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Smith DR, Holbrook MR, Gowen BB. Animal models of viral hemorrhagic fever. Antiviral Res 2014; 112:59-79. [PMID: 25448088 DOI: 10.1016/j.antiviral.2014.10.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Revised: 09/24/2014] [Accepted: 10/05/2014] [Indexed: 12/13/2022]
Abstract
The term "viral hemorrhagic fever" (VHF) designates a syndrome of acute febrile illness, increased vascular permeability and coagulation defects which often progresses to bleeding and shock and may be fatal in a significant percentage of cases. The causative agents are some 20 different RNA viruses in the families Arenaviridae, Bunyaviridae, Filoviridae and Flaviviridae, which are maintained in a variety of animal species and are transferred to humans through direct or indirect contact or by an arthropod vector. Except for dengue, which is transmitted among humans by mosquitoes, the geographic distribution of each type of VHF is determined by the range of its animal reservoir. Treatments are available for Argentine HF and Lassa fever, but no approved countermeasures have been developed against other types of VHF. The development of effective interventions is hindered by the sporadic nature of most infections and their occurrence in geographic regions with limited medical resources. Laboratory animal models that faithfully reproduce human disease are therefore essential for the evaluation of potential vaccines and therapeutics. The goal of this review is to highlight the current status of animal models that can be used to study the pathogenesis of VHF and test new countermeasures.
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Affiliation(s)
- Darci R Smith
- Southern Research Institute, Frederick, MD 21701, United States.
| | - Michael R Holbrook
- Integrated Research Facility, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Frederick, MD, United States
| | - Brian B Gowen
- Institute for Antiviral Research and Department of Animal, Dairy, and Veterinary Sciences, Utah State University, Logan, UT 84322, United States
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202
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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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Saijo M. [The Cutting-edge of Medicine; Severe fever with thrombocytopenia syndrome in Japan: challenges for the future]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2014; 103:2581-2586. [PMID: 27514209 DOI: 10.2169/naika.103.2581] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Wen HL, Zhao L, Zhai S, Chi Y, Cui F, Wang D, Wang L, Wang Z, Wang Q, Zhang S, Liu Y, Yu H, Yu XJ. Severe fever with thrombocytopenia syndrome, Shandong Province, China, 2011. Emerg Infect Dis 2014; 20:1-5. [PMID: 24378074 PMCID: PMC3884705 DOI: 10.3201/eid2001.120532] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Supportive therapy is recommended before laboratory confirmation of this disease. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China. The incidence and clinical and laboratory characteristics of SFTS are not clearly defined. During May 22–October 2, 2011, a total of 24 patients with fever, thrombocytopenia, and leukopenia were clinically diagnosed as having SFTS in Yiyuan County, Shandong Province, China. We conducted laboratory tests for these SFTS patients. SFTS virus (SFTSV) infection was confirmed in 22 patients by using reverse transcription PCR and ELISA by acute-phase and convalescent-phase serum samples. Clinical and laboratory manifestations included fever (100%), gastrointestinal symptoms (91%), myalgia (55%), chills (41%), thrombocytopenia (100%), and leukopenia (95%).
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205
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Wang LY, Cui N, Lu QB, Wo Y, Wang HY, Liu W, Cao WC. Severe fever with thrombocytopenia syndrome in children: a case report. BMC Infect Dis 2014; 14:366. [PMID: 24993119 PMCID: PMC4094669 DOI: 10.1186/1471-2334-14-366] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 06/30/2014] [Indexed: 12/13/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus (SFTSV) in China. Humans of all ages living in endemic areas have high risk of acquiring SFTS. Most clinical data so far have been from adults and no clinical study was available from children yet. The present study identified four SFTSV infected children through hospital based surveillance. A prospective observational study was performed to obtain their clinical and laboratory characteristics. Case presentation The patients’ age ranged from 4–15 years old and two were male. On hospitalization, fever, malaise and gastrointestinal syndromes were the most commonly presenting symptoms. Hemorrhagic symptoms or neurological manifestation was not recorded in any of the four pediatric patients. Hematological abnormalities at admission into hospital included leucopenia (4 cases), thrombocytopenia (1 case) and bicytopenia (1 case). The abnormal parameters included elevated aminotransferase (1 case), alanine transaminase (2 case), and lactate dehydrogenase (3 case). Laboratory parameters indicative of renal damage was not observed during the hospitalization. All the patients recovered well without sequelae being observed. Conclusion Compared with adults, pediatric patients with SFTSV infection seem to have less vague subjective complaints and less aggressive clinical course. Thrombocytopenia is suggested to be used less rigorously in recognizing SFTSV infection in pediatric patients, especially at early phase of disease.
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Affiliation(s)
| | | | | | | | | | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P, R, China.
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206
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Ecological niche modeling for predicting the potential risk areas of severe fever with thrombocytopenia syndrome. Int J Infect Dis 2014; 26:1-8. [PMID: 24981427 DOI: 10.1016/j.ijid.2014.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 03/17/2014] [Accepted: 04/09/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus. The spatial distribution has continued to expand, while the areas at potential high risk of SFTS have, to date, remained unclear. METHODS Using ecological factors as predictors, the MaxEnt model was first trained based on the locations of human SFTS occurrence in Shandong Province. The risk prediction map of China was then created by projecting the training model onto the whole country. The performance of the model was assessed using the known locations of disease occurrence in China. RESULTS The key environmental factors affecting SFTS occurrence were temperature, precipitation, land cover, normalized difference vegetation index (NDVI), and duration of sunshine. The risk prediction maps suggested that central, southwestern, northeastern, and the eastern coast of China are potential areas at high risk of SFTS. CONCLUSIONS The potential high risk SFTS areas are distributed widely in China. The epidemiological surveillance system should be enhanced in these high risk regions.
