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Gokuden M, Fukushi S, Saijo M, Nakadouzono F, Iwamoto Y, Yamamoto M, Hozumi N, Nakayama K, Ishitani K, Nishi N, Ootsubo M. Low Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Virus Antibodies in Individuals Living in an Endemic Area in Japan. Jpn J Infect Dis 2018; 71:225-228. [PMID: 29709983 DOI: 10.7883/yoken.jjid.2017.497] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infection with a high mortality rate. It is caused by the SFTS virus (SFTSV) and is endemic in some areas in western Japan, including the Kagoshima prefecture. In the present study, healthy individuals living in this prefecture were examined to assess for anti-SFTSV seroprevalence. An initial study was performed using the serum samples collected from a total of 646 individuals living in Kagoshima. At the same time, a questionnaire was used to collect information (such as occupation and a history of tick bite). Enzyme-linked immunosorbent assay and indirect immunofluorescence assay were used for the screening. Finally, the seroprevalence of anti-SFTSV antibodies was confirmed using a neutralization assay. Only 2 (0.3%) out of 646 study participants were positive for anti-SFTSV antibodies. No significant difference was observed between individuals who are at a high or low risk of tick bite in terms of seropositivity. Next, a total of 1,000 serum samples collected from general blood donors by the Japanese Red Cross Kyushu Block Blood Center were tested. None of these samples tested positive for anti-SFTSV antibodies. These results suggest a low seroprevalence of anti-SFTSV antibodies in healthy individuals living in an endemic area in Japan.
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Affiliation(s)
- Mutsuyo Gokuden
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | - Shuetsu Fukushi
- Department of Virology 1, National Institute of Infectious Diseases
| | - Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases
| | - Fumiko Nakadouzono
- Health Promotion Division of the Health and Social Welfare Department, Kagoshima Prefecture
| | - Yuka Iwamoto
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | - Mami Yamamoto
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | - Nodoka Hozumi
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | - Kouichiro Nakayama
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | - Kanji Ishitani
- Aira Public Health Center, Health Social Welfare and Environmental Department, Aira-Isa Regional Promotion Bureau
| | - Nobuyuki Nishi
- Kaseda Public Health Center, Health Social Welfare and Environmental Department, Nansatsu Regional Promotion Bureau
| | - Mitsuhiro Ootsubo
- Kagoshima Prefectural Institute for Environmental Research and Public Health
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Kang JG, Cho YK, Jo YS, Chae JB, Oh SS, Kim KH, Ko MK, Yi J, Choi KS, Yu DH, Kim HC, Park J, Park BK, Choi CY, Jung YH, Chae JS. Prevalence of severe fever with thrombocytopenia syndrome virus in black goats (Capra hircus coreanae) in the Republic of Korea. Ticks Tick Borne Dis 2018; 9:1153-1157. [PMID: 29724620 DOI: 10.1016/j.ttbdis.2018.04.018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 04/24/2018] [Accepted: 04/25/2018] [Indexed: 11/24/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne pathogen in China, Japan, and the Republic of Korea (ROK). The aim of this study was to investigate the prevalence of SFTSV antigens and anti-SFTSV antibodies in black goats (Capra hircus coreanae) throughout the ROK. Sera were collected from 737 black goats in nine provinces in the ROK. Eighteen of 737 (2.4%) goat sera were positive for SFTSV on one-step reverse transcription nested polymerase chain reaction. The amplified 346-bp S segments of SFTSV sequences were classified into three genotypes (BG1, BG2, and BG3), and were included in the Japanese clade rather than the Chinese clade, based on phylogenetic analysis. Forty-three of 624 (6.9%) serum samples were seropositive for anti-SFTSV antibodies on enzyme-linked immunosorbent assay analysis. This study is the first to examine the molecular prevalence of SFTSV in goats and the first to perform serological detection of anti-SFTSV antibodies in livestock in the ROK. Moreover, the results indicate that SFTSV is widely distributed in goats and that additional monitoring for SFTSV is needed in livestock in the ROK.
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Affiliation(s)
- Jun-Gu Kang
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Yoon-Kyoung Cho
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Yong-Sun Jo
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Jeong-Byoung Chae
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Sung-Suck Oh
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea
| | - Kye-Hyung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Mee-Kyung Ko
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Jongyoun Yi
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan 49241, Republic of Korea
| | - Kyoung-Seong Choi
- College of Ecology and Environmental Science, Kyungpook National University, Sangju 37224, Republic of Korea
| | - Do-Hyeon Yu
- College of Veterinary Medicine, Gyeongsang National University, Jinju 52828, Korea
| | - Hyeon-Cheol Kim
- College of Veterinary Medicine, Kwangwon National University, Chuncheon, Gangwon 24341, Republic of Korea
| | - Jinho Park
- College of Veterinary Medicine, Chonbuk National University, Iksan 54596, Republic of Korea
| | - Bae-Keun Park
- Research Institute of Veterinary Medicine and College of Veterinary Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Chang-Yong Choi
- National Institute of Animal Science, RDA, Jeonju 55365, Republic of Korea
| | - Young-Hun Jung
- National Institute of Animal Science, RDA, Jeonju 55365, Republic of Korea
| | - Joon-Seok Chae
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative for Veterinary Science Research, Research Institute of Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul 08826, Republic of Korea.
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53
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Robles NJC, Han HJ, Park SJ, Choi YK. Epidemiology of severe fever and thrombocytopenia syndrome virus infection and the need for therapeutics for the prevention. Clin Exp Vaccine Res 2018; 7:43-50. [PMID: 29399579 PMCID: PMC5795044 DOI: 10.7774/cevr.2018.7.1.43] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 01/06/2018] [Accepted: 01/13/2018] [Indexed: 01/13/2023] Open
Abstract
Over the past ten years there has been a marked increase in cases of severe fever and thrombocytopenia syndrome in East Asia. This tick-borne hemorrhagic fever presents along with clinical signs including high fever and leukopenia. In addition to humans, the virus has also been detected with shared genetic homology in farm animals including goats, cattle, horses, and pigs. Furthermore, several genotypes of severe fever and thrombocytopenia syndrome virus (SFTSV) are currently co-circulating between humans and animals. In China, where the virus was first detected in rural areas in 2009, the SFTSV mortality rate has been reported to be as 6% and higher than 30%, especially in immuno-compromised patients. Moreover, this virus has been isolated in neighbor countries including Japan and South Korea where the fatality rates in 2015 were more than 30% in both countries. In this review, we comprehensively summarize the virology, genotypes, pathogenesis, and epidemiology of SFTSV infection in humans and animals. Currently, a collaborative global approach against SFTSV infection is being undertaken; however, the need for continuous disease surveillance and production of an effective vaccine is imperative as this virus may lead to an epidemic of irreversible status in both humans and animals.
