Clinical and laboratory profile of patients with Kyasanur forest disease: A single-centre study of 192 patients from Karnataka, India

Gupta, Nitin; Chunduru, Kiran; K, Mohammad Safeer; Saravu, Kavitha

doi:10.1016/j.jcv.2021.104735

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…Haematuria, haemoptysis, melena, gum bleeding, and subconjunctival haemorrhages were observed. Bleeding manifestations recorded in the studies by Gupta et al [13] and Gladson et al [14] in 2021, were 8% and 20%, respectively, as shown in Table 3. Bleeding manifestations are attributed to the activation of the vascular endothelium.…”

Section: Discussionmentioning

confidence: 83%

“…Four patients with myocarditis succumbed to the illness. In the study by Gupta et al [13], hypotension at presentation and myocarditis were associated with an increased risk of mortality. Adhikari Prabha et al reported that out of four patients in whom the myocardium was examined in autopsy, two showed evidence of myocarditis (interstitial infiltration of round cells) [12].…”

Section: Discussionmentioning

confidence: 92%

“…All the patients in this case series belonged to tribal ethnic groups. Most of the people affected by KFD in the previous studies [12,13,14] were either frequent forest visitors or people of tribal ethnicity. A study that assessed the risk factors for being infected with KFDV in the tribal population found that 74% of the people belonging to tribal ethnic groups do not use footwear, and more than 88% do not cover their body or use gloves or tick repellents while working in the forest [15].…”

Section: Discussionmentioning

confidence: 96%

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A Case Series on the Spectrum of Complications Observed in Kyasanur Forest Disease

Gladson,

Mathew,

et al. 2024

Cureus

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BackgroundKyasanur Forest Disease (KFD) has emerged as an important differential diagnosis of febrile illness for physicians caring for patients in the Western Ghats of South India over the last decade. AimThis study seeks to familiarize physicians with the clinical presentation and the clinical, laboratory and imaging findings of the various complications of KFD. It also seeks to review the literature on the complications of KFD described. Material and methodsThis was a records-based retrospective study of the patients with KFD referred for tertiary care management to Government Medical College Kozhikode, Kerala over 11 years, from January 2013 to December 2023. ResultsA total of 12 case records were obtained and analysed. All the patients in this case series belonged to tribal ethnic groups enhancing its social significance. The complications of KFD (as calculated in the 11 patients for whom all the records were available) were altered sensorium (nine, 82%), persistent shock (seven, 64%), Acute Respiratory Distress Syndrome (ARDS)/pneumonitis (six, 55%), encephalitis (six, 55%), myocarditis (six, 55%), bleeding manifestations (six, 55%), hepatitis (six, 55%), acute kidney injury (four, 36%), rhabdomyolysis (three. 27%), hemophagocytic lymphohistiocytosis (HLH) (two, 18%), stress hyperglycaemia (two, 18%), pancreatitis (one, 9%), peritonitis (one, 9%). The case fatality rate in this series was 42%( n=5/12). An autopsy was done on one patient which showed congested and oedematous lungs with subpleural haemorrhage. Petechial haemorrhages were noted in the liver, spleen and kidney. The total leucocyte count was lower than 2500 c/mm3 in 10 (90%) patients. Out of the four patients in whom serum ferritin was tested, it was elevated (above 500 ng/ml) in all patients; and was above 1000 ng/ml in three patients. Hemophagocytic lymphohistiocytosis was diagnosed in two patients. This is a unique finding of our series. Both of these patients succumbed to the illness. A cerebrospinal fluid study was done in six patients and revealed normal values except in one patient. Troponin assays were done in seven patients and were positive in five patients indicating that myocarditis is a major contributor to shock, which is one of the commonest complications in KFD. Serum creatinine phosphokinase ranged from 656 to 23,000 U/L. ConclusionsAltered sensorium was the most common alarming symptom that warrants referral to a higher centre. The major organ involvements that dominated the clinical presentation and course of illness were neurological complications, hypotension, significantly contributed by myocarditis and acute respiratory distress syndrome/pneumonitis. Encephalitis, myocarditis, ARDS and HLH were the major complications that caused mortality in our series. The elevated serum ferritin and the mortality associated with HLH described need further research to investigate the role of the macrophage system in the pathogenesis of severe KFD.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 92%