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207
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Sun J, Chai C, Lv H, Lin J, Wang C, Chen E, Zhang Y, Chen Z, Liu S, Gong Z, Jiang J. Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Zhejiang Province, China. Int J Infect Dis 2014; 25:180-5. [PMID: 24947422 DOI: 10.1016/j.ijid.2014.02.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To summarize the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province, China. METHODS A standardized questionnaire was used to collect information on demographic features, exposure history, clinical symptoms, and timelines of medical visits. Descriptive statistics were used to analyze the characteristics of SFTS. RESULTS A total of 65 cases of SFTS were identified in Zhejiang Province from 2011 to 2013, of whom 34 were male and 31 were female. The median age was 66 years and 60 cases occurred in persons aged ≥ 50 years. The majority (91%) of SFTS cases occurred between May and August. With regard to exposure history, patients had pursued outdoor activities (63%), had a history of exposure to a tick (68%) or tick bite (29%), bred domestic animals (31%), or had a history of exposure to a mouse (57%), and some patients had a multi-exposure history. Approximately 98.46% of patients were hospitalized, and symptoms of the illness included fever (98%), fatigue (71%), chills (51%), etc. Two family clusters occurred, although there was no person-to-person transmission. CONCLUSIONS In Zhejiang Province, SFTS is prevalent between May and August among elderly persons who live in hilly areas, and clinical features are not specific. More emphasis should be given to this disease and further training of medical personnel should be carried out to prevent misdiagnosis.
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Affiliation(s)
- Jimin Sun
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Chengliang Chai
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Huakun Lv
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Junfen Lin
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Chengwei Wang
- Daishan Centre for Disease Control and Prevention, Daishan, China
| | - Enfu Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Yanjun Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhiping Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Shelan Liu
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhenyu Gong
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China.
| | - Jianmin Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China.
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208
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Seroprevalence of severe fever with thrombocytopenia syndrome virus in southeastern China and analysis of risk factors. Epidemiol Infect 2014; 143:851-6. [PMID: 24866248 PMCID: PMC4411641 DOI: 10.1017/s0950268814001319] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) has been prevalent for some time in China and it was first identified in 2010. However, the seroprevalence of SFTSV in the general population in southeastern China and risk factors associated with the infection are currently unclear. Blood samples were collected from seven counties across Zhejiang province and tested for the presence of SFTSV-specific IgG antibodies by ELISA. A total of 1380 blood samples were collected of which 5·51% were seropositive for SFTSV with seroprevalence varying significantly between sites. Seroprevalence of SFTSV in people who were family members of the patient, lived in the same village as the patient, or lived in a different village than the patient varied significantly. There was significant difference in seroprevalence between participants who bred domestic animals and participants who did not. Domestic animals are probably potential reservoir hosts and contact with domestic animals may be a transmission route of SFTSV.
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209
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Ding YP, Liang MF, Ye JB, Liu QH, Xiong CH, Long B, Lin WB, Cui N, Zou ZQ, Song YL, Zhang QF, Zhang S, Liu YZ, Song G, Ren YY, Li SH, Wang Y, Hou FQ, Yu H, Ding P, Ye F, Li DX, Wang GQ. Prognostic value of clinical and immunological markers in acute phase of SFTS virus infection. Clin Microbiol Infect 2014; 20:O870-8. [PMID: 24684627 DOI: 10.1111/1469-0691.12636] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Revised: 03/25/2014] [Accepted: 03/25/2014] [Indexed: 12/23/2022]
Abstract
SFTS virus (SFTSV) is a novel bunyavirus that causes severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease that occurred in China in recent years, with an average case fatality rate of 10-12%. Intervention in the early clinical stage is the most effective measure to reduce the mortality rate of disease. To elucidate the natural course of and immune mechanisms associated with the pathogenesis of SFTSV, 59 laboratory-confirmed SFTS patients in the acute phase, who were hospitalized between October 2010 and September 2011, were enrolled in this study, and the patients sera were dynamically collected and tested for SFTSV viral RNA load, 34 cytokines or chemokines and other related laboratory parameters. All clinical diagnostic factors in the acute phase of SFTS were evaluated and assessed. The study showed that the severity of the disease in 11 (18.6%) patients was associated with abdominal pain (p 0.007; OR = 21.95; 95% CI, 2.32-208.11) and gingival bleeding (p 0.001; OR=122.11; 95% CI, 6.41-2328). The IP-10, TNF-α, IL-6, IL-10, granzyme B and HSP70 levels were higher over the 7-8 days in severe cases, accompanied by altered AST, CK and LDH levels. HSP70 (p 0.012; OR=8.29; 95% CI, 1.58-43.40) was independently correlated with the severity of the early acute phase of SFTSV infection. The severity of SFTS can be predicted based on the presence of symptoms such as abdominal pain and gingival bleeding and on the level of HSP70 in the acute phase of the disease.
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Affiliation(s)
- Y-P Ding
- Department of Infectious Diseases, The Center for Liver Diseases, Peking University First Hospital, Beijing, China
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210
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Liu K, Cui N, Fang LQ, Wang BJ, Lu QB, Peng W, Li H, Wang LY, Liang S, Wang HY, Zhang YY, Zhuang L, Yang H, Gray GC, de Vlas SJ, Liu W, Cao WC. Epidemiologic features and environmental risk factors of severe fever with thrombocytopenia syndrome, Xinyang, China. PLoS Negl Trop Dis 2014; 8:e2820. [PMID: 24810269 PMCID: PMC4014392 DOI: 10.1371/journal.pntd.0002820] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 03/11/2014] [Indexed: 11/18/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in rural areas of Central China in 2009, caused by a novel bunyavirus, SFTS virus (SFTSV). The disease usually presents as fever, thrombocytopenia, and leukocytopenia, with case-fatality rates ranging from 2.5% to 30%. Haemaphysalis longicornis was suspected to be the most likely vector of SFTSV. By the end of 2012, the disease had expanded to 13 provinces of China. SFTS patients have been reported in Japan and South Korea, and a disease similar to SFTS has been reported in the United States. Methodology/Principal Findings We characterized the epidemiologic features of 504 confirmed SFTS cases in Xinyang Region, the most severely SFTS-afflicted region in China from 2011 to 2012, and assessed the environmental risk factors. All cases occurred during March to November, with the epidemic peaking from May to July. The patients' ages ranged from 7 to 87 years (median 61 years), and the annual incidence increased with age (χ2 test for trend, P<0.001). The female-to-male ratio of cases was 1.58, and 97.0% of the cases were farmers who resided in the southern and western parts of the region. The Poisson regression analysis revealed that the spatial variations of SFTS incidence were significantly associated with the shrub, forest, and rain-fed cropland areas. Conclusions The distribution of SFTS showed highly significant temporal and spatial heterogeneity in Xinyang Region, with the majority of SFTS cases being elderly farmers who resided in the southern and western parts of the region, mostly acquiring infection between May and July when H. longicornis is highly active. The shrub, rain-fed, and rain-fed cropland areas were associated with high risk for this disease. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in rural areas of Central China in 2009, caused by a novel bunyavirus, SFTS virus (SFTSV). The disease usually presents as fever, thrombocytopenia, and leukocytopenia, with case-fatality rates ranging from 2.5% to 30%. By the end of 2012, the disease had expanded to 13 provinces of China. SFTS patients have been reported in Japan and South Korea, and a disease similar to SFTS has been reported in the United States. Here we characterized the epidemiologic features of 504 confirmed SFTS cases in Xinyang, the most severely SFTS-affected region in China from 2011 to 2012, and identified the environmental risk factors. We found the distribution of SFTS cases showed highly significant temporal and spatial heterogeneity, with the majority of SFTS cases being elderly farmers who resided in the southern and western parts of the region, mostly acquiring infection between May and July when H. longicornis is highly active. The shrub, forest, and rain-fed cropland areas were strongly associated with high risk for SFTS.