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Affiliation(s)
- Norbert John C Robles
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea.,College of Veterinary Medicine and Agricultural Sciences, De La Salle Araneta University, Malabon City, Philippines
| | - Hae Jung Han
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.,Research & Development Center, Green Cross WellBeing Corporation, Seongnam, Korea
| | - Su-Jin Park
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
| | - Young Ki Choi
- Department of Microbiology, College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Korea.,Zoonotic Infectious Diseases Research Center, Chungbuk National University, Cheongju, Korea
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Wi YM, Woo HI, Park D, Lee KH, Kang CI, Chung DR, Peck KR, Song JH. Severe Fever with Thrombocytopenia Syndrome in Patients Suspected of Having Scrub Typhus. Emerg Infect Dis 2018; 22:1992-1995. [PMID: 27767909 PMCID: PMC5088014 DOI: 10.3201/eid2211.160597] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To determine prevalence of severe fever with thrombocytopenia syndrome in South Korea, we examined serum samples from patients with fever and insect bite history in scrub typhus-endemic areas. During the 2013 scrub typhus season, prevalence of this syndrome among patients suspected of having scrub typhus was high (23.0%), suggesting possible co-infection.
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Silvas JA, Aguilar PV. The Emergence of Severe Fever with Thrombocytopenia Syndrome Virus. Am J Trop Med Hyg 2017; 97:992-996. [PMID: 28820686 DOI: 10.4269/ajtmh.16-0967] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a newly recognized hemorrhagic fever disease found throughout Asia with a case fatality rate between 12% and 30%. Since 2009, SFTS has been reported in China throughout 14 Chinese Provinces. In addition, SFTS has been recognized in South Korea and Japan with the first confirmed cases reported in 2012. A similar disease, caused by the closely related Heartland virus, was also reported in the United States in 2009. SFTS is caused by SFTS virus, a novel tick-borne virus in the family Bunyaviridae, genus Phlebovirus. Unlike other mosquito- and sandfly-borne bunyaviruses, SFTS virus has not been extensively studied due to its recent emergence and many unknowns regarding its pathogenesis, life cycle, transmission, and options for therapeutics remains. In this review, we report the most current findings in SFTS virus research.
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Affiliation(s)
- Jesus A Silvas
- Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas.,Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Patricia V Aguilar
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas.,Department of Pathology, University of Texas Medical Branch, Galveston, Texas.,Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas
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56
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Increased Prevalence of Severe Fever with Thrombocytopenia Syndrome in Eastern China Clustered with Multiple Genotypes and Reasserted Virus during 2010-2015. Sci Rep 2017; 7:6503. [PMID: 28747674 PMCID: PMC5529542 DOI: 10.1038/s41598-017-06853-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 06/19/2017] [Indexed: 11/13/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a novel tick-borne viral disease with high mortality. Since January 2010, we have conducted an epidemiological surveillance and etiological study of SFTS in Jiangsu and Anhui provinces. From January 2010 through December 2015, a total of 286 SFTS cases were confirmed in Jiangsu and Anhui provinces with a case fatality rate of 16.1%. The majority of confirmed SFTS cases were distributed in the border area of Jiangsu and Anhui provinces. Our findings suggest that the SFTS prevalence rate rose since 2010 and reached its highest in 2015. Phylogenetic analysis demonstrated that the majority of the SFTSV strains (83.6%) from Jiangsu and Anhui provinces belonged to genotypes A and D. Notably, we identified three strains of SFTSV clustered into the genotype E. This is the first report of the genotype E SFTSV strains in mainland of China. A reassortment between genotype A and D was found in the central region of the endemic areas, where three SFTSV genotypes (A, C and D) were co-circulating.
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57
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Hu J, Li Z, Hong L, Bao C, Zhang Z, Zhang H, He H, Wang X, Liu W, Peng Z, Shi L, Zhu F. Preliminary fast diagnosis of severe fever with thrombocytopenia syndrome with clinical and epidemiological parameters. PLoS One 2017; 12:e0180256. [PMID: 28678811 PMCID: PMC5497983 DOI: 10.1371/journal.pone.0180256] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/13/2017] [Indexed: 11/19/2022] Open
Abstract
Objectives To identify specific clinical and epidemiological parameters for clinical diagnosis of SFTSV infection with relatively higher accuracy. Methods 231 suspected cases of SFTS were reported by various medical institutions from 2011 to 2013 in Jiangsu Province, China. They were followed with SFTSV diagnosis tests and interview-administered questionnaires about demographic characteristics, clinical symptoms and epidemiological exposure factors. Univariate and multivariable logistic regression analysis were used to examine the diagnostic value of these parameters. Results SFTSV infection occurred only from April to October annually and usually in hilly areas of specific regions. Three prediction models of SFTSV infection were constructed. Model 3 with clinical and epidemiological parameters combined the benefits of both Model 1and Model 2, which was optimal and had an overall accuracy of 80.2%. Independent indicators for clinical diagnosis of SFTSV infection in Model 3 were as follows: lymphadenopathy (P = 0.01), leucopenia (P<0.01), age >50 years (P = 0.01), tick bites (P<0.01), raising domestic animals in the residential areas (P<0.01) and farming (P = 0.03). Conclusions Our results show that using a combination of clinical and epidemiological parameters may be a feasible strategy to provide preliminary fast diagnosis as differentiating SFTSV infection from SFTS-like diseases, thus reducing the risk of misdiagnosis.
