Monkey fever kills 2 in Karnataka: Symptoms, preventive suggestions and all you wish to know

Monkey fever or Kyasanur Forest Disease (KFD) has claimed two lives in Karnataka calling for pressing motion and implementation of preventive measures to comprise unfold of the illness. The tick-borne haemorrhagic fever, normally contracted by monkeys, is brought on by KFD virus which is an arbobirus of the household Flaviviridae. An 18-year-old woman and a 79-year-old man have to date succumbed to the illness, out of 49 optimistic circumstances within the state. The preliminary signs of the viral illness are sudden fever, headache, physique ache, vomiting, belly ache, and diarrhoea. whereas extreme illness with haemorrhagic signs could happen later. It is essential to regulate tick populations in wildlife, significantly monkeys, to stop the unfold. (Also learn: India on the verge of eliminating ‘black fever’ kala-azar, second deadliest parasitic disease)

What is Monkey Fever?

Kyasanur Forest Disease (KFD) generally generally known as Monkey Fever is a viral haemorrhagic illness that was first recognized in 1957 within the Kyasanur Forest within the Western Ghats of India. It is brought on by KFD virus (KFDV) which is an arbovirus of the household Flaviviridae.

“Initially confined to the Western Ghats of Karnataka, the disease has expanded its presence over the past decade, with reported cases extending to neighbouring states along the Western Ghats, such as Kerala, Maharashtra, and Tamil Nadu. The disease’s burden is on the rise, reflecting a shift in its epidemiological profile and establishing it as an emerging tropical disease in India,” says Dr Laxman Jessani – Consultant Infectious Disease, Apollo Hospitals Navi Mumbai.

“Recently, 31 cases have been detected in Karnataka’s Uttara Kannada district with patients either being treated at home or admitted to hospitals but are reported to be stable. This indicates ongoing transmission and the need for continued surveillance and preventive measures in affected areas,” says Dr Jessani.

How does Monkey fever unfold?

“Infection occurs through tick bites carrying the virus or, less commonly, contact with infected animals, primarily monkeys. Symptoms include fever with possible haemorrhagic and/or neurological features. While approximately 80% of patients recover without post-viral symptoms, around 20% may develop severe haemorrhagic or neurological issues. Estimates suggest that around 500 human KFDV infections occur annually with a case fatality rate of 3-5%. As it is life-threatening and there is lack of effective countermeasures, KFDV is classified as a Biosafety level 4 (BSL4) pathogen,” says Dr Jessani.

Symptoms of Monkey Fever

After an incubation interval of three to every week post-tick chew, monkey fever begins abruptly with fever, chills, headache, and extreme exhaustion.

“As the disease progresses, symptoms can escalate to include nausea, vomiting, stomach pain, diarrhoea, meningitis, confusion and even haemorrhagic signs like nose bleeds and bleeding gums. Without proper supportive treatment, complications like shock, dehydration, electrolyte disturbances, haemorrhage and organ failure can arise and become fatal,” says Dr Shruti Sharma, Consultant-Internal Medicine, Yatharth Super Speciality Hospital.

“The virus has a 3-8 day incubation period and manifests in two or rarely four stages. In the first phase, symptoms include sudden fever, headache, body ache, conjunctiva inflammation, vomiting, abdominal pain, and diarrhoea. Clinical examination reveals lymphadenopathy, hepato-splenomegaly, weakness, and fatigue. Haemorrhagic symptoms may occur, with most patients recovering in 10-14 days,” says Dr Jessani.

“The initial symptoms often include a sudden onset of high fever accompanied by chills. Severe headaches and muscle pain are common, making the infected person feel extremely unwell. Nausea, vomiting, and diarrhoea may occur, impacting the digestive system. In severe cases, it can lead to bleeding tendencies, which may result in a range of complications,” says Dr Manjusha Agarwal, Senior Consultant, Internal Medicine Global Hospitals, Parel, Mumbai.

The virus could cause harm to very important organs, resulting in organ failure. Severe circumstances could progress to haemorrhagic fever, inflicting inner bleeding and doubtlessly deadly outcomes. If haemorrhagic signs persist, the second part could carry extreme neurological problems like drowsiness, disorientation, confusion, convulsion, and lack of consciousness.

“While most patients recover with subsided fever and rare long-term complications, continuous haemorrhagic issues may lead to poor outcomes, with a 2-10% mortality rate. Non-endemic areas show higher fatalities, potentially due to lower herd immunity and delayed diagnosis. Those with weakened immune systems or advanced age face a higher risk of severe outcomes,” provides Dr Jessani.

“The virus can cause damage to vital organs, leading to organ failure. Severe cases may progress to haemorrhagic fever, causing internal bleeding and potentially fatal outcomes,” says Dr Agarwal.

Diagnosis, prevention and administration suggestions

“Due to unclear early symptoms, monkey fever diagnosis relies on clinical suspicion and confirmatory lab tests like ELISA antibody assays and RT-PCR assays that can identify immune response to KFDV and detect viral genetic material, respectively. As there are no antiviral medications that directly target KFDV, management involves symptomatic relief, close monitoring of complications, maintenance of nutrition and organ function. Preventive measures emphasize personal protection against ticks in outbreak zones via repellents and appropriate clothing as well as spraying of acaricides to control tick population spread,” says Dr Sharma.

“Early detection is vital for effective management. Preventive measures involve avoiding tick bites through protective clothing, repellents, and caution in endemic areas. Education and awareness are crucial for at-risk populations. A vaccine for Kyasanur Forest Disease is recommended for those in or visiting endemic regions, with vaccination campaigns effectively reducing disease incidence. The current vaccine is a 0.1% formalin inactivated tissue culture vaccine, and ongoing research explores more effective options,” says Dr Jessani.

“Management involves supportive care, symptom relief, and complication treatment, as there is no specific antiviral for KFD. Severe cases may require hospitalization for complication management,” provides the professional.

Dr Agarwal shares prevention and administration suggestions for Monkey Fever:

1. A vaccine is offered in endemic areas, providing safety towards KFD.2. Wearing protecting clothes, utilizing tick repellents, and avoiding tick-infested areas scale back the danger of transmission.

2. Monitoring and controlling tick populations in wildlife, significantly monkeys, will help forestall the unfold of the virus.

How to take care

1. There is not any particular antiviral therapy for KFD, so medical care focuses on assuaging signs and offering supportive measures.

2. Severe circumstances could require hospitalization for shut monitoring and intensive care.

3. Maintaining hydration is essential to handle fever and stop problems.

4. Analgesics and antipyretics could also be prescribed to alleviate ache and scale back fever.