmukh Institute of Nursing Education, Lata Mangeshkar Hospital, Digdoh hills, Hingna, Nagpur.

 

ABSTRACT:

Kyasanur forest disease (KFD) is a tick borne viral haemorrhagic feveror monkey fever endemic to south-western part of India. This disease caused by a virus belonging to the family Flaviviridae. KFD is transmitted to humans through the bite of infected hard ticks (haemaphysalis spinigera) which act as a reservoir of KFD. High fever with chills, frontal headaches, severs muscle pain with vomiting, gastrointestinal symptoms these are the signs and symptoms will occur. Treatments include early hospitalization and supportive therapy is important. Supportive therapy includes the maintenance of hydration and the usual precautions for patients with bleeding disorders.

 

 

 

 

INTRODUCTION:

Kyasanur Forest Disease (KFD) is a tick-borne viral haemorrhagic fever endemic in Karnataka State, India. It is also called as monkey fever by local people. This is caused by Kyasanur Forest disease virus (KFDV), a member of the virus family Flaviviridae. It was identified in 1957 when a sick monkey isolated from the Kyasanur Forest in Karnataka (formerly Mysore) State, India.¹

 

Definition:

Kyasanur forest disease is a viral haemorrhagic fever caused by a virus that belongs to the family Flaviviridae. The virus is carried by ticks. Humans get infected when such ticks bite them.¹

 

Incidence:

This disease first emerged in Kyasanur Forest in the Indian state of Karnataka in the 1957, after this forest ecosystem became increasingly degraded by human activities. Since 2012, Kyasanur Forest Disease has spread to new districts and states in India, and human cases have increased significantly to around 500 each year. Between 5 and 10% of people who are known to be affected by KFD develop haemorrhagic symptoms and die. There have been at least 340 confirmed deaths from the disease over the last five years.²

 

 

Transmission:

It Transmit to humans after a tick bite or contact with an infected animal, most importantly a sick or recently dead monkey. No person-to-person transmission has been described. Animals are goats, cows, and sheep may become infected with KFD but play a limited role in the transmission of the disease. Though animals are the blood meals for ticks and even if possible for infected animals with viremia to infect other ticks, but transmission of KFDV to humans from these larger animals is extremely rare. No evidence found that KFD transmit via the unpasteurized milk of any of these animals.²

 

 

Risk of exposure:

KFD has historically been limited to the western and central districts of Karnataka State, India. The possibility of wider distribution of KFDV were indicated through the samples that were taken from humans and monkeys which tested positive for KFDV in the southernmost district of the State, Tamil Nadu State and Kerala State, in November 2012. There is similar to KFD virus (Alkhurma hemorrhagic fever virus) has been described in Saudi Arabia.²

 

People with recreational or occupational exposure to rural or outdoor settings like hunters, herders, forest workers, farmersin Karnataka State are potentially at risk for infection by contact with infected ticks. Important risk factors are reported during the dry season, from November through June.²

 

Signs and Symptoms:

1.     High fever with chills, frontal headaches

2.     Severe muscle pain with vomiting

3.     Gastrointestinal symptoms

4.     Bleeding problems may occur 3–4 days

 

Second waves of symptoms are;

1.    Fever

2.    Signs of neurological manifestations, such as severe headache,

3.    Mental disturbances,

4.    Tremors,

5.    Vision deficits.²

 

Diagnosis:

Diagnosis in the early stage of illness by;

·       Molecular detection by PCR

·       Virus isolation from blood.

·         Enzyme-linked immunosorbent serologic assay   (ELISA) can be performed.

 

Treatment:

There is no specific treatment for KFD, early hospitalization and supportive therapy is only important. Supportive therapy includes the maintenance of hydration and the usual precautions for patients with bleeding disorders.⁴

 

Prevention:

·       A killed vaccine used for KFD and is used in endemic areas (disease occurs regularly in a particular area) in India.

·       Other preventative measures are insect repellents and wearing protective clothing in areas where ticks are endemic.

·       The use of spray insecticides has been recommended in a 50-meter radius around a dead monkey⁴

 

Complication:

·         Hemorrhagic Manifestations:

Are intermittent epistaxis, haematemesis, melena, and frank blood in the stools.

 

·         Neurological Complications:

May occur due to meningoencephalitis. Symptoms include headache, neck stiffness, mental disturbance, coarse tremors, giddiness, and abnormality of reflexes.⁴

 

Dos and Don’ts:

National Centre for Disease Control has compiled a list of dos and don’ts that may help you stay away from this deadly disease.

 

 

Dos	Don’ts
Report unusual monkey deaths to forest officials or health department	Never use dried leaves and bushes for fodder or bedding for livestock from infected area
Before entering a forest, cover yourself fully and apply DMP on exposed skin	Never touch the carcasses of a dead monkey with bear hands
After returning from forest, wash yourself and clothes with hot water and soap	Never try to kill an infected tick by squeezing it in between your fingers
Educate everyone around you of the disease	Don’t go to any area where the KFD was reported in the past
Control the tick growth in your livestock

 

REFERENCE:

1.     www.searo.who.int/publications/

2.     https://www.nhp.gov.in/disease/communicable-disease/kyasanur-forest-disease

3.     https://www.cdc.gov/vhf/kyasanur/exposure/index.html

4.     https://link.springer.com/article/10.1007/s10916-018-1041-3

 

 

 

Received on 27.07.2020          Modified on 29.09.2020

Accepted on 05.11.2020       ©A&V Publications All right reserved