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Affiliation(s)
- Kun Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Ning Cui
- The 154 Hospital, People's Liberation Army, Xinyang, People's Republic of China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Bing-Jun Wang
- The 154 Hospital, People's Liberation Army, Xinyang, People's Republic of China
| | - Qing-Bin Lu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Wei Peng
- The Shangcheng People's Hospital, Shangcheng, People's Republic of China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Li-Yuan Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
- Anhui Medical University, Hefei, People's Republic of China
| | - Song Liang
- Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Hong-Yu Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
- Anhui Medical University, Hefei, People's Republic of China
| | - Yao-Yun Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
- Anhui Medical University, Hefei, People's Republic of China
| | - Lu Zhuang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Hong Yang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
| | - Gregory C. Gray
- Environmental and Global Health, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, Gainesville, Florida, United States of America
| | - Sake J. de Vlas
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
- * E-mail: (WL); (WCC)
| | - Wu-Chun Cao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China
- * E-mail: (WL); (WCC)
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Xing Z, Schefers J, Schwabenlander M, Jiao Y, Liang M, Qi X, Li C, Goyal S, Cardona CJ, Wu X, Zhang Z, Li D, Collins J, Murtaugh MP. Novel bunyavirus in domestic and captive farmed animals, Minnesota, USA. Emerg Infect Dis 2014; 19:1487-9. [PMID: 23966016 PMCID: PMC5485073 DOI: 10.3201/eid1909.130165] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We tested blood samples from domestic and captive farmed animals in Minnesota, USA, to determine exposure to severe fever with thrombocytopenia syndrome virus and Heartland-like virus. We found antibodies against virus nucleoproteins in 10%–18% of samples from cattle, sheep, goats, deer, and elk in 24 Minnesota counties.
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212
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Cui N, Bao XL, Yang ZD, Lu QB, Hu CY, Wang LY, Wang BJ, Wang HY, Liu K, Yuan C, Fan XJ, Wang Z, Zhang L, Zhang XA, Hu LP, Liu W, Cao WC. Clinical progression and predictors of death in patients with severe fever with thrombocytopenia syndrome in China. J Clin Virol 2014; 59:12-7. [DOI: 10.1016/j.jcv.2013.10.024] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2013] [Revised: 10/14/2013] [Accepted: 10/21/2013] [Indexed: 10/26/2022]
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Affiliation(s)
- Seung Jin Yoo
- Division of Infectious Disease, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Sang Taek Heo
- Division of Infectious Disease, Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Keun Hwa Lee
- Department of Microbiology and Immunology, Jeju National University School of Medicine, Jeju, Korea
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214
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Wang Y, Deng B, Zhang J, Cui W, Yao W, Liu P. Person-to-person asymptomatic infection of severe fever with thrombocytopenia syndrome virus through blood contact. Intern Med 2014; 53:903-6. [PMID: 24739616 DOI: 10.2169/internalmedicine.53.1164] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease recently discovered in northeastern and central China that is caused by a novel bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV). Humans are primarily infected through tick bites. Four previous reports have discussed SFTS infection from person to person, all cases of which were symptomatic. In this report, we analysed the epidemiological and clinical data for a cluster of cases, including one case of secondary-asymptomatic infection, and review the literature regarding SFTSV transmission from person to person. We conclude that SFTSV caused the asymptomatic infections via person-to-person contact with infected blood.
