Madani Tariq A
Department of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
J Infect. 2005 Aug;51(2):91-7. doi: 10.1016/j.jinf.2004.11.012. Epub 2005 Jan 11.
Four patients with typical acute viral hemorrhagic fever were identified in the holy city of Makkah, Saudi Arabia, between 8 and 23 February 2001, the Hajj (pilgrimage) period of that year. Tests for Rift Valley fever (RVF), Crimean-Congo hemorrhagic fever (CCHF), and dengue were negative. Blood specimens were sent to the Centres for Disease Control and Prevention (CDC), Atlanta for viral culture and testing for other hemorrhagic fever viruses. A new flavivirus closely related to the tick-borne Kyasanur forest disease virus was isolated. This new flavivirus was originally isolated in 1995 from 6 patients with dengue-like hemorrhagic fever from Alkhumra district, south of Jeddah, Saudi Arabia.
A case definition was formulated for surveillance of this new disease in Saudi Arabia. Blood specimens were collected from all patients with suspect 'Alkhumra' virus (ALKV) infection and tested for ALKV, RVF, CCHF, dengue, and West Nile encephalitis. Patients data were prospectively collected on standardized data collection forms.
From 8 February 2001 through 9 February 2003, a total of 37 cases were identified in Makkah, 20 of them were laboratory confirmed. Acute febrile flu-like illness with hepatitis (100%), hemorrhagic manifestations (55%), and encephalitis (20%) were the main clinical features. The case fatality was 25%. The disease seemed to be transmitted from sheep or goat to humans by the mosquito bites or direct contact with these animals.
ALKV infection is a novel serious zoonotic hemorrhagic fever virus discovered in Saudi Arabia. The role of arthropods such as ticks and mosquitoes, and animals such as sheep, goat, and rodents in the transmission and maintenance of the virus remains to be elucidated.
2001年2月8日至23日，即当年的朝觐（朝圣）期间，在沙特阿拉伯圣城麦加发现了4例典型急性病毒性出血热患者。裂谷热（RVF）、克里米亚-刚果出血热（CCHF）和登革热检测均为阴性。血液标本被送往亚特兰大疾病控制与预防中心（CDC）进行病毒培养及其他出血热病毒检测。分离出一种与蜱传卡萨努尔森林病病毒密切相关的新型黄病毒。这种新型黄病毒最初于1995年从沙特阿拉伯吉达以南的阿尔胡姆拉地区6例登革热样出血热患者中分离得到。
制定了沙特阿拉伯这种新疾病的监测病例定义。采集了所有疑似感染“阿尔胡姆拉”病毒（ALKV）患者的血液标本，检测ALKV、RVF、CCHF、登革热和西尼罗河脑炎。前瞻性地在标准化数据收集表上收集患者数据。
2001年2月8日至2003年2月9日，麦加共确诊37例病例，其中20例经实验室确诊。主要临床特征为伴有肝炎（100%）、出血表现（55%）和脑炎（20%）的急性发热性流感样疾病。病死率为25%。该疾病似乎通过蚊虫叮咬或直接接触绵羊或山羊等动物从羊或山羊传播给人类。
ALKV感染是在沙特阿拉伯发现的一种新型严重人畜共患出血热病毒。蜱和蚊子等节肢动物以及绵羊、山羊和啮齿动物等动物在该病毒传播和维持中的作用仍有待阐明。
