Abstract
Kyasanur Forest disease virus (KFDV) and Alkhurma hemorrhagic fever virus (AHFV) are tick-borne flaviviruses that cause life-threatening hemorrhagic fever in humans with case fatality rates of 3–5% for KFDV and 1–20% for AHFV, respectively. Both viruses are biosafety level 4 pathogens due to the severity of disease they cause and the lack of effective countermeasures. KFDV was discovered in India and is restricted to parts of the Indian subcontinent, whereas AHFV has been found in Saudi Arabia and Egypt. In recent years, both viruses have spread beyond their original endemic zones and the potential of AHFV to spread through ticks on migratory birds is a public health concern. While there is a vaccine with limited efficacy for KFDV used in India, there is no vaccine for AHFV nor are there any therapeutic concepts to combat infections with these viruses. In this review, we summarize the current knowledge about pathogenesis, vector distribution, virus spread, and infection control. We aim to bring attention to the potential public health threats posed by KFDV and AHFV and highlight the urgent need for the development of effective countermeasures.
Highlights
Kyasanur Forest disease virus (KFDV) and Alkhurma hemorrhagic fever virus (AHFV) belong to the tick-borne encephalitis virus serocomplex of flaviviruses that cause severe hemorrhagic fever in humans [1,2,3]
We summarize the current knowledge and emphasize the urgent need for more basic and applied research and countermeasure development to combat these significant public health threats
As KFDV was first found in tissue homogenates derived from a dead monkey [4,5], KFDV pathogenesis was initially studied in non-human primate (NHP) models
Summary
Kyasanur Forest disease virus (KFDV) and Alkhurma hemorrhagic fever virus (AHFV) belong to the tick-borne encephalitis virus serocomplex of flaviviruses that cause severe hemorrhagic fever in humans [1,2,3]. It has been hypothesized that AHFV might have arisen from an introduction of KFDV to Saudi Arabia [12]. Haemaphysalis spinigera and Ornithodoros savignyi are the main tick vectors involved in KFDV and AHFV transmission, respectively [13,14]. Humans become infected with AHFV either by bites of infected ticks or contact with infected blood or milk [20]. KFDV India 1957 Haemophysalis spinigera Tick bite, encounter with dead or dying monkeys Black-faced langur, Red-faced bonnet macaque, rodents, shrews, birds Bonnet macaques, mice Formalin-inactivated virus Unknown 3–5%. KFDV and AHFV are neglected human pathogenic viruses, and there remains a lack of insight into their pathogenesis, ecology, and epidemiology and the development of effective countermeasures. We summarize the current knowledge and emphasize the urgent need for more basic and applied research and countermeasure development to combat these significant public health threats
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