Khumra Virus

It causes a severe peracute haemorrhagic fever in humans. The disease is manifested by hepatitis, encephalitis, bleeding from the gums, rectum, bloody vomition, melena, subcutaneous

ALKV was isolated for the first time in 1995, at Al-Khumra district, south of Jeddah. To the best of our knowledge, it has not so far been isolated from any other place outside Saudi Arabia. Preliminary studies indicated that the virus is most probably transmitted to humans through contact with animals and/or by ticks or mosquito bites.

As this virus is transmitted from animals to humans, it was necessary to seek collaboration between the chair and the relevant bodies such as the Ministry of Agriculture, Ministry of Health, Municipality, The Commission for Wildlife Conservation and The Islamic Bank for Utilization of Sacrificed animals during “Al-Hajj” season.

After the appearance of Rift Valley Fever (RVF) in Saudi Arabia for the first time outside the African continent in September 2000, the Saudi Ministry of Health developed and implemented strict plans to prevent the appearance of this disease in the Hajj (pilgrimage) period. Annually, 2-3 million people from all over the world convene in the holy city of Makkah in the Western Province of Saudi Arabia to perform Hajj, part of which involves slaughtering of hundreds of thousands of livestock animals. As part of active surveillance for viral hemorrhagic fever (VHF) in Makkah between 8 and 23 February 2001, the Hajj period of year 2001, all patients hospitalized with acute febrile illness were reviewed and clinically assessed by Prof. Tareq Madani. He identified 4 patients with typical acute VHF who were imprecisely diagnosed as acute hepatitis and encephalitis. Laboratory tests for RVF, Crimean-Congo hemorrhagic fever (CCHF), and dengue were negative in the 4 patients. Blood specimens were therefore sent to the centres for Disease Control and Prevention (CDC) for viral culture and testing for other hemorrhagic fever viruses. A new flavivirus closely related to the Indian tick-borne Kyasanur forest disease virus (KFDV) was isolated. This new flavivirus, however, was originally isolated in Jeddah, Saudi Arabia in 1995 from 6 patients with Dengue-like hemorrhagic fever. These 6 patients were from Alkhumra district, south of Jeddah, Saudi Arabia. Therefore, it was referred to it as Alkhumra virus (ALKV). The name ‘Alkhurma’ used by Charrel et al. and others, is not accurate as Alkhurma refers to a small city, 200km east of Makkah, which is different from Alkhumra district in Jeddah, from which the original cases were identified. After its first identification in Jeddah, ALKV was not reported until its reappearance in Makkah in 2001, following which a total of 37 cases, 20 of them laboratory-confirmed, were identified over a 24-monthes period. This study describes the epidemiological, clinical, and laboratory features of this new VHF.