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Affiliation(s)
- Yanli Wang
- Department of Infectious Diseases, The First Affiliated Hospital, China Medical University, China
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215
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Liu S, Chai C, Wang C, Amer S, Lv H, He H, Sun J, Lin J. Systematic review of severe fever with thrombocytopenia syndrome: virology, epidemiology, and clinical characteristics. Rev Med Virol 2013; 24:90-102. [PMID: 24310908 PMCID: PMC4237196 DOI: 10.1002/rmv.1776] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/19/2013] [Accepted: 11/04/2013] [Indexed: 01/12/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) was firstly discovered in China in 2010, followed by several reports from many other countries worldwide. SFTS virus (SFTSV) has been identified as the causative agent of the disease and has been recognized as a public health threat. This novel Bunyavirus belongs to the Phlebovirus genus in the family Bunyaviridae. This review also describes the different aspects of virology, pathogenesis, epidemiology, and clinical symptoms on the basis of the published article surveillance data and phylogenetic analyses of viral sequences of large, medium, and small segments retrieved from database using mega 5.05, simplot 3.5.1, network 4.611, and epi information system 3.5.3 software. SFTS presents with fever, thrombocytopenia, leukocytopenia, and considerable changes in several serum biomarkers. The disease has 10 ∼ 15% mortality rate, commonly because of multiorgan dysfunction. SFTSV is mainly reported in the rural areas of Central and North-Eastern China, with seasonal occurrence from May to September, mainly targeting those of ≥50 years of age. A wide range of domesticated animals, including sheep, goats, cattle, pigs, dogs, and chickens have been proven seropositive for SFTSV. Ticks, especially Haemaphysalis longicornis, are suspected to be the potential vector, which have a broad animal host range in the world. More studies are needed to elucidate the vector–animal–human ecological cycle, the pathogenic mechanisms in high level animal models and vaccine development. © 2013 The Authors. Reviews in Medical Virology published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Xu H, Zhang L, Shen G, Feng C, Wang X, Yan J, Zhang Y. Establishment of a novel one-step reverse transcription loop-mediated isothermal amplification assay for rapid identification of RNA from the severe fever with thrombocytopenia syndrome virus. J Virol Methods 2013; 194:21-5. [DOI: 10.1016/j.jviromet.2013.07.037] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 07/11/2013] [Accepted: 07/18/2013] [Indexed: 12/13/2022]
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217
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Takahashi T, Maeda K, Suzuki T, Ishido A, Shigeoka T, Tominaga T, Kamei T, Honda M, Ninomiya D, Sakai T, Senba T, Kaneyuki S, Sakaguchi S, Satoh A, Hosokawa T, Kawabe Y, Kurihara S, Izumikawa K, Kohno S, Azuma T, Suemori K, Yasukawa M, Mizutani T, Omatsu T, Katayama Y, Miyahara M, Ijuin M, Doi K, Okuda M, Umeki K, Saito T, Fukushima K, Nakajima K, Yoshikawa T, Tani H, Fukushi S, Fukuma A, Ogata M, Shimojima M, Nakajima N, Nagata N, Katano H, Fukumoto H, Sato Y, Hasegawa H, Yamagishi T, Oishi K, Kurane I, Morikawa S, Saijo M. The first identification and retrospective study of Severe Fever with Thrombocytopenia Syndrome in Japan. J Infect Dis 2013; 209:816-27. [PMID: 24231186 PMCID: PMC7107388 DOI: 10.1093/infdis/jit603] [Citation(s) in RCA: 605] [Impact Index Per Article: 55.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background. Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV), a novel bunyavirus reported to be endemic in central and northeastern China. This article describes the first identified patient with SFTS and a retrospective study on SFTS in Japan. Methods. Virologic and pathologic examinations were performed on the patient's samples. Laboratory diagnosis of SFTS was made by isolation/genome amplification and/or the detection of anti-SFTSV immunoglobulin G antibody in sera. Physicians were alerted to the initial diagnosis and asked whether they had previously treated patients with symptoms similar to those of SFTS. Results. A female patient who died in 2012 received a diagnosis of SFTS. Ten additional patients with SFTS were then retrospectively identified. All patients were aged ≥50 years and lived in western Japan. Six cases were fatal. The ratio of males to females was 8:3. SFTSV was isolated from 8 patients. Phylogenetic analyses indicated that all of the Japanese SFTSV isolates formed a genotype independent to those from China. Most patients showed symptoms due to hemorrhage, possibly because of disseminated intravascular coagulation and/or hemophagocytosis. Conclusions. SFTS has been endemic to Japan, and SFTSV has been circulating naturally within the country.
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218
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Kleinman S, Busch MP, Murphy EL, Shan H, Ness P, Glynn SA. The National Heart, Lung, and Blood Institute Recipient Epidemiology and Donor Evaluation Study (REDS-III): a research program striving to improve blood donor and transfusion recipient outcomes. Transfusion 2013; 54:942-55. [PMID: 24188564 DOI: 10.1111/trf.12468] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/11/2013] [Accepted: 09/11/2013] [Indexed: 12/29/2022]
Abstract
BACKGROUND The Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) is a 7-year multicenter transfusion safety research initiative launched in 2011 by the National Heart, Lung, and Blood Institute. STUDY DESIGN AND METHODS The domestic component involves four blood centers, 12 hospitals, a data coordinating center, and a central laboratory. The international component consists of distinct programs in Brazil, China, and South Africa, which involve US and in-country investigators. RESULTS REDS-III is using two major methods to address key research priorities in blood banking and transfusion medicine. First, there will be numerous analyses of large "core" databases; the international programs have each constructed a donor and donation database while the domestic program has established a detailed research database that links data from blood donors and their donations, the components made from these donations, and data extracts from the electronic medical records of the recipients of these components. Second, there are more than 25 focused research protocols involving transfusion recipients, blood donors, or both that either are in progress or are scheduled to begin within the next 3 years. Areas of study include transfusion epidemiology and blood utilization, transfusion outcomes, noninfectious transfusion risks, human immunodeficiency virus-related safety issues (particularly in the international programs), emerging infectious agents, blood component quality, donor health and safety, and other donor issues. CONCLUSIONS It is intended that REDS-III serve as an impetus for more widespread recipient and linked donor-recipient research in the United States as well as to help assure a safe and available blood supply in the United States and in international locations.
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Affiliation(s)
- Steven Kleinman
- Department of Pathology, University of British Columbia, Victoria, British Columbia, Canada
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219
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Niu G, Li J, Liang M, Jiang X, Jiang M, Yin H, Wang Z, Li C, Zhang Q, Jin C, Wang X, Ding S, Xing Z, Wang S, Bi Z, Li D. Severe fever with thrombocytopenia syndrome virus among domesticated animals, China. Emerg Infect Dis 2013; 19:756-63. [PMID: 23648209 PMCID: PMC3647489 DOI: 10.3201/eid1905.120245] [Citation(s) in RCA: 182] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
To investigate the infections of severe fever with thrombocytopenia syndrome virus (SFTSV) in domesticated animals, we sampled a total of 3,039 animals in 2 counties in Shandong Province, People’s Republic of China, from April to November 2011. SFTSV-specific antibodies were detected in 328 (69.5%) of 472 sheep, 509 (60.5%) of 842 cattle, 136 (37.9%) of 359 dogs, 26 (3.1%) of 839 pigs, and 250 (47.4%) of 527 chickens. SFTSV RNA was detected in all sampled animal species, but the prevalence was low, ranging from 1.7% to 5.3%. A cohort study in 38 sheep was conducted to determine when seroconversion to SFTSV occured. SFTSVs were isolated from sheep, cattle, and dogs and shared >95% sequence homology with human isolates from the same disease-endemic regions. These findings demonstrate that natural infections of SFTSV occur in several domesticated animal hosts in disease-endemic areas and that the virus has a wide host range.