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Affiliation(s)
- Jianli Hu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhifeng Li
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
- Medical School, Nanjing University, Nanjing, China
| | - Lei Hong
- Department of Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Changjun Bao
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
- * E-mail:
| | - Zhong Zhang
- Department of Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Hongying Zhang
- Department of Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Hao He
- Department of Disease Control and Prevention, Gulou District Center for Disease Control and Prevention, Nanjing, China
| | - Xiaochen Wang
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
| | - Wendong Liu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Limin Shi
- Department of Acute Infectious Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Fengcai Zhu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu provincial Center for Disease Control and Prevention, Nanjing, China
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58
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Li P, Tong ZD, Li KF, Tang A, Dai YX, Yan JB. Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis. PLoS One 2017; 12:e0175592. [PMID: 28399161 PMCID: PMC5388504 DOI: 10.1371/journal.pone.0175592] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/28/2017] [Indexed: 02/04/2023] Open
Abstract
Objective Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus-SFTSV. The seroprevalence of anti-SFTSV antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTSV in the general population has been investigated in various epidemiological studies with inconsistent results. Here, we clarify this discrepancy and reach a more comprehensive result by mean of a meta-analysis. Methods All relevant articles were searched in the electronic databases (PubMed, Web of science, Embase, Chinese National Knowledge Infrastructure database, Chinese Wanfang database) up to November 2016. The pooled seroprevalence and 95% confidence intervals (95% CIs) were calculated by random- or fixed- model on the basis of heterogeneity. Results In total, 21 studies containing 23,848 blood samples from 7 provinces were included in this meta-analysis. The minimum and maximum reported seroprevalences of SFTSV among humans in China were 0.23% and 9.17%, respectively. The overall pooled seroprevalence of SFTSV antibodies was 4.3% (95%CI: 3.2%-5.5%). The pooled prevalence was 5.9% (95%CI: 4.7%-7.0%) in Zhejiang province, 4.9% (95%CI: 4.1–5.8%) in Anhui province, 3.9% (95%CI: 1.3%-6.4%) in Shandong province, and 0.7% (95%CI: 0.2%-1.1%) in Jiangsu province. Stratified by occupation, the pooled prevalence of farmer was 6.1% (95%CI: 3.4%-8.9%) and others (mainly are students) was 3.3% (95%CI: 2.4%-4.2%). Additionally, seroprevalence of SFTSV in people who lived in the same village with the patient were higher than that of people who lived in a different village. Seropositive rates in sampling years after 2012 were higher than that before 2012. The prevalence of SFTSV did not differ by age or gender. Sensitive analysis by omitting one study at a time indicated the results of the pooled seroprevalence were robust. Conclusions Seroprevalence of SFTSV among healthy population in central and eastern China is high. Surveillance efforts on mild or asymptomatic infections among endemic persons are needed.
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Affiliation(s)
- Peng Li
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Zhen-Dong Tong
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- * E-mail: (ZDT); (JBY)
| | - Ke-Feng Li
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - An Tang
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Ya-Xin Dai
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Jian-Bo Yan
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- * E-mail: (ZDT); (JBY)
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Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV), a novel phlebovirus reported to be endemic to China in 2011. In Japan, the first SFTS patient was identified during the autumn of 2012; since then, over 100 SFTS patients have been reported. The SFTSV has been identified throughout Japan over the past two years; however, SFTS patients are specifically localized to western Japan. The clinical symptoms of SFTS include fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and various other symptoms, including muscular symptoms, neurological abnormalities, and coagulopathy. SFTS is often accompanied by hemophagocytic syndrome. The histopathological findings are characterized by necrotizing lymphadenitis, with infiltration of the virus-infected cells to the local lymph nodes. Pathophysiological analyses of SFTS include studies regarding the kinetics of cytokine production and immune responses in patients with SFTS and in SFTSV-infection animal models. This article aimed to survey the history of SFTS in Japan and to review the clinical, epidemiological, and virological aspects of SFTS and SFTSV infection.
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60
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Gowen BB, Hickerson BT. Hemorrhagic fever of bunyavirus etiology: disease models and progress towards new therapies. J Microbiol 2017; 55:183-195. [DOI: 10.1007/s12275-017-7029-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 02/06/2017] [Accepted: 02/06/2017] [Indexed: 01/14/2023]
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A Case-control Study of Risk Sources for Severe Fever with Thrombocytopenia Syndrome in Hubei Province, China. Int J Infect Dis 2017; 55:86-91. [PMID: 28088586 DOI: 10.1016/j.ijid.2017.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/03/2017] [Accepted: 01/05/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease caused by a novel bunyavirus, was discovered in rural areas of Central China in 2009. METHODS A case-control study based on hospital data was applied to detect the potential risk sources for SFTS in SFTS-endemic counties in Hubei Province. Cases were defined as hospitalized SFTSV confirmed patients. Controls were randomly selected from non-SFTSV patients in the same hospital ward within 2 weeks of inclusion of the cases, and they were matched by age (+/- 5 years) and gender according to 1:2 matching condition. RESULTS 68 cases and 136 controls participated in this study. In multivariate analysis, "Contact with cattle tick" was the major risk source (Conditional Logistic Regression OR-MH=8.62, 95% CI=1.79-41.51), outdoor activities and working in weeds or hillside fields could increase risk of cattle tick contact and SFTS infection (Conditional Logistic Regression OR-MH=8.82, 95% CI=1.69-46.05, P value=0.01). CONCLUSION Our results suggested cattle might be dominant hosts in SFTS-endemic regions in Hubei Province, which provided clues to transmission mechanism of "vectors, host animals, and humans", thus more effectively preventing and controlling the disease.
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Kim KH, Ko MK, Kim N, Kim HH, Yi J. Seroprevalence of Severe Fever with Thrombocytopenia Syndrome in Southeastern Korea, 2015. J Korean Med Sci 2017; 32:29-32. [PMID: 27914128 PMCID: PMC5143294 DOI: 10.3346/jkms.2017.32.1.29] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 09/11/2016] [Indexed: 11/20/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease characterized by fever, thrombocytopenia and diarrhea. SFTS was firstly reported in Korea in 2013 but its seroprevalence in the country has yet to be investigated. Here, we investigate the seroprevalence of SFTS in a Korean population. A cross-sectional study was conducted on patients who had their sera tested for various reasons at a tertiary university hospital on particular days in May 2015. This study was conducted in a tertiary hospital in southeastern Korea. Total antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTS virus (SFTSV) in serum samples were detected by a double-antigen sandwich enzyme-linked immunosorbent assay (ELISA). A total of 1,069 serum samples were tested. Median age was 59 years (range 12-96 years), and 51.5% were male. Overall, 22 patients (2.1%) were tested positive for anti-SFTSV antibodies. The SFTS seroprevalence increased significantly with age (P = 0.034). The seropositive rate of rural area was higher than that of urban area (7.7% vs. 1.9%, P = 0.040). Seropositive rates were not significantly different among underlying diseases. None of the antibody-positive patients showed typical symptoms or laboratory findings of SFTS at the time of sample collection. Results of real-time reverse transcription polymerase chain reaction (RT-PCR) were negative for all the seropositive patients. Our study shows 2.1% SFTS seroprevalence among the patients visiting a tertiary hospital in Korea. Seroprevalence is higher in older and rural population.
