Alkhurma Hemorrhagic Fever | Risks factors and Preventive measures

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Alkhurma hemorrhagic fever also known as (AHF) is a viral hemorrhagic disease. The causative agent of Alkhurma hemorrhagic fever is Alkhurma hemorrhagic fever virus which is a tick-borne virus of the Flavivirus family.This disease is mainly reported in Saudi Arabia. It is reported that this virus was isolated at first in 1994 from a patient in Jeddah, Saudi Arabia. The patient was a butcher and he had severe illness. There are records that this patient got the condition after he had butchered a sheep brought from Alkhurma, Makkah province. That is exactly how this disease got its name. Most of the cases of this disease were reported among Butchers. The fatality rate of this disease is said to be around 30 percent.

Around 40 cases of Alkhurma hemorrhagic fever have been reported since 1994.While some other sources claim hundreds of cases since the beginning. It is also reported that many tourists in Egypt also came in contact with this virus. This means that Alkhurma hemorrhagic fever cannot be limited to a certain geographical territory or inside Saudi Arabia only. It is an indication that cases of its infection have been under-reported. The causative agent of this condition is a Flavivirus which genetically belongs to the tick-borne group closely related to Kyasanur forest disease virus. Kyasanur forest disease virus is a severe tick-borne hemorrhagic disease reported in Karnataka state, India.  Kyasanur Forest disease virus shares 89% nucleotide sequence homology with Alkhurma hemorrhagic fever virus. It seems that both these viruses had diverged 700 years back. Other related viruses are Karshi virus and Farm Royal virus.

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Transmission of Alkhurma Hemorrhagic Fever

Ticks are the known vectors of this virus. Alkhurma hemorrhagic fever virus is a zoonotic virus. It’s described tick hosts the soft tick, Ornithodoros savignyi, and the hard tick, Hyalomma dromedaries are widely distributed. Generally, hard ticks transmit Tickborne flaviviruses but Alkhumra viral RNA has been detected in soft ticks called Ornithodoros savignyi.  A person can be infected with the virus when bitten by the tick or also by crushing infected ticks. It can be transmitted by coming in contact with infected blood on a skin wound for example during animal slaughter. This is the reason why most butchers were infected with this virus. This disease can also be transmitted by consumption of dairy products from infected animals like a camel. Though there is no exact information about the incubation period of this virus it is estimated that it is 3-8 days which is similar to other tick-borne flavivirus infections. Human to human transmission of this disease has not been reported till date.

Risk factors of Alkhurma Hemorrhagic Fever

People who work with the animals or in animal farms are at high risk of getting Alkhurma Hemorrhagic Fever. As it is evident that most of the patients reported were butchers so contact with animals that are exposed to ticks can be a big risk factor. The infected tick may bite or the virus may enter through any wounds or openings on the skin of the human being. Animals or pets at home infected with ticks can also increase the chances of getting the disease. A lot of research and study is yet to be done about Alkhurma Hemorrhagic Fever. A proper understanding of Alkhumra virus transmission cycle is necessary to reveal further information. There is a potential of spread of this disease at a large scale because of large livestock trade between neighboring countries. So this thing also should be considered with care while involving in international trade of livestock.

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Signs and symptoms of Alkhurma Hemorrhagic Fever

There is very limited information regarding Alkhurma Hemorrhagic Fever but based on whatever information we have available, the signs and symptoms are as given below.

  1. In the beginning stages, the disease may seem like flu, with symptoms like loss of appetite, Vomiting, and diarrhea.
  2. In the second stage, the disease may develop serious neurologic and hemorrhagic symptoms.
  3. There are also chances of multiple organ failures in case of serious infection.
  4. There can be symptoms of Thrombocytopenia, leukopenia, and elevated liver enzymes in patients who are hospitalized.
  5. Once the patient recovers, no repeated symptoms have been reported.

Diagnosis of Alkhurma Hemorrhagic Fever

Diagnosis at the right time is extremely important in case of Alkhurma Hemorrhagic Fever too because only a proper diagnosis can ensure necessary treatment. A necessary treatment on time can avoid any complications. Exact clinical diagnosis is difficult because there are similarities between AVHF, Crimean-Congo Hemorrhagic fever, and Rift Valley fever. They all occur in similar geographical areas. Molecular detection by PCR or virus isolation from blood can be done to detect the virus in the early stages. Serologic testing using enzyme-linked immunosorbent serologic assay can be done to identify it in the later stages. It helps to determine possible cross-reactions with other flaviviruses.

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Treatment of Alkhurma Hemorrhagic Fever

There is no treatment available for Alkhurma Hemorrhagic Fever. The doctors treat the patient according to the signs and symptoms noticed. The medical professionals and doctors resort to supportive therapy for this disease. Supportive therapy may include balancing the fluid and electrolytes in the patient’s body. Oxygen status and blood pressure also have to be maintained. In case of any complications, immediate emergency treatment has to be provided. According to published researches, the mortality rate in hospitalized patients stands at around 1-20%.

Preventive measures of Alkhurma Hemorrhagic Fever

For any health-related problems, Preventive measures are the best options because it is better to be safe than sorry. In addition to that, this disease, Alkhurma Hemorrhagic Fever has no specific treatment discovered yet. So prevention and staying safe from it can be considered as the best available option. The preventive measures are as mentioned below:

  1. It is necessary to stay away from tick-infested areas.
  2. Avoid contact with animals which have a possibility of being infested with ticks.
  3. Use tick repellants on skin and clothes and check skin for attached ticks.
  4. Tick collars can be used on a domestic animal to get rid of it.
  5. Those people working in slaughterhouses and animal farms should be extra cautious.
  6. It is important to avoid unprotected contact with the blood, fluids, or tissues of any potentially infected animals.

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