Associated direct animal contact with AHFV incidence, albeit in a non-causal manner. The high frequency of housewives also corroborates previous studies that epidemiologically linked AHFV infected housewives in Najran with histories of tick bites. However that as much as a third of cases had no jobs directly related to animal handling or its potentially infected products might just suggest there could be other modes of transmission of the virus. Also, the good proportion of women of more than 40% observed over these three years can be explained by the burden of taking care of livestock often kept within the Saudi compounds borne by these women which could have increased their risk of exposure to tick bites. The vast majority of non- Saudis do not keep animals where they live because their residences are usually not suitable for keeping animals and so this could have limited their direct contact with animals. This might also be a likely explanation for the low proportion of female non-Saudis among cases of the AHFV found in this study. Of all clinical symptoms observed in the AHFV infected patients in our study, gastro intestinal symptoms such as anorexia, nausea, abdominal pain and vomiting were present in almost all the patients. This was followed by some form of pain in about 90% of AHFV infected cases. Our study also noted that hemorrhagic manifestations such as epitasix occurred in less than 5% of cases. On the other hand, CNS involvement, manifesting as disorientation, hallucination and convulsions, occurred in less than 30% of the patients. These data should be of value in the clinical diagnosis, case definition and management of acute AHFV infections. Our study showed that a distinctively high proportion of cases were reported by the Najran region, an agricultural area with emphasis on livestock farming might be the consequences of a higher exposure to direct contact with animals. Also, it seemed enhanced surveillance including case investigation in the Najran region may explain the high number of reported cases from this region compared to other regions like Makkah, Jizan, Taif and Asir which have similar agricultural conditions. Also, the presence of putative tick vectors in the region and a higher exposure of females to animals and animal products as housewives could have contributed to the high number of female cases. However, the absence of a history of tick bite does not rule outtick exposure because tick vectors have been observed in the past and recently in almost all parts of KSA regions that are Saikosaponin-C presently reporting AHFV cases. It can also not be ruled out that transmission of the virus is occurring elsewhere within the country but remains undetected. The singular and first ever case reported from Turbah in the Taif region was fatal. It was diagnosed in a health facility in Jeddah and initially thought to be a case of Dengue infection, and so other similar cases from that region might have been missed or misdiagnosed as Dengue or Brucellosis. Although there is no data on the Procyanidin-B1 sensitivity or specificity of PCR assay used to confirm AHFV cases in this study, published data showed that the PCR is sensitive in detecting active disease. To enhance surveillance and address the issue of misdiagnosis and under-reporting, the Ministry of Health in KSA has produced a comprehensive set of guidelines for the diagnosis, management, reporting and prevention of AHFV infection. The guidelines also emphasized the immediate implementation of health education programs within the community in order to prevent transmission especially in communities thought to be at high risk of AHFV infection AHFV. The influenza viruses are members of the orthomyxoviridae family of which there are three distinct types – A, B, and C.