Kyasanur forest disease

Kyasanur forest disease is limited to India. This tickborne viral infection may cause marked leukopenia and thrombocytopenia. Hemorrhages and shock are seen in severe cases. Patients may have low back, limb pain, conjunctivitis, cervical lymphadenopathy, sore throat, and papulovesicular eruptions.

CASES/YEAR
0 (US); 500 (Global)
CATEGORY
Arthropod-Borne
AGENT TYPE
Viruses
OTHER NAMES
KFD;
ACUITY
Acute-Severe
INCUBATION
3-7 days (range of 1-12 days); [CCDM]
INITIAL SYMPTOMS
Severe flu-like illness with fever, vomiting, diarrhea, low back and limb pain, prostration, conjunctivitis, and sore throat; [CCDM]
PRECAUTIONS
No person-to-person transmission; [ABX Guide]
COMMENTS
This tickborne viral infection may cause marked leukopenia and thrombocytopenia. Hemorrhages and shock are seen in severe cases. Patients may have low back and limb pain, conjunctivitis, cervical lymphadenopathy, sore throat, and papulovesicular eruptions may occur. Some patients have a biphasic course with neurological symptoms (severe headache, mental disturbances, tremors, and visual deficits) developing 1-2 weeks after the initial febrile period. The case-fatality rate varies from 3-5%. A vaccine is available. Ticks are reservoirs. Rodents, shrews, and monkeys are amplifiers. [CCDM, p. 43-6] Findings may include hemorrhage, thrombocytopenia, encephalitis, myocarditis, pneumonitis, and retinal lesions. [Guerrant, p. 444-6, 514] Patients initially have a flu-like illness with vomiting. The first phase of illness may also include lymphadenopathy, hepatosplenomegaly, petechiae, and hemorrhages. After a 1-2 week remission, neurological symptoms develop. Lab findings include elevated liver enzymes. Hemorrhagic pulmonary edema occurs in 40% of cases and acute renal failure in severe cases. [PPID, p. 2031]
DIAGNOSTIC
PCR; Culture; Antigen detection; Paired sera; [CCDM]
SCOPE
India; [CCDM]
SIGNS & SYMPTOMS
  • >fatigue, weakness
  • >fever
  • >fever, biphasic or relapsing
  • >myalgia
  • E epistaxis
  • E pharyngitis
  • E stomatitis
  • G blood in stool
  • G diarrhea
  • G hematemesis
  • G hepatomegaly
  • G liver function test, abnormal
  • G nausea, vomiting
  • H leukopenia
  • H lymphadenopathy
  • H splenomegaly
  • H thrombocytopenia
  • N headache
  • N lethargy
  • O conjunctivitis, acute
  • R cough
  • R hemoptysis
  • S papules or plaques
  • S petechiae and ecchymoses
  • S skin blister or vesicles
  • *acute renal failure
  • *bleeding tendency
  • *encephalitis
  • *meningitis
  • *myocarditis
  • *pneumonitis
  • *pulmonary edema
  • *shock
  • *uveitis
ANTIMICROBIC

No

VACCINE

Yes

ENTRY
VECTOR
Ticks
RESERVOIR
Monkeys, Rodents, Wild Animals
RISK FACTORS
  • Travel to endemic area
  • Victim--air release of infectious agents
  • Work in a medical or research lab
  • Work or play in tick-infested area
TREATMENT
IV ribavirin may be of benefit. [CCDM]
DRUG LINK
CDC - Kyasanur Forest Disease
REFERENCES FOR CASES/YEAR
1.
2. (Global) About 500 cases/year; [Cecil, p. 2215t]