Case Report
Open Access
Outbreak of Kyasanur Forest Disease in Shivamogga,
Karnataka State, India, during 2015
NB Thippeswamy1* SK Kiran2
1Department of post graduate studies and Research in Microbiology, Jnana Sahyadri campus, Kuvempu University, Shivamogga, Karnataka, India
2Department of Health and Family Welfare, Shivamogga, Karnataka, India
2Department of Health and Family Welfare, Shivamogga, Karnataka, India
*Corresponding author: NB Thippeswamy, Department of post graduate studies and Research in Microbiology, Jnana Sahyadri campus, Kuvempu University, Shivamogga, Karnataka, India, Tel: +91 9731728364; E-mail:
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Received: 09 February, 2017; Accepted:13 March, 2017; Published:23 March, 2017
Citation: Thippeswamy NB, Kiran SK (2017) Outbreak of Kyasanur Forest Disease in Shivamogga, Karnataka State, India, during 2015. SOJ Vet Sci 3(2): 1-3. DOI: 10.15226/2381-2907/3/2/00127
Abstract
KFD is a Tick born viral disease with seasonal outbreak between
the months of December to May. The number of cases of Kyasanur
Forest Disease was investigated in Karnataka state, India, during
January to July 2015. Reported incidences in 2015 were relatively less
with 124 suspected and 41 RT-PCR or IgM Elisa positive cases when
compared to 400 suspected and 166 positive cases reported in 2014.
Majority of suspected KFD cases (124) in 2015 were reported from
Shivamogga District, with only few cases reported from remaining
endemic districts of KFD and one death was recorded. The number
of KFD cases reported every year even after regular vaccination
program in its original endemic area. KFD spreads from the zone of
first outbreak along the belt of Western Ghats continuously to the
newer area. New diagnostic techniques for quick diagnosis and more
effective and specific drug to treat KFD patients is the need of the
hour in the light of available vaccine which is not so readily accepted
by the people in the endemic area.
Introduction
Kyasanur Forest disease (KFD) is a tick-borne viral disease
caused by Kyasanur Forest disease virus (KFDV), a member
of the virus family Flaviviridae. Kyasanur Forest Disease was
first discovered in 1956 in Kyasanur village of Soraba Taluk,
Shivamogga District, Karnataka state, India [1]. The KFDV spreads
to monkeys and human beings through the bite of infected ticks.
It mainly infects two types of monkeys, one is black faced langurs
(Semnopethicus entellus) and red faced bonnet monkeys (Macaca
radiate) and various tick species (Genus Hemaphysalis). KFDV
infected ticks spread the virus after feeding onto healthy monkeys.
Uninfected ticks get the virus by feeding infected monkeys. KFDV
infection causes severe febrile illness in monkeys. After the death
of infected monkeys, ticks drop off from the body of the dead
monkeys and create the danger zone or hot spots of infectious
ticks which spread the virus further by infecting healthy animals.
KFDV circulates in the forest through different hosts like, rodents,
shrews, birds, and ticks [2]. KFDV infects human beings through
the bite of infected ticks when the people enter the hot spot area
of KFD. Infected individuals manifest symptoms of KFD like,
high fever, headache, myalgia, bleeding from nasal cavity, throat,
gingivae and gastrointestinal tract [3].
KFD was initially restricted to 5 districts, Shivamogga, Chikkamagalore, Uttara kannada, Dakshina kannada and Udupi, but Chamarajanagara, District of Karnataka state also reported for KFD during 2012-13 [4]. Usually, KFD cases were reported from December - May and there will be around 100-500 infections on an average every year [2]. Hence, the present work was conducted to study the epidemiological distribution of KFD outbreak during the year 2015 in Karnataka (State) and compare it with the KFD outbreak, 2014.
KFD was initially restricted to 5 districts, Shivamogga, Chikkamagalore, Uttara kannada, Dakshina kannada and Udupi, but Chamarajanagara, District of Karnataka state also reported for KFD during 2012-13 [4]. Usually, KFD cases were reported from December - May and there will be around 100-500 infections on an average every year [2]. Hence, the present work was conducted to study the epidemiological distribution of KFD outbreak during the year 2015 in Karnataka (State) and compare it with the KFD outbreak, 2014.
Methodology
Preparation of Human samples
Blood samples (5 ml) were collected from the people reported
to the primary health centres and Taluk hospitals of the affected
area with the history of unexplained fever. Serum was separated
from the blood samples after centrifugation at 3000rpm/15min.
Serum samples were transported to National Institute of
Virology (NIV) Pune, through Virus Diagnostic Laboratory (VDL),
Shivamogga for the detection of etiologic agent KFDV.
Preparation of Monkey samples
Through the surveillance system (Field health workers,
ASHA, Forest guards, Anganavadi workers, community leaders
and sensitized individuals), we got the information about
monkey deaths. We used the services of local veterinary
surgeon to conduct autopsy at place of death itself and collect
visceral samples. They are collected in sterilized test tubes
and transported to NIV Pune through VDL, Shivamogga for the
detection of etiologic agent KFDV.
