Karnataka’s Minister for Health and Family Welfare Dinesh Gundu Rao, while answering a question on manufacturing a vaccine for Kyasanur Forest Disease (KFD), a viral infection, during the legislature session in December 2023, said that private manufacturers were not showing any interest in taking it up. The reason for the companies’ reluctance, he said, was that the number of people getting infected by the disease was too small and it does not make business sense for them, given the investment required for the research and development of a vaccine. This underlined the limitations of relying on private players in matters of serious public health issues.
Since the Minister made this statement, two people have died due to the disease in Karnataka. From January 1 to February 18, as many as 103 people have contracted the infection in three districts of Shivamogga, Uttara Kannada and Chikkamagaluru in Karnataka, stressing the need for an effective vaccination to contain this tick-borne disease. The positivity rate stands at 2.52 and the fatality rate at 1.94.
The disease has a history dating back to 1956 when it was first noticed in the Kyasanur forest areas of Sorab taluk in the hilly Shivamogga district. It has been named after the place. Since then, many experts have conducted research on its origin, spread, and impact on health. The disease is also known as “monkey fever”, as it also affects monkeys. too. The death of monkeys serves as a forecast for the KFD outbreak. Studies have shown that it spreads through tick bites. The ticks that come into contact with KFD-affected monkeys carry the disease to human habitats.
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For the first 15 years, the disease was confined to Shivamogga district. However, gradually, it has spread to other areas. Outside Shivamogga, It was noticed in Uttara Kannada district in 1972. Later, cases started being reported from Koppa in Chikkamagaluru, in 1980. By 1982, cases were reported in Dakshina Kannada district. It was traced in Chamarajanagara in the Old Mysore region in 2012. Then, in Belagavi in 2016, reached Gadag in 2017 (both in north Karnataka), and cases were reported in Mysuru and Hassan districts in 2019.
The virus has shown its presence in neighbouring States as well. An autopsy of a dead monkey in the Nilgiri district of Tamil Nadu in 2012 showed KFD virus. Six people were infected with the disease in Wayanad and Malappuram, Kerala, in 2013–14. An outbreak of KFD was reported in north Goa in 2015-16. Maharashtra also reported KFD cases in 2016.
The number of people who have died since 1956 is above 560. The highest number of deaths in a year was reported in 1983 (110) and 1984 (171), forcing the government to give approval for the manufacture of a vaccine to avoid the spread of the disease.
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With the help of the National Institute of Virology in Pune, the vaccine was developed from chick embryo fibroblast culture. It was administered in the KFD-affected areas until 2019-20. In the last year alone, 1.79 lakh people were covered by the vaccination programme. The data shows that the vaccination drive brought down the number of confirmed cases in the 1990s. However, recent tests have shown that the vaccine is now ineffective and the department stopped administering the vaccine. As of now, there is no vaccine and no proper medicine to treat the patients. Treatment is symptomatic.
The trends show that KFD human positive cases peak between December and June. During the rainy season, cases are hardly reported. Those who work in forests, firewood collectors, wildlife personnel, and those who enter forests for trekking are among the most vulnerable. The State government has been distributing tick-repellent oil to the people in the affected areas. Residents of villages close to forests have been advised to consult primary health centres as soon as they develop symptoms like high fever, redness in the eyes, and body pain. The Department of Health and Family Welfare has made it mandatory to treat all KFD patients in hospitals.
Karnataka government has approached the Indian Council of Medical Research (ICMR) about manufacturing vaccines. The ICMR in turn, is in consultation with Indian Immunologicals Limited. However, it is not clear when an effective vaccine will be available. As cases mount, it is clear vaccine will not be available this season for certain.