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Affiliation(s)
- Guoyu Niu
- Key Laboratory for Medical Virology–Chinese Center for Disease Control and Prevention, Beijing, People’s Republic of China
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220
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Zhang X, Liu Y, Zhao L, Li B, Yu H, Wen H, Yu XJ. An emerging hemorrhagic fever in China caused by a novel bunyavirus SFTSV. SCIENCE CHINA-LIFE SCIENCES 2013; 56:697-700. [PMID: 23917841 DOI: 10.1007/s11427-013-4518-9] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/16/2013] [Indexed: 10/26/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever in rural areas of China and is caused by a new bunyavirus, SFTSV, named after the disease. The transmission vectors and animal hosts of SFTSV are unclear. Ticks are the most likely transmission vectors and domestic animals, including goats, dogs, and cattle, are potential amplifying hosts of SFTSV. The clinical symptoms of SFTS are nonspecific, but major symptoms include fever, gastrointestinal symptoms, myalgia, dizziness, joint pain, chills, and regional lymphadenopathy. The most common abnormalities in laboratory test results are thrombocytopenia (95%), leukocytopenia (86%), and elevated levels of serum alanine aminotransferase, aspartate aminotransferase, creatine kinase, and lactate dehydrogenase. The fatality rate for SFTS is 12% on average, and the annual incidence of the disease is approximately five per 100000 of the rural population.
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Affiliation(s)
- XiaoShuang Zhang
- School of Public Health, Shandong University, Jinan 250012, China
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221
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Human antibody neutralizes severe Fever with thrombocytopenia syndrome virus, an emerging hemorrhagic Fever virus. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2013; 20:1426-32. [PMID: 23863504 DOI: 10.1128/cvi.00222-13] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV), a newly discovered member of the Bunyaviridae family, is the causative agent of an emerging hemorrhagic fever, SFTS, in China. Currently, there are no vaccines or effective therapies against SFTS. In this study, a combinatorial human antibody library was constructed from the peripheral lymphocytes of 5 patients who had recovered from SFTS. The library was screened against purified virions for the production of single-chain variable-region fragments (ScFv). Of the 6 positive clones, one clone (monoclonal antibody [MAb] 4-5) showed neutralizing activity against SFTSV infection in Vero cells. MAb 4-5 was found to effectively neutralize all of the clinical isolates of SFTSV tested, which were isolated from patients in China from 2010 to 2012. MAb 4-5 was found to bind a linear epitope in the ectodomain of glycoprotein Gn. Its neutralizing activity is attributed to blockage of the interactions between the Gn protein and the cellular receptor, indicating that inhibition of virus-cell attachment is its main mechanism. These data suggest that MAb 4-5 can be used as a promising candidate molecule for immunotherapy against SFTSV infection.
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222
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Infection with a novel virus causes hemorrhagic fever in China. Int J Infect Dis 2013; 17:e556-61. [DOI: 10.1016/j.ijid.2013.03.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2012] [Revised: 03/02/2013] [Accepted: 03/04/2013] [Indexed: 11/21/2022] Open
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223
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Pan H, Hu J, Liu S, Shen H, Zhu Y, Wu J, Zhang X, Zhou X, Wang C, Qu J, Yuan Z. A reported death case of a novel bunyavirus in Shanghai, China. Virol J 2013; 10:187. [PMID: 23758684 PMCID: PMC3689053 DOI: 10.1186/1743-422x-10-187] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2012] [Accepted: 05/31/2013] [Indexed: 11/12/2022] Open
Abstract
This paper describes the first case of infection with a recently described novel bunyavirus, severe fever with thrombocytopenia syndrome virus (SFTSV), in Shanghai, China. The case is originally from Chizhou City, Anhui province within an endemic area for SFTSV. We describe the etiology, epidemiological characteristics, clinical diagnosis and treatment of this fatal case. This case is unique because major cause of death was renal failure, whereas other reported cases have been due to hemorrhage. The investigation and response to this case provides meaningful insight for the early and rapid diagnosis, treatment, prevention and control of severe fever with thrombocytopenia syndrome virus in non-endemic regions in China and globally.
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Affiliation(s)
- Hao Pan
- Shanghai Municipal Center for Disease Control and Prevention, No 1380, West Zhongshan Road, Shanghai 200336, China
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224
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Affiliation(s)
- Mee Soo Chang
- Department of Pathology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul, Korea
| | - Jun Hee Woo
- Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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225
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Zivcec M, Safronetz D, Feldmann H. Animal models of tick-borne hemorrhagic Fever viruses. Pathogens 2013; 2:402-21. [PMID: 25437041 PMCID: PMC4235721 DOI: 10.3390/pathogens2020402] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/03/2013] [Accepted: 05/09/2013] [Indexed: 12/22/2022] Open
Abstract
Tick-borne hemorrhagic fever viruses (TBHFV) are detected throughout the African and Eurasian continents and are an emerging or re-emerging threat to many nations. Due to the largely sporadic incidences of these severe diseases, information on human cases and research activities in general have been limited. In the past decade, however, novel TBHFVs have emerged and areas of endemicity have expanded. Therefore, the development of countermeasures is of utmost importance in combating TBHFV as elimination of vectors and interrupting enzootic cycles is all but impossible and ecologically questionable. As in vivo models are the only way to test efficacy and safety of countermeasures, understanding of the available animal models and the development and refinement of animal models is critical in negating the detrimental impact of TBHFVs on public and animal health.
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Affiliation(s)
- Marko Zivcec
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg R3E 0J9, Canada.
| | - David Safronetz
- Laboratory of Virology Division of Intramural Research, National Institute Allergy and Infectious Disease, National Institutes of Health, Rocky Mountain Laboratories, Hamilton 59840, Montana, USA.
| | - Heinz Feldmann
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg R3E 0J9, Canada.
