Kyasanur Forest Disease Outbreak and Vaccination Strategy, Shimoga District, India, 2013–2014 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

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Kyasanur Forest Disease Outbreak and Vaccination Strategy, Shimoga District, India, 2013–2014 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 1—January 2015

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Kyasanur Forest Disease Outbreak and Vaccination Strategy, Shimoga District, India, 2013–2014

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• The Study
• Conclusions
• Suggested Citation

Figures

• Figure 1
• Figure 2

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S.K. Kiran, Achhelal Pasi, Satish Kumar, Gudadappa S. Kasabi, Prabhakara Gujjarappa, Aakash Shrivastava, Sanjay Mehendale, L.S. Chauhan, Kayla F. Laserson, and Manoj Murhekar 

Author affiliations: National Institute of Epidemiology, Chennai, India (S.K. Kiran, S. Mehendale, M. Murhekar);National Centre for Disease Control, Delhi, India (A. Pasi, S. Kumar, A. Shrivastava, L.S. Chauhan, K.F. Laserson);Department of Health and Family Welfare, Shimoga, India (G.S. Kasabi); Thirthahalli Taluk Hospital, Thirthahalli, India (P. Gujjarappa)

Suggested citation for this article

Abstract

We investigated a Kyasanur Forest disease outbreak in Karnataka, India during December 2013–April 2014. Surveillance and retrospective study indicated low vaccine coverage, low vaccine effectiveness, and spread of disease to areas beyond those selected for vaccination and to age groups not targeted for vaccination. To control disease, vaccination strategies need to be reviewed.

In India, Kyasanur Forest disease (KFD), a tickborne viral hemorrhagic fever that occurs as seasonal outbreaks during January–June (1,2), has been endemic to 5 districts of Karnataka State. However, during 2012–2013, KFD infection was reported from other districts and states in India: Chamarajanagara District, Karnataka State; Nilgiri District, Tamil Nadu State; and Waynad District, Kerala State (3).

Vaccination with formalin-inactivated tissue-culture vaccine has been the primary strategy for controlling KFD. The strategy involves mass vaccination in areas reporting KFD activity (i.e., laboratory evidence of KFD virus [KFDV] in monkeys, humans, or ticks) and in villages within a 5-km radius of such areas (Directorate of Health and Family Welfare Services, Government of Karnataka, 2005 manual on Kyasanur Forest disease; unpub. data). Two vaccine doses are administered at least 1 month apart to persons 7–65 years of age. Vaccine-induced immunity is short-lived, so the first booster dose of vaccine is recommended within 6–9 months after primary vaccination; thereafter, annual booster doses are recommended for 5 years after the last confirmed case in the area (4).

Figure 1. Map of Shimoga District, Karnataka State, India, showing the location of Thirthahalli and Hosanagara Taluks, which were affected by an outbreak of Kyasanur Forest disease virus during December 31, 2013–April 7,...

Beginning in January 2014, increased cases of unexplained fevers were reported from Thirthahalli Taluk, a subdistrict of Shimoga District (Figure 1). On February 6, 2014, the National Institute of Virology (Pune, India) confirmed the presence of KFDV in 5/12 serum samples from patients. We investigated the outbreak to describe the epidemiologic characteristics of KFD, estimate vaccine effectiveness (VE) and coverage, and propose recommendations for control.

Dr. Kiran is a senior medical officer with the Department of Health and Family Welfare, in Shimoga District, India, and he conducted this outbreak investigation as a part of a Master of Public Health course at the National Institute of Epidemiology, Chennai, India. His research interests include emerging and reemerging infectious diseases and vaccine-preventable diseases.

Acknowledgment

We gratefully acknowledge the assistance provided by Rajesh Suragihalli, K.S. Prakash, K.O. Narasimhamurthy, and Shama Begum Fakruddin.

References

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Figures

• Figure 1. Map of Shimoga District, Karnataka State, India, showing the location of Thirthahalli and Hosanagara Taluks, which were affected by an outbreak of Kyasanur Forest disease virus during December 31,...
• Figure 2. Distribution of 106 laboratory-confirmed Kyasanur Forest disease cases by date of symptom onset, Shimoga District, Karnataka State, India, December 2013–April 2014.

Table

• Table. Distribution of patients with laboratory-confirmed Kyasanur Forest disease, by age and sex, Shimoga District, Karnataka State, India, December 31, 2013–April 7, 2014

Suggested citation for this article: Kiran SK, Pasi A, Kumar S, Kasabi GS, Gujjarappa P, Shrivastava A, et al. Kyasanur Forest disease outbreak and vaccination strategy, Shimoga District, India, 2013–2014. Emerg Infect Dis. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.14-1227

DOI: 10.3201/eid2101.141227