GOVERNMENT OF KARNATAKA OFFICE OF THE DEPUTY

GOVERNMENT OF KARNATAKA
OFFICE OF THE DEPUTY DIRECTOR, VIRUS DIAGNOSTIC
LABORATORY, SHIMOGA.
KARNATAKA STATE.
E,mail [email protected] ,
Phone/ Fax 08182 - 222050
No.VDL/KFD/DIA/216/13-14
Dated 03-03-2014.
CIRCULAR ON KYASANUR FOREST DISEASE
SUB:- Control measures for prevention of Kyasanur Forest Disease In the year
2013-14.
Kyasanur forest disease is an arthropod borne viral disease discovered in
shimoga district of Karnataka state during March-1957. ETIOLOGY:- The disease
is caused by " B" group Arbo Virus. The agent KFD Virus is a RNA Genome
Virus of the genus flavi virus, Family flavi viride. It is antigenicaly related to
Langat, DHF and westnile viruses.
GEOGRAPHICAL DISTRIBUTION;KFD was persisting only in 5 Districts of Karnataka namely Shimoga,
Chickmagalur, Dakshina Kannada, Uttara Kannada and Udupi till 2012. In
December -2012 incidences of KFD was confirmed in monkeys, Ticks and Human
in Chamarajanagara District. Incidence of KFD in Monkey was confirmed in
Mysore distri ct in January-2013. Later incidences of KFD in monkey was also
confirmed in Nilgiris district of Tamilnadu. One incidence of Human was
confirmed In Kerala State also.
EPIDEMIOLOGY:- The disease affects all ages in both sexes . But it is common
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in young people who are more exposed to forest. This is a seasonal disease usually
from December to May. During this period, nymphal stage of Tick is very active,
the exposure of Human is also more in the forest.
MODE OF TRANSMISSION;- The disease is transmitted by the bite of infected
ticks. The nymphal stage of tick is primarily responsible for the transmission of
the disease. The ticks once infected remains infective through out their life. The
tick belongs to genus Heamophysalis and speices spinigera which is the
commonest vector. Incubation period is 3 - 8 days.
CLINICAL SIGNS AND SYMPTOMS:- The onset is sudden with high fever,
severe headache, Nausea and Severe bodypain more in back and legs. The viremia
is upto 12 days maximum between 3 - 6 days. Persons with above symptoms may
be treated in the nearest Primary Health Centre. I E C activities to be carried out
for the local people.
HAEMATOLOGICAL MANIFESTATION:- There may be bleeding from
nose, gums, rectum, urethra person may become hypotensive leading to shock.
NEUROLOGICAL SYMPTOMS;- Drowsiness, twitching of muscles, tremors,
convulsions and neck stiffness.
TREATMENT FOR THE KFD PATIENTS;- There is no specific treatment for
KFD. Hence, all the patients are treated symptomatically. Correction severe
dehydration by infusion of I.V. Fluids, use of antipyretics to control fever help in
recovery of patients. There is no special drug for KFD, therefore following steps
are adopted for treating the patients.
a) Early hospitalization.
b)
Absolute bedrest.
c)
Administration of oral and I.V.Fluids.
d)
Vitamin C and K.
e)
Antibiotics.
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f) Eye ointment.
g)
Injection perinorm.
h) If there is cerebral edema 10% Dextrose I.V or Manitol should be
administered.
i)
Inj. Batrophase and blood transfusion in case of haemorraghic symptoms.
SURVEILLANCE PROGRAMME;- Active and intensive surveillance should
be carried out. The following preventive measures are to be taken in KFD
epidemic area.
1) People should be advised not to go to the forest where monkey deaths are
reported.
2) Persons whose visit to the forest is inevitable should be advised to cover the
body with thick cloths and Gum boots.
3)
Application of D.M.P Oil (Insect repellent) to expose parts before going to
forest.
4)
Washing clothes and body with hotwater and soap, after returning from the
forest.
5) Incidences of human fever cases and unnatural monkey deaths occurred KFD
epidemic area to be monitored and detail information be communicated to health
authorities.
6)
Monkey death should be reported to the nearest PHC/PHU/CSC/GH. Samples
of brain, Lungs, Heart, Kidney and Lever may be collected from dead monkey
(Fresh) in Sterile plastic vials by Health workers with the co-operation of local
Veterinarians and transported in cold chain to VDL, Shimoga. Carcass of the dead
monkey should be burnt after collection of samples. Hot spot dusting with
Malathion powder in the areas were monkey death have been reported with in 50
meter radius around the spot of monkey death besides the endemic foci.
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7)
Haemaphysalis spinigera, H.Turturis, H.Kinneri and H.Kyasanurensis, are the
commonest vector of KFD. Collection of ticks, larvae, nymphs are carriedout by
flag dragging method. Some of the ticks are collected from domestic animals and
body of the forest workers and arround Hot spots where unnatural monkey deaths
have occurred by plucking method. Ticks samples are labled and sent in cold-chain
to VDL.Shimoga.
8) The surveillance programme includes detection of Human fever cases.
Collection of suspected human blood samples for diagnosis is necessary. 3 - 5 ml
of serum is to be collected aseptically labled and sent in cold-chain to VDL
Shimoga.
KFD VACCINATION PROGRAMME;- KFD vaccination is the Key for the
whole programme. The timing of vaccination should be linked to the transmission
cycle so that people can be protected. Population at risk should immunized.
a) Population at risk
1) Previously affected villages.
2)
Surrounding villages of 5 kms radius around monkey deaths, Tick positives
and Human positives.
b) Planning of vaccination:1) Population at risk are to be identified.
2)
Estimation of doses of vaccine required.
3)
Emphasis should be on I.E.C. activities to create awareness about vaccination
in the community.
C) Vaccination schedule:1) Two doses at an interval of one month.
2) Age group 6 - 14 years - 0.5 ml S C route.
15 - 65 years - 1.0 ml S C route.
4)
Booster dose is administered after 6 - 9 months.
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Warning: Vaccine should not be administered to pregnant women, person
allergic to Gentamycin, Crystaline pencilin and Egg protein, and also to person
with symptoms of Jaundice and Cardiac complaints.
There will be irritation at the site of inoculation for 2 - 8 minutes.
D) Storage of Vaccine:1) Vaccine should be stored at + 2 C to + 4 C temperature. Vaccine should not
be frozen at any cost, if frozen discard.
I/C DEPUTY DIRECTOR,
VIRUS DIAGNOSTIC LABORATORY,
SHIMOGA.
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