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226
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Chen H, Hu K, Zou J, Xiao J. A cluster of cases of human-to-human transmission caused by severe fever with thrombocytopenia syndrome bunyavirus. Int J Infect Dis 2013; 17:e206-8. [DOI: 10.1016/j.ijid.2012.11.006] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 11/02/2012] [Indexed: 11/16/2022] Open
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227
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Jie SH, Zhou Y, Sun LP, Liang KW, Yi XL, Li HY. Close correlation between development of MODS during the initial 72 h of hospitalization and hospital mortality in severe fever with thrombocytopenia syndrome. ACTA ACUST UNITED AC 2013; 33:81-85. [PMID: 23392712 DOI: 10.1007/s11596-013-1075-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Indexed: 11/25/2022]
Abstract
An emerging infectious disease was identified as severe fever with thrombocytopenia syndrome (SFTS) in central China since late March 2009. We found the patients with SFTS had severe clinical symptoms, and progressed rapidly to multiple organ dysfunction syndrome (MODS) with high fatality rate of 25%-30%. The aim of this study was to assess the significance of risk factors predicting the development of MODS and death in SFTS patients. Consecutive SFTS admissions between May 2009 and September 2011 were analyzed for parameters of organ function during hospitalization using Marshall scoring system for MODS, and platelet counts were recorded on admission and at 24, 48, 72 h and one week after admission. We investigated the kinetics of organ failures and analyzed the association between age, platelet count and development of MODS or death. A total of 92 SFTS patients were enrolled in this study. Among them, 32 patients with dysfunction of over 4 organs were identified, 45% of them died within 72 h, 72% died within 5 days, and 76% died within 7 days after admission. We also found cumulative Marshall score was significantly higher in death patients (11.76±2.05) than in survival patients (4.22±1.98) (P<0.001). In addition, SFTS patients had older age and lower platelet counts in MODS and death groups. Furthermore, we also observed that there was a close correlation between platelet count on admission and Marshall score (P<0.001). High Marshall score, advanced age and lower platelet counts were the main risk factors for the development of MODS, and those factors could predict mortality in SFTS patients, suggesting prompt treatment and close monitoring of severe complications, especially MODS, are of great importance in saving patients' lives.
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Affiliation(s)
- Sheng-Hua Jie
- Department of Infectious Diseases, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yan Zhou
- Department of Infectious Diseases, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Li-Ping Sun
- Department of Infectious Diseases, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Kai-Wei Liang
- Center for Stem Cell Research and Application, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Xiao-Ling Yi
- Department of Infectious Diseases, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Hui-Yu Li
- Center for Stem Cell Research and Application, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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228
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Severe fever with thrombocytopenia virus glycoproteins are targeted by neutralizing antibodies and can use DC-SIGN as a receptor for pH-dependent entry into human and animal cell lines. J Virol 2013; 87:4384-94. [PMID: 23388721 DOI: 10.1128/jvi.02628-12] [Citation(s) in RCA: 92] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel bunyavirus that recently emerged in China. Infection with SFTSV is associated with case-fatality rates of up to 30%, and neither antivirals nor vaccines are available at present. Development of antiviral strategies requires the elucidation of virus-host cell interactions. Here, we analyzed host cell entry of SFTSV. Employing lentiviral and rhabdoviral vectors, we found that the Gn/Gc glycoproteins (Gn/Gc) of SFTSV mediate entry into a broad range of human and animal cell lines, as well as human macrophages and dendritic cells. The Gn/Gc proteins of La Crosse virus (LACV) and Rift Valley Fever Virus (RVFV), other members of the bunyavirus family, facilitated entry into an overlapping but not identical range of cell lines, suggesting that SFTSV, LACV, and RVFV might differ in their receptor requirements. Entry driven by SFTSV Gn/Gc was dependent on low pH but did not require the activity of the pH-dependent endosomal/lysosomal cysteine proteases cathepsins B and L. Instead, the activity of a cellular serine protease was required for infection driven by SFTSV and LACV Gn/Gc. Sera from convalescent SFTS patients inhibited SFTSV Gn/Gc-driven host cell entry in a dose-dependent fashion, demonstrating that the vector system employed is suitable to detect neutralizing antibodies. Finally, the C-type lectin DC-SIGN was found to serve as a receptor for SFTSV Gn/Gc-driven entry into cell lines and dendritic cells. Our results provide initial insights into cell tropism, receptor usage, and proteolytic activation of SFTSV and will aid in the understanding of viral spread and pathogenesis.
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229
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Zhang L, Wang X, Zhang Y, Zhang Y, Wang H, Wang C, Sun J, Lin J, Chai C, Yan J. Severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) infections in Zhejiang Province, China. Int J Infect Dis 2013; 17:e137-8. [DOI: 10.1016/j.ijid.2012.07.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 07/03/2012] [Indexed: 11/26/2022] Open
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230
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Li D. A highly pathogenic new bunyavirus emerged in China. Emerg Microbes Infect 2013; 2:e1. [PMID: 26038435 PMCID: PMC3630492 DOI: 10.1038/emi.2013.1] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Revised: 10/08/2012] [Accepted: 12/19/2012] [Indexed: 12/05/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was discovered in China in 2010. The causative agent has been identified as a new member of the Phlebovirus genus in the family Bunyaviridae and has been designated severe fever with thrombocytopenia virus (SFTSV). SFTSV infection can be transmitted person-to-person, and the average case fatality rate is approximately 10% in humans. There is a high seroprevalence of SFTSV infection in a wide range of domesticated animals, including sheep, goats, cattle, pigs, dogs and chickens. Ticks are suspected to be the vector that transmits the virus to humans. Currently, the SFTS endemic area is expanding. Therefore, SFTSV infection is an increasingly important public health threat.
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Affiliation(s)
- Dexin Li
- National Institute for Viral Disease Control and Prevention, China CDC , Beijing 102206, China
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231
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Risk assessment of human infection with a novel bunyavirus in China. Western Pac Surveill Response J 2012; 3:61-6. [PMID: 23908943 DOI: 10.5365/wpsar.2012.3.4.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To assess the public health risk of human infection from a novel bunyavirus - severe fever with thrombocytopenia syndrome virus (SFTSV) - in China. METHODS The likelihood of disease spread and the magnitude of public health impact were assessed to clarify overall risk. Literature about hazard, exposure and contextual factors associated with SFTSV infection was collected and reviewed. Information on SFTSV cases and the population in six provinces under surveillance was compared. RESULTS SFTSV is a member of the Phlebovirus genus of the Bunyaviridae family. A widely distributed tick species, Haemaphysalis longicornis, can act as the vector; thus the disease is likely to spread in China. Symptoms of SFTSV infection are nonspecific, but have led to multiorgan dysfunction in severe cases. High-risk populations include farmers and older females. Evidence of human-to-human transmission within family and hospital has been reported. The capacity for treatment and diagnosis of SFTSV are adequate in rural communities in China, and community awareness of the disease should be high. DISCUSSION There is a low to moderate public health risk related to SFTSV human infection in China. There is potential for an increase in the number of cases reported as awareness increases and when surveillance is expanded.