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Affiliation(s)
- Kye Hyung Kim
- Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
| | - Mee Kyung Ko
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Namhee Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Hyung Hoi Kim
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Jongyoun Yi
- Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, Korea.
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Emergence of New Tickborne Infections. EMERGING ZOONOSES 2017. [PMCID: PMC7122411 DOI: 10.1007/978-3-319-50890-0_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Spatial Analysis of Severe Fever with Thrombocytopenia Syndrome Virus in China Using a Geographically Weighted Logistic Regression Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:ijerph13111125. [PMID: 27845737 PMCID: PMC5129335 DOI: 10.3390/ijerph13111125] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 10/28/2016] [Accepted: 11/02/2016] [Indexed: 12/23/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is caused by severe fever with thrombocytopenia syndrome virus (SFTSV), which has had a serious impact on public health in parts of Asia. There is no specific antiviral drug or vaccine for SFTSV and, therefore, it is important to determine the factors that influence the occurrence of SFTSV infections. This study aimed to explore the spatial associations between SFTSV infections and several potential determinants, and to predict the high-risk areas in mainland China. The analysis was carried out at the level of provinces in mainland China. The potential explanatory variables that were investigated consisted of meteorological factors (average temperature, average monthly precipitation and average relative humidity), the average proportion of rural population and the average proportion of primary industries over three years (2010-2012). We constructed a geographically weighted logistic regression (GWLR) model in order to explore the associations between the selected variables and confirmed cases of SFTSV. The study showed that: (1) meteorological factors have a strong influence on the SFTSV cover; (2) a GWLR model is suitable for exploring SFTSV cover in mainland China; (3) our findings can be used for predicting high-risk areas and highlighting when meteorological factors pose a risk in order to aid in the implementation of public health strategies.
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Severe Fever with Thrombocytopenia Syndrome Virus Antigen Detection Using Monoclonal Antibodies to the Nucleocapsid Protein. PLoS Negl Trop Dis 2016; 10:e0004595. [PMID: 27045364 PMCID: PMC4821557 DOI: 10.1371/journal.pntd.0004595] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/10/2016] [Indexed: 11/24/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease with a high case fatality rate, and is caused by the SFTS virus (SFTSV). SFTS is endemic to China, South Korea, and Japan. The viral RNA level in sera of patients with SFTS is known to be strongly associated with outcomes. Virological SFTS diagnosis with high sensitivity and specificity are required in disease endemic areas. Methodology/Principal Findings We generated novel monoclonal antibodies (MAbs) against the SFTSV nucleocapsid (N) protein and developed a sandwich antigen (Ag)-capture enzyme-linked immunosorbent assay (ELISA) for the detection of N protein of SFTSV using MAb and polyclonal antibody as capture and detection antibodies, respectively. The Ag-capture system was capable of detecting at least 350–1220 TCID50/100 μl/well from the culture supernatants of various SFTSV strains. The efficacy of the Ag-capture ELISA in SFTS diagnosis was evaluated using serum samples collected from patients suspected of having SFTS in Japan. All 24 serum samples (100%) containing high copy numbers of viral RNA (>105 copies/ml) showed a positive reaction in the Ag-capture ELISA, whereas 12 out of 15 serum samples (80%) containing low copy numbers of viral RNA (<105 copies/ml) showed a negative reaction in the Ag-capture ELISA. Among these Ag-capture ELISA-negative 12 samples, 9 (75%) were positive for IgG antibodies against SFTSV. Conclusions The newly developed Ag-capture ELISA is useful for SFTS diagnosis in acute phase patients with high levels of viremia. Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne emerging infectious disease caused by a novel bunyavirus, SFTS virus (SFTSV). Since first discovered in China in 2011, SFTSV has been detected from SFTS patients and ticks with expanding geographic ranges from China to Japan and South Korea. The potential for SFTS spread to other warm or sub-tropical regions makes it a serious concern to the public health. It is of great importance to detect SFTSV rapidly and specifically for the effective control of the disease. For the diagnosis of viral infections, a sandwich antigen (Ag)-capture ELISA detecting viral nucleoprotein (N) in viremic serum samples has been widely applied to detect the agents, since it is the most abundant viral antigen and has highly conserved amino acid sequence. In this study, using the novel monoclonal antibodies raised against SFSTV-N, an Ag-capture ELISA system was developed, and the validation of this system was performed using sera collected from SFTS-suspected patients. Our data show that the Ag-capture ELISA was useful for the diagnosis of SFTS patients in the acute phase of the disease. This study shows a novel methodology for the diagnosis of SFTS, which may provide helpful information for the effective control of the disease.
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Hayasaka D, Fuxun Y, Yoshikawa A, Posadas-Herrera G, Shimada S, Tun MMN, Agoh M, Morita K. Seroepidemiological evidence of severe fever with thrombocytopenia syndrome virus infections in wild boars in Nagasaki, Japan. Trop Med Health 2016; 44:6. [PMID: 27433125 PMCID: PMC4940765 DOI: 10.1186/s41182-016-0009-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Accepted: 03/02/2016] [Indexed: 11/10/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease in East Asia. It is thought that the SFTS virus (SFTSV) circulates between ticks and animals in nature and that the virus is transmitted to humans by tick bites. SFTS is endemic to Nagasaki in western Japan; however, epidemiological information regarding SFTSV in Nagasaki is not known. In this study, we performed SFTSV IgG ELISAs and neutralization antibody assays for a seroepidemiological survey using samples from wild boars captured in six areas of Nagasaki. SFTSV seropositive animals were found in three areas. Our findings provide epidemiological information on the distribution of SFTSV in Nagasaki.