Preparation of Tick samples
Ticks were collected from, villages with the history of KFD
activity, villages within 10 km radius of places with previous
history of KFD activity, places reported with unusual high number
of fever cases and area reported for monkey’s death. Ticks were
collected with the help of KFD field station staff and district
entomologist team in sterilized test tubes and transported to NIV,
Pune via VDL, Shivamogga for the detection of etiologic agent
of KFDV. All the samples were maintained at cold temperature
between 4-8ºC throughout the procedure.
Human serum samples, monkey brain, liver, heart, lungs, kidney and tick pools were sonicated in 600ml of minimum essential media (GIBCO/ BRL, Life technologies, Grand Island, NY, USA) and 400ml of media was added to the homogenate, Tripure isolation reagent (Roche Diagnostics, Indianapolis, in USA) was used to perform RNA extraction as described by Mourya et al , [5]. Samples were tested for KFDV by nested reverse transcription PCR (RT-PCR) and real time RT-PCR as described by Mourya et al, [5]. Human serum samples were also tested for the presence of IgM antibody by Elisa method.
Human serum samples, monkey brain, liver, heart, lungs, kidney and tick pools were sonicated in 600ml of minimum essential media (GIBCO/ BRL, Life technologies, Grand Island, NY, USA) and 400ml of media was added to the homogenate, Tripure isolation reagent (Roche Diagnostics, Indianapolis, in USA) was used to perform RNA extraction as described by Mourya et al , [5]. Samples were tested for KFDV by nested reverse transcription PCR (RT-PCR) and real time RT-PCR as described by Mourya et al, [5]. Human serum samples were also tested for the presence of IgM antibody by Elisa method.
Results and discussion
Highest number of cases reported between January to April
because of high temperature before the commencement of
rainfall. In 2015, maximum number of KFD cases was found
in January when compared to remaining months (Table 1).
Table 1: Data showed the incidences of Kyasanur Forest disease with month wise in Karnataka state for the year 2015.
Month |
Total villages reported |
Total villages positive |
Total cases reported |
Total cases Positive |
Monkey specimen collected |
Monkey specimen positive |
Total ticks collected |
Total ticks positive |
January |
47 |
10 |
57 |
15 |
0 |
0 |
125 |
0 |
February |
9 |
5 |
38 |
12 |
6 |
0 |
2 |
0 |
March |
1 |
0 |
7 |
5 |
10 |
0 |
7 |
0 |
April |
2 |
3 |
8 |
3 |
0 |
0 |
7 |
0 |
May |
10 |
3 |
12 |
6 |
12 |
0 |
13 |
0 |
June |
2 |
0 |
2 |
0 |
0 |
0 |
1 |
0 |
July |
0 |
0 |
0 |
0 |
14 |
0 |
3 |
0 |
Total |
71 |
21 |
124 |
47 |
42 |
00 |
158 |
00 |
Enterotoxigenic E. coli
Figure 1: Map of India showing the rate of incidences reported in 3 different regions of Karnataka.
area. The number of incidences of KFD differs with different
districts, where Shivamogga district has more number of KFD
cases compared to Uttarakannada and Chikkamagalur (Figure
2). Year wise, the number of incidences of KFD fluctuating very
much, it shows the uncertainty of KFD cases in every year. In the
year 2012, number of cases were 97, cases were reduced to 17 in
2013 whereas in 2014 positive cases increased to 166 and again
reduced to 41 in 2015 (Table 2). We have also compared the
data of KFD cases year wise from 2011-12 to 2014-15 as well as
month wise (Figure 3). The graph clearly indicated the number of
incidences of KFD were more from January-May, where increased
temperature correlated with increased incidences of KFD. From
the month of June no cases of KFD were found because of onset
of monsoon during which ticks enter into non feeding phase of
metamorphosis. It is very difficult to predict the place and time of
KFD outbreak since 1956. The KFDV keeps on spreading towards
north-west and south-west from the place of its discovery. To
control mortality and morbidity of KFD following things needs to
be done; development of quick diagnostic tool for the early and
accurate diagnosis of the disease, discovery of drug to treat the
patients of KFD and improvement of the efficacy of the current
vaccine.
Figure 2: District wise incidence of Kyasanur forest disease in
Karnataka state for the year 2015.
Table 2: Data showed the incidences of KFD cases, Monkeys death and
tick pools from 2012-2015, Karnataka.
Year |
Suspected cases |
confirmed cases |
Monkey Deaths |
Tick Pools collected |
2012 |
359 |
97 |
64 |
239 |
2013 |
82 |
17 |
50 |
290 |
2014 |
400 |
166 |
31 |
262 |
2015 |
124 |
41 |
41 |
176 |
Enterotoxigenic E. coli
Figure 3: Month wise KFD cases from 2011-12 to 2014-15, in Karnataka
state.
Acknowledgments
The authors are grateful to VGST, Karnataka for the financial
assistance provided in conducting this study. We also gratefully
acknowledge the assistance provided by Rajesh Suragihalli,
District health and family welfare officer, Shivamogga; Dr.
Ravikumar, Deputy director, Virus Diagnostic Laboratory,
Shimoga; Sandhya V K, Microbiologist; Anand, Senior Laboratory
technician, Virus Diagnostic Laboratory Shimoga and Dr. Mourya
D.T, Director, National institute of virology, Pune.
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