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232
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Detection of severe fever with thrombocytopenia syndrome virus by reverse transcription-cross-priming amplification coupled with vertical flow visualization. J Clin Microbiol 2012; 50:3881-5. [PMID: 22993179 DOI: 10.1128/jcm.01931-12] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A virus known as severe fever with thrombocytopenia syndrome virus (SFTSV) was recently identified as the etiological agent of severe fever with thrombocytopenia syndrome (SFTS) in China. Reliable laboratory detection and identification of this virus are likely to become clinically and epidemiologically desirable. We developed a nearly instrument-free, simple molecular method which incorporates reverse transcription-cross-priming amplification (RT-CPA) coupled with a vertical flow (VF) visualization strip for rapid detection of SFTSV. The RT-CPA-VF assay targets a conserved region of the M segment of the SFTSV genome and has a limit of detection of 100 copies per reaction, with no cross-reaction with other vector-borne bunyaviruses and bacterial pathogens. The performance of the RT-CPA-VF assay was determined with 175 human plasma specimens collected from 89 clinically suspected SFTS patients and 86 healthy donors. The sensitivity and specificity of the assay were 94.1% and 100.0%, respectively, compared with a combination of virus culture and real-time RT-PCR. The entire procedure, from specimen processing to result reporting, can be completed within 2 h. The simplicity and nearly instrument-free platform of the RT-CPA-VF assay make it practical for point-of-care testing.
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233
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McMullan LK, Folk SM, Kelly AJ, MacNeil A, Goldsmith CS, Metcalfe MG, Batten BC, Albariño CG, Zaki SR, Rollin PE, Nicholson WL, Nichol ST. A new phlebovirus associated with severe febrile illness in Missouri. N Engl J Med 2012; 367:834-41. [PMID: 22931317 DOI: 10.1056/nejmoa1203378] [Citation(s) in RCA: 481] [Impact Index Per Article: 40.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Two men from northwestern Missouri independently presented to a medical facility with fever, fatigue, diarrhea, thrombocytopenia, and leukopenia, and both had been bitten by ticks 5 to 7 days before the onset of illness. Ehrlichia chaffeensis was suspected as the causal agent but was not found on serologic analysis, polymerase-chain-reaction (PCR) assay, or cell culture. Electron microscopy revealed viruses consistent with members of the Bunyaviridae family. Next-generation sequencing and phylogenetic analysis identified the viruses as novel members of the phlebovirus genus. Although Koch's postulates have not been completely fulfilled, we believe that this phlebovirus, which is novel in the Americas, is the cause of this clinical syndrome.
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Affiliation(s)
- Laura K McMullan
- Viral Special Pathogens Branch, Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA
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234
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Discovery of severe fever with thrombocytopenia syndrome bunyavirus strains originating from intragenic recombination. J Virol 2012; 86:12426-30. [PMID: 22933273 DOI: 10.1128/jvi.01317-12] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
This study analyzes available severe fever with thrombocytopenia syndrome virus (SFTSV) genomes and reports that a sublineage of lineage I bears a unique M segment recombined from two of three prevailing SFTSV lineages. Through recombination, the sublineage has acquired nearly complete G1 associated with protective epitopes from lineage III, suggesting that this recombination has the capacity to induce antigenic shift of the virus. Therefore, this study provides some valuable implications for the vaccine design of SFTSV.
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235
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Sun Y, Jin C, Zhan F, Wang X, Liang M, Zhang Q, Ding S, Guan X, Huo X, Li C, Qu J, Wang Q, Zhang S, Zhang Y, Wang S, Xu A, Bi Z, Li D. Host cytokine storm is associated with disease severity of severe fever with thrombocytopenia syndrome. J Infect Dis 2012; 206:1085-94. [PMID: 22904342 DOI: 10.1093/infdis/jis452] [Citation(s) in RCA: 188] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral disease in China, caused by SFTS virus (SFTSV). Severe SFTS patients can quickly proceed to multiorgan dysfunction and death; however, underlying pathogenic mechanisms remain unclear. METHODS Serum samples from 15 fatal and 44 nonfatal SFTS cases were subjected to multiplex-microbead immunoassays to detect a broad spectrum of cytokines. The viral load and virus-specific IgG titers were also tested by real-time PCR and ELISA, respectively. RESULTS Cytokines IL-1RA, IL-6, IL-10, G-CSF, IP-10, and MCP-1 were elevated in SFTS patients and produced at robust levels in fatal cases. In contrast, cytokines PDGF-BB and RANTES decreased in SFTS patients. These cytokines reverted to normal ranges during the convalescent phase of SFTSV infection. Cytokines IL-1β, IL-8, MIP-1α, and MIP-1β showed a unique pattern of elevation in fatal cases but not in nonfatal cases. However, these cytokines increased in the convalescent phase of nonfatal SFTS cases. Our regression analysis revealed that the serum viral load correlated with these cytokines. Moreover, levels of these cytokines correlated with various clinical parameters and virus-specific IgG titers. CONCLUSION The study demonstrates that SFTSV infection induces a cytokine storm with abnormally expressed cytokine profiles, which are associated with the disease severity.