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Affiliation(s)
- Daisuke Hayasaka
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Leading Graduate School Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Yu Fuxun
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Akira Yoshikawa
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Nagasaki Prefectural Institute for Environmental Research and Public Health, Omura, Nagasaki, 856-0026 Japan
| | - Guillermo Posadas-Herrera
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Present address: National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku Tokyo, 162-8640 Japan
| | - Satoshi Shimada
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Leading Graduate School Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
| | - Masanobu Agoh
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Nagasaki Prefectural Institute for Environmental Research and Public Health, Omura, Nagasaki, 856-0026 Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan ; Leading Graduate School Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, 852-8523 Japan
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67
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Zhang YZ, Xu J. The emergence and cross species transmission of newly discovered tick-borne Bunyavirus in China. Curr Opin Virol 2016; 16:126-131. [PMID: 26949898 DOI: 10.1016/j.coviro.2016.02.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Accepted: 02/18/2016] [Indexed: 02/05/2023]
Abstract
A novel tick-borne Bunyavirus, discovered in China and later in South Korea and Japan, is now known as Huaiyangshan virus or severe fever with thrombocytopenia syndrome virus and has been identified as the causative agent of a hemorrhagic fever-like disease. Of five species of ticks carrying Huaiyangshan viruses, Haemaphysalis longicornis was the most abundant in regions where the virus was endemic. Its usual hosts (cattle, goats, dogs, rats and chickens) tested positive for Huaiyangshan virus RNA and had a high seroprevalence. The distribution of H. longicornis and the migratory routes of four wild fowl across China, South Korea and Japan are coincident. Thus a tick and migratory bird model for the transmission of the Huaiyangshan virus was proposed.
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Affiliation(s)
- Yong-Zhen Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing 102206, China
| | - Jianguo Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing 102206, China.
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Xing X, Guan X, Liu L, Zhan J, Jiang H, Liu L, Li G, Xiong J, Tan L, Xu J, Jiang Y, Yao X, Zhan F, Nie S. Natural Transmission Model for Severe Fever With Thrombocytopenia Syndrome Bunyavirus in Villages of Hubei Province, China. Medicine (Baltimore) 2016; 95:e2533. [PMID: 26825892 PMCID: PMC5291562 DOI: 10.1097/md.0000000000002533] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), an emerging high-fatality infectious disease, is caused by a novel bunyavirus. However, a clear natural transmission model has not yet been established. We conducted a cross-sectional study with in-depth investigation of villages to systematically understand the transmission and risk factors among humans, host animals, and vectors. Village residents were interviewed using standardized questionnaires, in which there were confirmed cases of new infections, between August 2012 and May 2013. Serum samples from all villagers and animals, as well as tick specimens, were collected for qRT-PCR and antibody testing. The seropositivity rate among villagers was 8.4% (35/419), which was lower than that among domesticated animals (54.0%, 27/50; χ(2)= 81.1, P < 0.05). SFTS viral RNA was most commonly detected among domesticated animals (14.0%), followed by ticks (3.1%) and humans (1.7%; χ(2) = 23.1, P < 0.05). The homology of the S gene fragment was 98%. Tick bites were significantly associated with SFTSV infection (Conditional Logistic Regression odds ratio [OR] = 2.5, 95% confidence interval [CI], 1.0-6.6). We provided systematic evidence on a natural transmission model for SFTSV from reservoir hosts (domesticated animals) to vectors (Haemaphysalis longicornis) to humans, and close contact with SFTS confirmed patients was not found to be a risk factor for natural transmission.
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Affiliation(s)
- Xuesen Xing
- From Department of Epidemiology and Health Statistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China (XX, HJ, LL, SN); Hubei Provincial Center for Disease Control and Prevention, Wuhan, China (XX, FZ, XG, LL, JZ, GL, JX, LT, JX, YZ, XY)
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Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China: an integrated data analysis. Epidemiol Infect 2015; 144:1345-54. [PMID: 26542444 DOI: 10.1017/s0950268815002678] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was caused by a novel bunyavirus, SFTSV. The study aimed to disclose the epidemiological and clinical characteristics of SFTSV infection in China so far. An integrated clinical database comprising 1920 SFTS patients was constructed by combining first-hand clinical information collected from SFTS sentinel hospitals (n = 1159) and extracted data (n = 761) from published literature. The considered variables comprised clinical manifestations, routine laboratory tests of acute infection, hospitalization duration and disease outcome. SFTSV-IgG data from 19 119 healthy subjects were extracted from the published papers. The key clinical variables, case-fatality rate (CFR) and seroprevalence were estimated by meta-analysis. The most commonly seen clinical manifestations of SFTSV infection were fever, anorexia, myalgia, chill and lymphadenopathy. The major laboratory findings were elevated lactate dehydrogenase, aminotransferase, followed by thrombocytopenia, lymphocytopenia, elevated alanine transaminase and creatine kinase. A CFR of 12·2% was estimated, significantly higher than that obtained from national reporting data, but showing no geographical difference. In our paper, the mortality rate was about 1·9 parts per million. Older age and longer delay to hospitalization were significantly associated with fatal outcome. A pooled seroprevalence of 3·0% was obtained, which increased with age, while comparable for gender. This study represents a clinical characterization on the largest group of SFTS patients up to now. A higher than expected CFR was obtained. A wider spectrum of clinical index was suggested to be used to identify SFTSV infection, while the useful predictor for fatal outcome was found to be restricted.
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Fang LQ, Liu K, Li XL, Liang S, Yang Y, Yao HW, Sun RX, Sun Y, Chen WJ, Zuo SQ, Ma MJ, Li H, Jiang JF, Liu W, Yang XF, Gray GC, Krause PJ, Cao WC. Emerging tick-borne infections in mainland China: an increasing public health threat. THE LANCET. INFECTIOUS DISEASES 2015; 15:1467-1479. [PMID: 26453241 PMCID: PMC4870934 DOI: 10.1016/s1473-3099(15)00177-2] [Citation(s) in RCA: 194] [Impact Index Per Article: 21.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 06/18/2015] [Accepted: 07/07/2015] [Indexed: 12/30/2022]
Abstract
Since the beginning of the 1980s, 33 emerging tick-borne agents have been identified in mainland China, including eight species of spotted fever group rickettsiae, seven species in the family Anaplasmataceae, six genospecies in the complex Borrelia burgdorferi sensu lato, 11 species of Babesia, and the virus causing severe fever with thrombocytopenia syndrome. In this Review we have mapped the geographical distributions of human cases of infection. 15 of the 33 emerging tick-borne agents have been reported to cause human disease, and their clinical characteristics have been described. The non-specific clinical manifestations caused by tick-borne pathogens present a major diagnostic challenge and most physicians are unfamiliar with the many tick-borne diseases that present with non-specific symptoms in the early stages of the illness. Advances in and application of modern molecular techniques should help with identification of emerging tick-borne pathogens and improve laboratory diagnosis of human infections. We expect that more novel tick-borne infections in ticks and animals will be identified and additional emerging tick-borne diseases in human beings will be discovered.