Section: Discussionmentioning

confidence: 96%

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A Case Series on the Spectrum of Complications Observed in Kyasanur Forest Disease

Gladson,

Mathew,

et al. 2024

Cureus

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“…The predominance of cases in adult males of specific age groups in our study is similar to that reported in literature and may be associated with occupational or behavioural factors that increase exposure to forest or farming activities and subsequently increase exposure to tick bites. 14,15,16 Emerging zoonotic diseases are known to disproportionately affect small holder farmers from marginalised communities whose residence and occupation is closely linked to forest. 17 Asaaga et al argue that access to disease information improved the ability of these marginalised groups to use adaptive strategies and hence preventive interventions should take into effect the social determinants of health.…”

Section: Discussionmentioning

confidence: 99%

Descriptive Epidemiology of Kyasanur Forest Disease in Thirthahalli Taluk, Shivamogga, 2018-2022

Srividya,

Bhavesh,

Choudhary

et al. 2024

Preprint

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Background Kyasanur Forest Disease (KFD) is a zoonotic viral disease caused by the Kyasanur Forest Disease Virus (KFDV), belongs to the family Flaviviridae, and is transmitted to humans through the bites of infected ticks, primarily in forested regions. Thirthahalli taluk from Shivamogga district of Karnataka has been reporting a consistently high burden of KFD. We describe the epidemiology of KFD cases in Thirthahalli taluk including their temporal and spatial distribution, correlate KFD hot spots with the number of cases, and identify high-risk groups. Methods We conducted a retrospective analysis of KFD surveillance data obtained from the district surveillance unit, Shivamogga, on human, tick, and monkey data, of Thirthahalli taluk from November 2017 to May 2022, described epidemiology, calculated the annual and seasonal time-trend of cases and correlated number of cases with number of tick pools and/ or monkey carcass positive for KFDV. We report Pearson correlation coefficient. We performed spatial analysis to identify clustering patterns and describe the PHC-wise disease burden. Results Thirthahalli taluk reported 326 cases, all were lab-confirmed using either RT-PCR (93%) or IgM-ELISA (7%); with an annual incidence rate of 45.9 per 100,000 population, 58% in males and median age 40 (IQR 28-51) years. Most (71,5%) cases occurred from February to April, case fatality rate was 1.8%. The maximum number of cases occurred in the years 2019 (38%) and 2020 (44%) crossing the outbreak threshold. The populations coming under six Primary Health Centre (PHCs) reported 84% of all cases and reported all deaths. There was correlation between the number of human cases in a PHC and tick pool positivity (r=0.62); and positive tick pools and positive monkey carcasses (r=0.71). Age groups with the highest average annual incidence were 45 to 49 years (8.4 per 100,000 population) and 50-54 years (8.1 per 100,000 population). Conclusion Thirthahalli taluk had an ongoing endemic transmission of KFD during the study period including two outbreaks in consecutive years. All deaths occurred in PHCs with a high case burden; occurrence of human cases per year was moderately correlated with tick pool positivity. Age groups most at risk for both the occurrence of the disease and mortality were middle-aged adult males. We recommend continued tick surveillance and monkey carcass testing to map disease hot-spots; and targeted interventions in high-burden PHCs and at-risk age groups for effective disease control. Keywords: Flaviviridae, Tick surveillance, Animal mortality surveillance, Zoonoses, One-health

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“…The ensuing encephalitis can result in death (1-20% case fatality rate) or permanent and debilitating neurological sequelae. 4,5 Four dengue serotypes comprise the dengue virus complex, with each serotype eliciting an antibody response capable of facilitating ADE, and more severe forms of dengue, upon subsequent infection with a distinct serotype. Mild liver injury with elevations in serum liver enzymes is not uncommon during infection.…”

Section: Liver Function Tests*mentioning

confidence: 99%

Hepatopathology of flaviviruses

Bailey¹,

Diamond²

2022

Journal of Hepatology

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Clinical and laboratory profile of patients with Kyasanur forest disease: A single-centre study of 192 patients from Karnataka, India

Cited by 8 publications

References 11 publications

A Case Series on the Spectrum of Complications Observed in Kyasanur Forest Disease

A Case Series on the Spectrum of Complications Observed in Kyasanur Forest Disease

Descriptive Epidemiology of Kyasanur Forest Disease in Thirthahalli Taluk, Shivamogga, 2018-2022

Hepatopathology of flaviviruses

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