Alkhurma haemorrhagic fever—a viral haemorrhagic disease unique to the Arabian Peninsula

The emergence and re-emergence of human and animal pathogens on a global scale continues unabated. One such pathogen is the arbovirus that causes Alkhurma haemorrhagic fever, which emerged in the Kingdom of Saudi Arabia in the mid 1990s. It has since re-emerged in other regions of the country and threatens to widen its area of endemicity beyond the peninsula. Human and animal movements, especially those associated with the annual mass gathering event of Hajj (pilgrimage) may facilitate introduction into other continental masses, where it must be differentiated from dengue and other similar arboviral haemorrhagic fevers. In addition to dengue and Kadam viruses, which are known to be endemic in Saudi Arabia, it is thought that other flaviviruses exist in the region, though undetected. Collectively, these viruses present diagnostic challenges that may confound the recognition of clinical cases of Alkhurma haemorrhagic fever. The Saudi Ministry of Health is making concerted efforts to expand the evidence base in order to enhance the diagnostic and preventive protocols used to address the challenge of Alkhurma haemorrhagic fever.