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Affiliation(s)
- Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Kun Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Xin-Lou Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Song Liang
- College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Yang Yang
- College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Hong-Wu Yao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Ruo-Xi Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Ye Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wan-Jun Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Shu-Qing Zuo
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Mai-Juan Ma
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Jia-Fu Jiang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - X Frank Yang
- Department of Microbiology and Immunology, Indiana University School of Medicine, Barnhill, IN, USA
| | | | - Peter J Krause
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale School of Medicine, New Haven, CT, USA
- Department of Medicine and Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA
| | - Wu-Chun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- Correspondence to: Prof Wu-Chun Cao, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Fengtai District, Beijing 100071, China
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Ni H, Yang F, Li Y, Liu W, Jiao S, Li Z, Yi B, Chen Y, Hou X, Hu F, Ding Y, Bian G, Du Y, Xu G, Cao G. Apodemus agrarius is a potential natural host of severe fever with thrombocytopenia syndrome (SFTS)—causing novel bunyavirus. J Clin Virol 2015; 71:82-8. [DOI: 10.1016/j.jcv.2015.08.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2015] [Revised: 08/03/2015] [Accepted: 08/11/2015] [Indexed: 01/28/2023]
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Liu K, Zhou H, Sun RX, Yao HW, Li Y, Wang LP, Di Mu, Li XL, Yang Y, Gray GC, Cui N, Yin WW, Fang LQ, Yu HJ, Cao WC. A national assessment of the epidemiology of severe fever with thrombocytopenia syndrome, China. Sci Rep 2015; 5:9679. [PMID: 25902910 PMCID: PMC4407178 DOI: 10.1038/srep09679] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/12/2015] [Indexed: 01/18/2023] Open
Abstract
First discovered in rural areas of middle-eastern China in 2009, severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis affecting hundreds of cases reported in China each year. Using the national surveillance data from 2010 to 2013, we conducted this retrospective epidemiological study and risk assessment of SFTS in China. We found that the incidence of SFTS and its epidemic areas are continuing to grow, but the case fatality rate (CFR) has steadily decreased. SFTS most commonly affected elderly farmers who acquired infection between May and July in middle-eastern China. However, other epidemiological characteristics such as incidence, sex ratio, CFR, and seasonality differ substantially across the affected provinces, which seem to be consistent with local agricultural activities and the seasonal abundance of ticks. Spatial scan statistics detected three hot spots of SFTS that accounted for 69.1% of SFTS cases in China. There was a strong association of SFTS incidence with temporal changes in the climate within the clusters. Multivariate modeling identified climate conditions, elevation, forest coverage, cattle density, and the presence of Haemaphysalis longicornis ticks as independent risk factors in the distribution of SFTS, based on which a predicted risk map of the disease was derived.
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Affiliation(s)
- Kun Liu
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Hang Zhou
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Ruo-Xi Sun
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China.,Anhui Medical University, Hefei, 230032, P. R. China
| | - Hong-Wu Yao
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Di Mu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Xin-Lou Li
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 32311, Florida, USA
| | - Gregory C Gray
- Duke University School of Medicine, Durham, 27710, North Carolina, USA
| | - Ning Cui
- The 154 Hospital, People's Liberation Army, Xinyang, 464000, P.R. China
| | - Wen-Wu Yin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Li-Qun Fang
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Hong-Jie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Wu-Chun Cao
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
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Hayasaka D, Shimada S, Aoki K, Takamatsu Y, Uchida L, Horio M, Fuxun Y, Morita K. Epidemiological Survey of Severe Fever with Thrombocytopenia Syndrome Virus in Ticks in Nagasaki, Japan. Trop Med Health 2015; 43:159-64. [PMID: 26543390 PMCID: PMC4593780 DOI: 10.2149/tmh.2015-01] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Accepted: 04/06/2015] [Indexed: 11/26/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease endemic in East Asia. Transmitted to other organisms by infected ticks, the SFTS virus (SFTSV) and is endemic to Nagasaki in western Japan. However, epidemiological information regarding SFTSV in Nagasaki ticks has not been available to date. In this study, we began by examining the sensitivities of SFTSV gene detection by real-time RT-PCR and virus isolation in cultured cells and mice. These methods could detect SFTSV in the samples containing more than 4 × 100 ffu. Next, we attempted to isolate SFTSV and to detect viral gene in 2,222 nymph and adult ticks collected from May to August 2013 among seven regions of Nagasaki. However, neither virus isolation nor viral gene detection were confirmed in the tick pools. SFTSV positivity rates are considered to be very low in ticks, and viral loads are also very limited. Further investigations increasing the number of ticks and including larval samples as well as improved detection methods, may be required to find SFTSV-positive ticks in this region.
