Am. Zaki, ISOLATION OF A FLAVIVIRUS RELATED TO THE TICK-BORNE ENCEPHALITIS COMPLEX FROM HUMAN CASES IN SAUDI-ARABIA, Transactions of the Royal Society of Tropical Medicine and Hygiene, 91(2), 1997, pp. 179-181
Citations number
13
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
A flavivirus related to the tick-borne encephalitis complex was isolat
ed from the blood of 6 male butchers, aged 24-39 years, in Jeddah, Sau
di Arabia in November and December 1995. Two of the patients died and
the other 4 recovered completely. Four more patients, 3 males and 1 fe
male, were diagnosed serologically by immunoglobulin M capture enzyme-
linked immunosorbent assay and seroconversion in acute and convalescen
t blood samples examined by indirect immunofluorescent test using Vero
cells infected with the isolated virus. The virus identity was confir
med at the Centers for Disease Control and Prevention, Fort Collins, C
olorado, USA, by the polymerase chain reaction; it was closely related
to Kayasanur Forest disease virus. All infected patients had similar
clinical and laboratory symptoms and signs, including fever, headache,
generalized body aches, arthralgia, anorexia, vomiting, leucopenia, t
hrombocytopenia, elevated liver enzymes (serum glutamic oxalacetic and
serum glutamic pyruvic transaminases), elevated creatinine phosphokin
ase, and elevated blood urea. One patient developed symptoms of enceph
alitis, but survived without any sequel. Skin rash developed in 2 pati
ents, morbilliform on the hands, feet, and lower abdomen of one patien
t and purpuric associated with melaena in the second patient. Eight of
the 10 confirmed patients were working with sheep, and the disease ma
y be a zoonotic viral infection.