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Monkey fever or Kyasanur Forest Disease (KFD) has claimed the lives of two people in Karnataka, calling for immediate action and implementation of preventive measures to stop the spread of the disease. Tick-borne hemorrhagic fever, which commonly affects monkeys, is caused by KFD virus, an arbovirus of the Flaviviridae family. Of the 49 positive cases in the state so far, an 18-year-old girl and a 79-year-old man have died of the disease. The initial symptoms of viral illness are sudden fever, headache, body ache, vomiting, abdominal pain and diarrhea. Whereas severe disease with hemorrhagic symptoms may occur later. It is important to control tick populations in wildlife, especially monkeys, to prevent the spread. (Also read: India on verge of eliminating ‘black fever’ kala-azar, the second deadliest parasitic disease)
What is monkey fever?
Kyasanur Forest Disease (KFD), commonly known as monkey fever, is a viral hemorrhagic disease that was first identified in 1957 in the Kyasanur Forest in the Western Ghats of India. It is caused by KFD virus (KFDV), an arbovirus of the Flaviviridae family.
“Initially the disease was confined to the Western Ghats of Karnataka, but over the last decade the disease has increased its presence, with reported cases spreading to the Western Ghats as well as neighboring states such as Kerala, Maharashtra and Tamil Nadu The burden of the disease is increasing, reflecting changes in its epidemiological profile and establishing it as an emerging tropical disease in India,” says Dr Laxman Jesani – Consultant Infectious Diseases, Apollo Hospitals Navi Mumbai.
“Recently, 31 cases have been detected in Uttara Kannada district of Karnataka, in which patients are either being treated at home or admitted to hospitals, but their condition is said to be stable. These are ongoing transmission and indicates the need for continued surveillance and preventive measures in affected areas,” says. Dr. Jesani.
How does monkey fever spread?
“Infection occurs through the bite of a tick carrying the virus or, more commonly, by contact with infected animals, primarily monkeys. Symptoms include fever with possible hemorrhagic and/or neurological features. While approximately 80% of patients Although patients recover without post-viral symptoms, approximately 20% may develop serious hemorrhagic or neurological problems. Estimates suggest that approximately 500 human KFDV infections occur annually and the case fatality rate is 3–5%. .Because it is life-threatening and lacks effective countermeasures, KFDV is classified as a biosafety level 4 (BSL4) pathogen,” says Dr. Jessani.
Symptoms of Monkey Fever
Monkey fever begins suddenly, with fever, chills, headache, and severe exhaustion, following an incubation period of 3 to 1 week following a tick bite.
“As the disease progresses, symptoms can include nausea, vomiting, abdominal pain, diarrhea, meningitis, confusion, and even hemorrhagic symptoms such as nose bleeding and bleeding gums. Without proper supportive treatment Complications like shock, dehydration, electrolyte disturbances, bleeding and the like can occur. “Organ failure can occur and can be fatal,” says Dr Shruti Sharma, Consultant-Internal Medicine, Yatharth Super Specialty Hospital.
“The incubation period of the virus is 3-8 days and it manifests in two or rarely four stages. In the first stage, symptoms include sudden fever, headache, body aches, conjunctiva swelling, vomiting, abdominal pain and diarrhea Clinical examination reveals lymphadenopathy, hepato-splenomegaly, weakness and fatigue. Hemorrhagic symptoms may occur, most patients recover in 10-14 days,” says Dr. Jessani.
“Early symptoms often include a sudden high fever with chills. Severe headache and muscle pain are common, making the infected person feel extremely unwell. Nausea, vomiting and diarrhea may occur, affecting the digestive system In severe cases, it can lead to bleeding tendencies, which can result in several complications,” says Dr. Manjusha Agarwal, Senior Consultant, Internal Medicine Global Hospitals, Parel, Mumbai.
The virus can damage vital organs, leading to organ failure. Severe cases can turn into hemorrhagic fever, causing internal bleeding and potentially fatal consequences. If hemorrhagic symptoms persist, the second stage may lead to serious neurological complications such as drowsiness, disorientation, confusion, convulsions, and loss of consciousness.
“Although most patients recover with low fever and rare long-term complications, persistent bleeding issues can lead to poor outcomes, with a 2-10% mortality rate. Higher mortality rates appear in non-endemic areas, possibly “People with weakened immune systems or older age are at greater risk for serious outcomes,” says Dr. Jesani, due to low herd immunity and delayed diagnosis.
“The virus can damage vital organs, leading to organ failure. Severe cases can turn into hemorrhagic fever, causing internal bleeding and potentially fatal outcomes,” says Dr Agarwal.
Diagnosis, Prevention and Management Tips
“Because of the vagueness of early symptoms, diagnosis of monkey fever depends on clinical suspicion and confirmatory laboratory tests such as the ELISA antibody test and RT-PCR test that can identify the immune response to KFDV and viral genetic material, respectively. Since there are no antiviral drugs that directly target KFDV, management includes symptomatic relief, close monitoring of complications, nutrition, and maintenance of organ function. Preventive measures include controlling the spread of tick populations. “To control, emphasis is placed on personal protection against ticks in outbreak areas through repellents and appropriate clothing as well as spraying of acaricides,” says Dr. Sharma name of cast.
“Early detection is important for effective management. Preventive measures include avoiding tick bites through protective clothing, repellents, and caution in endemic areas. Education and awareness are important for at-risk populations. Kyasanur Forest is a safe haven for the disease. The vaccine is recommended for those visiting endemic areas, with vaccination campaigns effectively reducing the incidence of the disease. Dr. Jessani says, “The current vaccine is a 0.1% formalin inactivated tissue culture vaccine, and ongoing research is more effective Let’s explore options.”
“Management includes supportive care, symptom relief and complication treatment, as there is no specific antiviral for KFD. Severe cases may require hospitalization for complication management,” the expert says.
Dr. Aggarwal shares tips for prevention and management of monkey fever:
1. A vaccine is available in endemic areas, which provides protection against KFD.2. Wearing protective clothing, using tick repellent, and avoiding tick-infested areas reduces the risk of transmission.
2. Monitoring and controlling tick populations in wildlife, especially monkeys, can help prevent the spread of the virus.
how care
1. There is no specific antiviral treatment for KFD, so medical care focuses on reducing symptoms and providing supportive measures.
2. Severe cases may require hospitalization for close monitoring and intensive care.
3. Maintaining hydration is important to control fever and prevent complications.
4. Analgesics and antipyretics may be prescribed to ease pain and reduce fever.
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