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Affiliation(s)
- Daisuke Hayasaka
- Department of Virology, Institute of Tropical Medicine ; Leading Graduate School Program
| | - Satoshi Shimada
- Department of Virology, Institute of Tropical Medicine ; Leading Graduate School Program
| | - Kotaro Aoki
- Department of Virology, Institute of Tropical Medicine
| | | | - Leo Uchida
- Department of Virology, Institute of Tropical Medicine
| | | | - Yu Fuxun
- Department of Virology, Institute of Tropical Medicine
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine ; Leading Graduate School Program ; J-Grid, Nagasaki University . 1-12-4 Sakamoto, Nagasaki, 852-8523
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Wei J, Li S, Dong JH, Tian H, Chowell G, Tian HY, Lv W, Han ZQ, Xu B, Yu PB, Wang JJ. The first human infection with severe fever with thrombocytopenia syndrome virus in Shaanxi Province, China. Int J Infect Dis 2015; 35:37-9. [PMID: 25722283 DOI: 10.1016/j.ijid.2015.02.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/15/2015] [Accepted: 02/18/2015] [Indexed: 10/24/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in China in 2009. In July 2013, the first human infection with SFTS virus (SFTSV) was detected in Shaanxi Province, Western China. METHODS A seroprevalence study among humans was carried out in an SFTS endemic village; specifically, serum samples were collected from 363 farmers in an SFTS endemic village in Shaanxi Province. The presence of SFTSV antibodies in serum was determined using an ELISA. RESULTS SFTSV antibodies were found in a total of 20 people (5.51%), with no significant difference between males and females (6.93% and 4.42%, respectively; Chi-square=1.29, p=0.25). Moreover, the SFTSV antibody positive rate was not significantly different across different age groups (Chi-square=2.23, p=0.69). CONCLUSIONS SFTSV readily infects humans with outdoor exposure. The results of the serological study indicate that the virus circulates widely in Shaanxi Province. SFTSV represents a public health threat in China.
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Affiliation(s)
- Jing Wei
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China
| | - Shen Li
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China
| | - Jian-Hua Dong
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China
| | - Hui Tian
- Baoji Center for Disease Control and Prevention, Baoji, Shaanxi, China
| | - Gerardo Chowell
- School of Public Health, Georgia State University, Atlanta, Georgia, USA
| | - Huai-Yu Tian
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Wen Lv
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China
| | - Zong-Qi Han
- Long County Center for Disease Control and Prevention of Shaanxi Province, Baoji, Shaanxi, China
| | - Bing Xu
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China; Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, School of Environment, Tsinghua University, Beijing, China
| | - Peng-Bo Yu
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China.
| | - Jing-Jun Wang
- Shaanxi Provincial Center for Disease Control and Prevention, Xi'an, Shaanxi 710054, China.
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Zhang L, Ye L, Ojcius DM, Lou X, Wang C, feng C, Sun Y, Wang Z, Li S, Zhang Y. Characterization of severe fever with thrombocytopenia syndrome in rural regions of Zhejiang, China. PLoS One 2014; 9:e111127. [PMID: 25356556 PMCID: PMC4214719 DOI: 10.1371/journal.pone.0111127] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 09/18/2014] [Indexed: 11/18/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) infections have recently been found in rural regions of Zhejiang. A severe fever with thrombocytopenia syndrome (SFTS) surveillance and sero-epidemiological investigation was conducted in the districts with outbreaks. During the study period of 2011–2014, a total of 51 SFTSV infection cases were identified and the case fatality rate was 12% (6/51). Ninety two percent of the patients (47/51) were over 50 years of age, and 63% (32/51) of laboratory confirmed cases occurred from May to July. Nine percent (11/120) of the serum samples from local healthy people without symptoms were found to be positive for antibodies to the SFTS virus. SFTSV strains were isolated by culture using Vero, and the whole genomic sequences of two SFTSV strains (01 and Zhao) were sequenced and submitted to the GenBank. Homology analysis showed that the similarity of the target nucleocapsid gene from the SFTSV strains from different geographic areas was 94.2–100%. From the constructed phylogenetic tree, it was found that all the SFTSV strains diverged into two main clusters. Only the SFTSV strains from the Zhejiang (Daishan) region of China and the Yamaguchi, Miyazakj regions of Japan, were clustered into lineage II, consistent with both of these regions being isolated areas with similar geographic features. Two out of eight predicted linear B cell epitopes from the nucleocapsid protein showed mutations between the SFTSV strains of different clusters, but did not contribute to the binding ability of the specific SFTSV antibodies. This study confirmed that SFTSV has been circulating naturally and can cause a seasonal prevalence in Daishan, China. The results also suggest that the molecular characteristics of SFTSV are associated with the geographic region and all SFTSV strains can be divided into two genotypes.
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Affiliation(s)
- Lei Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
| | - Ling Ye
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - David M. Ojcius
- Health Sciences Research Institute and School of Natural Sciences, University of California Merced, Merced, California, United States of America
| | - Xiuyu Lou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Chengwei Wang
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - Cen feng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Yi Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Zhongfa Wang
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - Shibo Li
- Zhoushan Hospital, Zhoushan, Zhejiang, P.R. China
| | - Yanjun Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
- * E-mail:
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Comprehensive molecular detection of tick-borne phleboviruses leads to the retrospective identification of taxonomically unassigned bunyaviruses and the discovery of a novel member of the genus phlebovirus. J Virol 2014; 89:594-604. [PMID: 25339769 DOI: 10.1128/jvi.02704-14] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
UNLABELLED Until the recent emergence of two human-pathogenic tick-borne phleboviruses (TBPVs) (severe fever with thrombocytopenia syndrome virus [SFTSV] and Heartland virus), TBPVs have been neglected as causative agents of human disease. In particular, no studies have addressed the global distribution of TBPVs, and consequently, our understanding of the mechanism(s) underlying their evolution and emergence remains poor. In order to provide a useful tool for the ecological and epidemiological study of TBPVs, we have established a simple system that can detect all known TBPVs, based on conventional reverse transcription-PCR (RT-PCR) with degenerate primer sets targeting conserved regions of the viral L genome segment. Using this system, we have determined that several viruses that had been isolated from ticks decades ago but had not been taxonomically identified are novel TBPVs. Full-genome sequencing of these viruses revealed a novel fourth TBPV cluster distinct from the three known TBPV clusters (i.e., the SFTS, Bhanja, and Uukuniemi groups) and from the mosquito/sandfly-borne phleboviruses. Furthermore, by using tick samples collected in Zambia, we confirmed that our system had enough sensitivity to detect a new TBPV in a single tick homogenate. This virus, tentatively designated Shibuyunji virus after the region of tick collection, grouped into a novel fourth TBPV cluster. These results indicate that our system can be used as a first-line screening approach for TBPVs and that this kind of work will undoubtedly lead to the discovery of additional novel tick viruses and will expand our knowledge of the evolution and epidemiology of TBPVs. IMPORTANCE Tick-borne phleboviruses (TBPVs) have been largely neglected until the recent emergence of two virulent viruses, severe fever with thrombocytopenia syndrome virus and Heartland virus. Little is known about the global distribution of TBPVs or how these viruses evolved and emerged. A major hurdle to study the distribution of TBPVs is the lack of tools to detect these genetically divergent phleboviruses. In order to address this issue, we have developed a simple, rapid, and cheap RT-PCR system that can detect all known TBPVs and which led to the identification of several novel phleboviruses from previously uncharacterized tick-associated virus isolates. Our system can detect virus in a single tick sample and novel TBPVs that are genetically distinct from any of the known TBPVs. These results indicate that our system will be a useful tool for the surveillance of TBPVs and will facilitate understanding of the ecology of TBPVs.
