Abstract
Alkhurma virus is a flavivirus discovered in 1994 in a person who died of hemorrhagic fever after slaughtering a sheep from the city of Alkhurma, Saudi Arabia Since then several cases of Alkhurma hemorrhagic fever (ALKHF) with fatality rates up to 25% have been documented From January 1 2006 through April 1 2009 active disease surveillance and serologic testing of household contacts identified ALKHF in 28 persons in Najran Saudi Arabia For epidemiologic comparison serologic testing of household and neighborhood controls identified 65 serologically negative persons Among ALKHF patients 11 were hospitalized and 17 had subclinical infection Univariate analysis indicated that the following were associated with Alkhurma virus infection contact with domestic animals feeding and slaughtering animals handling raw meat products drinking unpasteurized milk and being bitten by a tick After multivariate modeling the following associations remained significant animal contact neighboring farms and tick bites