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Affiliation(s)
- Yulan Sun
- National Institute for Viral Disease Control and Prevention, China Centers for Disease Control and Prevention (CDC), China
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236
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Gai ZT, Zhang Y, Liang MF, Jin C, Zhang S, Zhu CB, Li C, Li XY, Zhang QF, Bian PF, Zhang LH, Wang B, Zhou N, Liu JX, Song XG, Xu A, Bi ZQ, Chen SJ, Li DX. Clinical progress and risk factors for death in severe fever with thrombocytopenia syndrome patients. J Infect Dis 2012; 206:1095-102. [PMID: 22850122 DOI: 10.1093/infdis/jis472] [Citation(s) in RCA: 220] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus (SFTSV) with an average fatality rate of 12%. The clinical factors for death in SFTS patients remain unclear. METHODS Clinical features and laboratory parameters were dynamically collected for 11 fatal and 48 non-fatal SFTS cases. Univariate logistic regression was used to evaluate the risk factors associated with death. RESULTS Dynamic tracking of laboratory parameters revealed that during the initial fever stage, the viral load was comparable for the patients who survived as well as the ones that died. Then in the second stage when multi-organ dysfunction occurred, from 7-13 days after disease onset, the viral load decreased in survivors but it remained high in the patients that died. The key risk factors that contributed to patient death were elevated serum aspartate aminotransferase, lactate dehydrogenase, creatine kinase, and creatine kinase fraction, as well as the appearance of CNS (central nervous system) symptoms, hemorrhagic manifestation, disseminated intravascular coagulation, and multi-organ failure. All clinical markers reverted to normal in the convalescent stage for SFTS patients who survived. CONCLUSIONS We identified a period of 7-13 days after the onset of illness as the critical stage in SFTS progression. A sustained serum viral load may indicate that disease conditions will worsen and lead to death.
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Affiliation(s)
- Zhong-Tao Gai
- Jinan Infectious Disease Hospital, Shandong University, Shandong Province, China
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237
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Dilcher M, Alves MJ, Finkeisen D, Hufert F, Weidmann M. Genetic characterization of Bhanja virus and Palma virus, two tick-borne phleboviruses. Virus Genes 2012; 45:311-5. [PMID: 22806684 DOI: 10.1007/s11262-012-0785-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2012] [Accepted: 07/04/2012] [Indexed: 02/02/2023]
Abstract
The genomes of Bhanja virus (BHAV) and Palma virus (PALV) two tick-borne viruses hitherto grouped into the Bhanja virus antigenic complex of the Bunyaviridae were determined by pyrosequencing. Phylogenetic analysis groups all three segments of BHAV and PALV into a distinct clade of tick-borne phleboviruses together with the newly described severe fever with thrombocytopenia syndrome virus and Uukuniemi virus. The terminal signature sequences which are signatures for taxonomic grouping and important for virus replication and RNA transcription show marked differences in the L- and S-segments.
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Affiliation(s)
- Meik Dilcher
- Department of Virology, University Medical Center Goettingen, Kreuzbergring 57, 37075 Göttingen, Germany
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238
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Yu L, Zhang L, Sun L, Lu J, Wu W, Li C, Zhang Q, Zhang F, Jin C, Wang X, Bi Z, Li D, Liang M. Critical epitopes in the nucleocapsid protein of SFTS virus recognized by a panel of SFTS patients derived human monoclonal antibodies. PLoS One 2012; 7:e38291. [PMID: 22719874 PMCID: PMC3373585 DOI: 10.1371/journal.pone.0038291] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2012] [Accepted: 05/03/2012] [Indexed: 12/13/2022] Open
Abstract
Background SFTS virus (SFTSV) is a newly discovered pathogen to cause severe fever with thrombocytopenia syndrome (SFTS) in human. Successful control of SFTSV epidemic requires better understanding of the antigen target in humoral immune responses to the new bunyavirus infection. Methodology/Principal Findings We have generated a combinatorial Fab antibody phage library from two SFTS patients recovered from SFTSV infection. To date, 94 unique human antibodies have been generated and characterized from over 1200 Fab antibody clones obtained by screening the library with SFTS purified virions. All those monoclonal antibodies (MAbs) recognized the nucleocapsid (N) protein of SFTSV while none of them were reactive to the viral glycoproteins Gn or Gc. Furthermore, over screening 1000 mouse monoclonal antibody clones derived from SFTSV virions immunization, 462 clones reacted with N protein, while only 16 clones were reactive to glycoprotein. Furthermore, epitope mapping of SFTSV N protein was performed through molecular simulation, site mutation and competitive ELISA, and we found that at least 4 distinct antigenic epitopes within N protein were recognized by those human and mouse MAbs, in particular mutation of Glu10 to Ala10 abolished or significantly reduced the binding activity of nearly most SFTS patients derived MAbs. Conclusions/Significance The large number of human recombinant MAbs derived from SFTS patients recognized the viral N protein indicated the important role of the N protein in humoral responses to SFTSV infection, and the critical epitopes we defined in this study provided molecular basis for detection and diagnosis of SFTSV infection.
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Affiliation(s)
- Li Yu
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Li Zhang
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Lina Sun
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Jing Lu
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Wei Wu
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Chuan Li
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Quanfu Zhang
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Fushun Zhang
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Cong Jin
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Xianjun Wang
- Shandong Key Laboratory for Infectious Disease Prevention and Control, Shandong Province CDC, Jinan Shandong, China
| | - Zhenqiang Bi
- Shandong Key Laboratory for Infectious Disease Prevention and Control, Shandong Province CDC, Jinan Shandong, China
| | - Dexin Li
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
| | - Mifang Liang
- Laboratory Institute for Viral Disease Control and Prevention, China CDC, Beijing, China
- * E-mail:
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239
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Pathogenesis of emerging severe fever with thrombocytopenia syndrome virus in C57/BL6 mouse model. Proc Natl Acad Sci U S A 2012; 109:10053-8. [PMID: 22665769 DOI: 10.1073/pnas.1120246109] [Citation(s) in RCA: 178] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The discovery of an emerging viral disease, severe fever with thrombocytopenia syndrome (SFTS), caused by SFTS virus (SFTSV), has prompted the need to understand pathogenesis of SFTSV. We are unique in establishing an infectious model of SFTS in C57/BL6 mice, resulting in hallmark symptoms of thrombocytopenia and leukocytopenia. Viral RNA and histopathological changes were identified in the spleen, liver, and kidney. However, viral replication was only found in the spleen, which suggested the spleen to be the principle target organ of SFTSV. Moreover, the number of macrophages and platelets were largely increased in the spleen, and SFTSV colocalized with platelets in cytoplasm of macrophages in the red pulp of the spleen. In vitro cellular assays further revealed that SFTSV adhered to mouse platelets and facilitated the phagocytosis of platelets by mouse primary macrophages, which in combination with in vivo findings, suggests that SFTSV-induced thrombocytopenia is caused by clearance of circulating virus-bound platelets by splenic macrophages. Thus, this study has elucidated the pathogenic mechanisms of thrombocytopenia in a mouse model resembling human SFTS disease.
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