KFDV Alkhurma Subtype in Ticks, Saudi Arabia | CDC EID

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Volume 17, Number 5–May 2011
Letter
Kyasanur Forest Disease Virus Alkhurma Subtype in Ticks, Najran Province, Saudi Arabia
Mustafa Mahdi, Bobbie Rae Erickson, J. Andy Comer, Stuart T. Nichol, Pierre E. Rollin, Mohammed A. AlMazroa, and Ziad A. Memish
Author affiliations: Najran Preventive Medicine Department, Najran, Saudi Arabia (M. Mahdi); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (B.R. Erickson, J.A. Comer, S.T. Nichol, P.E. Rollin); and Ministry of Health, Riyadh, Saudi Arabia (M.A. AlMazroa, Z.A. Memish)


Suggested citation for this article

To the Editor: The lineage of Kyasanur Forest disease virus (KFDV) found in the Kingdom of Saudi Arabia is commonly referred to as Alkhurma hemorrhagic fever virus (AHFV). This virus was first isolated from a specimen collected in 1994 from a butcher living in Makkah Province, who was hospitalized for a hemorrhagic fever from which he died (1). The virus was assigned to the genus Flavivirus on the basis of reactivity with genus-specific monoclonal antibodies and sequencing of a fragment of the nonstructural 5 (NS5) gene, which showed >89% identity with KFDV. Ten other cases were confirmed among patients who had leukopenia, thrombocytopenia, and elevated liver enzymes. Observations of patients in the original study or in a subsequent analysis (2) suggested that Alkhurma hemorrhagic fever (AHF) disease was associated with contact with blood from infected animals, bites from infected ticks, or the drinking of raw milk. However, the exact mode of transmission to humans has still not been fully elucidated. More recently, AHFV RNA was detected in a single pool of sand tampans (Ornithodoros savignyi, soft ticks), collected in western Saudi Arabia (3), which suggests a link with these ticks.

To analyze the virus association with arthropods further, we collected and identified ticks and mosquitoes in Najran Province, southern Saudi Arabia, during May and June 2009 from different sites close to where human AHF cases had been recently confirmed (4,5). Camel ticks (Hyalomma dromedarii) (130 adults) were collected while they fed on camels, and O. savignyi sand tampans (243 adults) were collected from the ground in camel resting places (except 1 collected while feeding on a camel). Mosquitoes were collected by using light traps (203 Culex decens females) or as larvae that were then raised in the laboratory (9 Culiseta sp. females). Ticks and mosquitoes were stored at room temperature and killed by overnight freezing the day before shipping to the Centers for Disease Control and Prevention (Atlanta, GA, USA). All arthropods were processed in the BioSafety Level 4 laboratory by injecting Vero E6 cells and by intracerebrally inoculating suckling mice with ground pools of either 5 ticks or 10 mosquitoes. All the tick material was used for the tested pools. Isolates of AHFV were obtained from 1 of 13 pools of H. dromedarii ticks and 1 of 6 pools of O. savignyi sand tampans, both from Al Mishaaliyia district, and from 5 of 8 pools of O. savignyi sand tampans from the Al Balad Magan camel market. Virus identity was confirmed by sequencing a 390-nt fragment from the virus core protein C and preM genes. No virus was isolated from any mosquito suspensions.

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KFDV Alkhurma Subtype in Ticks, Saudi Arabia | CDC EID


Suggested Citation for this Article
Mahdi M, Erickson BR, Comer AJ, Nichol ST, Rollin PE, AlMazroa MA, et al. Kyasanur Forest disease virus Alkhurma subtype in ticks, Najran Province, Saudi Arabia [letter]. Emerg Infect Dis [serial on the Internet]. 2011 May [date cited].
http://www.cdc.gov/EID/content/17/5/945.htm

DOI: 10.3201/eid1705.101824


Comments to the Authors
Please use the form below to submit correspondence to the authors or contact them at the following address:

Pierre E. Rollin, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop G14, Atlanta, GA 30333, USA; email: pyr3@cdc.gov