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Jin C, Jiang H, Liang M, Han Y, Gu W, Zhang F, Zhu H, Wu W, Chen T, Li C, Zhang W, Zhang Q, Qu J, Wei Q, Qin C, Li D. SFTS virus infection in nonhuman primates. J Infect Dis 2014; 211:915-25. [PMID: 25326554 DOI: 10.1093/infdis/jiu564] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
SFTS virus (SFTSV) is a highly pathogenic bunyavirus that causes severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease in China. Laboratory mice have been reported to be susceptible to SFTSV infection, but the infection in nonhuman primates has not been investigated. This study is the first to report that, in rhesus macaques, SFTSV does not cause severe symptoms or death but causes fever, thrombocytopenia, leukocytopenia, and increased levels of transaminases and myocardial enzymes in blood. Viremia, virus-specific immunoglobulin M and immunoglobulin G antibodies, and neutralizing antibodies were identified in all infected macaques. Levels of the cytokines interferon γ, eotaxin, tumor necrosis factor α, and macrophage inflammatory protein 1β were significantly elevated in the blood. Minor pathological lesions were observed in the liver and kidney during the late stages of infection. Overall, SFTSV infection in rhesus macaques resembled mild SFTS in humans.
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Affiliation(s)
- Cong Jin
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Hong Jiang
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Mifang Liang
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Ying Han
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC Wenzhou Medical University, China
| | - Wen Gu
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Fushun Zhang
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Hua Zhu
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Wei Wu
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Ting Chen
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Chuan Li
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Weilun Zhang
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Quanfu Zhang
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Jing Qu
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
| | - Qiang Wei
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Chuan Qin
- Laboratory of Virus, Institute of Laboratory Animal Science, Chinese Academy of Medical Sciences, Beijing
| | - Dexin Li
- Key Laboratory for Medical Virology, NHFPC, National Institute for Viral Disease Control and Prevention, China CDC
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Ding F, Guan XH, Kang K, Ding SJ, Huang LY, Xing XS, Sha S, Liu L, Wang XJ, Zhang XM, You AG, Du YH, Zhou H, Vong S, Zhang XD, Feng ZJ, Yang WZ, Li Q, Yin WW. Risk factors for bunyavirus-associated severe Fever with thrombocytopenia syndrome, china. PLoS Negl Trop Dis 2014; 8:e3267. [PMID: 25330383 PMCID: PMC4199554 DOI: 10.1371/journal.pntd.0003267] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 09/11/2014] [Indexed: 01/14/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging disease that is caused by a novel bunyavirus, referred to as SFTS virus. During January 2011 to December 2011 we conducted a case-control study in Henan, Hubei and Shandong Provinces of China to determine the risk factors for SFTS. Methods Case-patients were identified in hospitals and reported to provincial Centers for Disease Control and Prevention while being notified electronically to the National Surveillance System. Controls were randomly selected from a pool of patients admitted to the same hospital ward within one week of the inclusion of the cases. They were matched by age (+/−5 years) and gender. Results A total of 422 patients participated in the study including 134 cases and 288 matched controls. The median age of the cases was 58.8 years, ranging from 47.6 to 70.1 years; 54.5% were male. No differences in demographics were observed between cases and controls; however, farmers were frequent and more common among cases (88.8%) than controls (58.7%). In multivariate analysis, the odds for SFTS was 2.4∼4.5 fold higher with patients who reported tick bites or presence of tick in the living area. Other independent risk factors included cat or cattle ownership and reported presence of weeds and shrubs in the working environment. Conclusions Our findings support the hypothesis that ticks are important vectors of SFTS virus. Further investigations are warranted to understand the detailed modes of transmission of SFTS virus while vector management, education on tick bites prevention and personal hygiene management should be implemented for high-risk groups in high incidence areas. Since 2009, an emerging infectious disease which was identified as the severe fever with thrombocytopenia syndrome (SFTS) was reported in rural areas of Hubei, Shandong and Henan provinces in China. A novel bunyavirus designated severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) had been identified to be the etiological cause of SFTS. But what risk factors lead to the disease is still not clear. Further investigations for risk factors are needed to effectively prevent and control the disease. Here we have designed case-control study to try to develop the risk factors of the spread of SFTSV. It is hoped that our research could provide epidemiological evidence for further study. Also help to determine the spread of the virus in the environment.
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Affiliation(s)
- Fan Ding
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Xu-Hua Guan
- Institute of Infectious Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, P.R. China
| | - Kai Kang
- Institute of infection Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, P.R. China
| | - Shu-Jun Ding
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Jinan, China
| | - Li-Yong Huang
- Beijing Chaoyang District Center for Disease Control and Prevention, Beijing, China
| | - Xue-Sen Xing
- Institute of Infectious Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, P.R. China
| | - Sha Sha
- Institute of Infectious Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, P.R. China
| | - Li Liu
- Institute of Infectious Disease Control and Prevention, Hubei Provincial Center for Disease Control and Prevention, Hubei, P.R. China
| | - Xian-Jun Wang
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Jinan, China
| | - Xiao-Mei Zhang
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Communicable Disease Control and Prevention, Jinan, China
| | - Ai-Guo You
- Institute of infection Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, P.R. China
| | - Yan-Hua Du
- Institute of infection Disease Control and Prevention, Henan Provincial Center for Disease Control and Prevention, Zhengzhou, P.R. China
| | - Hang Zhou
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sirenda Vong
- World Health Organization (WHO), Representative Office in China, Beijing, China
| | - Xiao-Dong Zhang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zi-Jian Feng
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Wei-Zhong Yang
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Qun Li
- Chinese Center for Disease Control and Prevention, Beijing, P.R. China
- * E-mail: (QL); (WWY)
| | - Wen-Wu Yin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (QL); (WWY)
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