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Wang Y, Tian X, Pang B, Ma W, Kou Z, Wen H. Long-term effects of meteorological factors on severe fever with thrombocytopenia syndrome incidence in eastern China from 2014 to 2020: An ecological time-series study. PLoS Negl Trop Dis 2024; 18:e0012266. [PMID: 38917232 DOI: 10.1371/journal.pntd.0012266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/01/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease with susceptibility influenced by meteorological factors. However, there is limited understanding of the delayed and interactive impacts of meteorological factors on SFTS incidence. METHODS Daily incidence data of SFTS and corresponding meteorological factors for the Jiaodong Peninsula in northeast China were collected from January 1, 2014, to December 31, 2020. Random forest regression model, based on custom search, was performed to compare the importance of meteorological factors. Generalized additive model with quasi-Poisson regression was conducted to examine the nonlinear relationships and interactive effects using penalized spline methods. A distributed lag nonlinear model with quasi-Poisson regression was constructed to estimate exposure-lag effects of meteorological factors. RESULTS The most important meteorological factor was weekly mean lowest temperature. The relationship between meteorological factors and SFTS incidence revealed a nonlinear and intricate pattern. Interaction analyses showed that prolonged sunshine duration posed a climatic risk within a specific temperature range for SFTS incidence. The maximum relative risk (RR) observed under extremely low temperature (-4°C) was 1.33 at lag of 15 week, while under extremely high temperature (25°C), the minimum RR was 0.65 at lag of 13 week. The RRs associated with both extremely high and low sunshine duration escalated with an increase in lag weeks. CONCLUSIONS This study underscores that meteorological factors exert nonlinear, delayed, and interactive effects on SFTS incidence. These findings highlight the importance of understanding the dependency of SFTS incidence on meteorological factors in particular climates.
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Affiliation(s)
- Yao Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Xueying Tian
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Bo Pang
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zengqiang Kou
- Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, China
| | - Hongling Wen
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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Wang W, Wang Z, Chen Z, Liang M, Zhang A, Sheng H, Ni M, Yang J. Construction of an early differentiation diagnosis model for patients with severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome. J Med Virol 2024; 96:e29626. [PMID: 38654664 DOI: 10.1002/jmv.29626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with a high mortality rate. Differentiating between SFTS and hemorrhagic fever with renal syndrome (HFRS) is difficult and inefficient. Retrospective analysis of the medical records of individuals with SFTS and HFRS was performed. Clinical and laboratory data were compared, and a diagnostic model was developed based on multivariate logistic regression analyzes. Receiver operating characteristic curve analysis was used to evaluate the diagnostic model. Among the 189 patients, 113 with SFTS and 76 with HFRS were enrolled. Univariate analysis revealed that more than 20 variables were significantly associated with SFTS. Multivariate logistic regression analysis revealed that gender, especially female gender (odds ratio [OR]: 4.299; 95% confidence interval [CI]: 1.163-15.887; p = 0.029), age ≥65 years (OR: 16.386; 95% CI: 3.043-88.245; p = 0.001), neurological symptoms (OR: 12.312; 95% CI: 1.638-92.530; p = 0.015), leukopenia (<4.0 × 109/L) (OR: 17.355; 95% CI: 3.920-76.839; p < 0.001), and normal Cr (OR: 97.678; 95% CI: 15.483-616.226; p < 0.001) were significantly associated with SFTS but not with HFRS. The area under the curve of the differential diagnostic model was 0.960 (95% CI: 0.936-0.984), which was significantly better than that of each single factor. In addition, the model exhibited very excellent sensitivity and specificity (92.9% and 85.5%, respectively). In cases where HFRS and SFTS are endemic, a diagnostic model based on five parameters, such as gender, age ≥65 years, neurological symptoms, leukopenia and normal Cr, will facilitate the differential diagnosis of SFTS and HFRS in medical institutions, especially in primary care settings.
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Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zijian Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zumin Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Manman Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Aiping Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Haoyu Sheng
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Mingyue Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jianghua Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Wu Y, Zhou Q, Mao M, Chen H, Qi R. Diversity of species and geographic distribution of tick-borne viruses in China. Front Microbiol 2024; 15:1309698. [PMID: 38476950 PMCID: PMC10929907 DOI: 10.3389/fmicb.2024.1309698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 02/13/2024] [Indexed: 03/14/2024] Open
Abstract
Introduction Tick-borne pathogens especially viruses are continuously appearing worldwide, which have caused severe public health threats. Understanding the species, distribution and epidemiological trends of tick-borne viruses (TBVs) is essential for disease surveillance and control. Methods In this study, the data on TBVs and the distribution of ticks in China were collected from databases and literature. The geographic distribution of TBVs in China was mapped based on geographic locations of viruses where they were prevalent or they were detected in vector ticks. TBVs sequences were collected from The National Center for Biotechnology Information and used to structure the phylogenetic tree. Results Eighteen TBVs from eight genera of five families were prevalent in China. Five genera of ticks played an important role in the transmission of TBVs in China. According to phylogenetic analysis, some new viral genotypes, such as the Dabieshan tick virus (DTV) strain detected in Liaoning Province and the JMTV strain detected in Heilongjiang Province existed in China. Discussion TBVs were widely distributed but the specific ranges of viruses from different families still varied in China. Seven TBVs belonging to the genus Orthonairovirus of the family Nairoviridae such as Nairobi sheep disease virus (NSDV) clustered in the Xinjiang Uygur Autonomous Region (XUAR) and northeastern areas of China. All viruses of the family Phenuiviridae except Severe fever with thrombocytopenia syndrome virus (SFTSV) were novel viruses that appeared in the last few years, such as Guertu virus (GTV) and Tacheng tick virus 2 (TcTV-2). They were mainly distributed in the central plains of China. Jingmen tick virus (JMTV) was distributed in at least fourteen provinces and had been detected in more than ten species of tick such as Rhipicephalus microplus and Haemaphysalis longicornis, which had the widest distribution and the largest number of vector ticks among all TBVs. Parainfluenza virus 5 (PIV5) and Lymphatic choriomeningitis virus (LCMV) were two potential TBVs in Northeast China that could cause serious diseases in humans or animals. Ixodes persulcatus carried the highest number of TBVs, followed by Dermacentor nuttalli and H. longicornis. They could carry as many as ten TBVs. Three strains of Tick-borne encephalitis (TBEV) from Inner Mongolia Province clustered with ones from Russia, Japan and Heilongjiang Province, respectively. Several SFTSV strains from Zhejiang Province clustered with strains from Korea and Japan. Specific surveillance of dominant TBVs should be established in different areas in China.
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Affiliation(s)
| | | | | | | | - Rui Qi
- Institute of Microbiome Frontiers and One Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
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Park JY, Chandran S, Hewawaduge C, Lee JH. Development and evaluation of a mouse model susceptible to severe fever with thrombocytopenia syndrome virus by rAAV-based exogenous human DC-SIGN expression. Microb Pathog 2023; 178:106079. [PMID: 36966885 DOI: 10.1016/j.micpath.2023.106079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/14/2023] [Accepted: 03/19/2023] [Indexed: 04/01/2023]
Abstract
Experimental animal model is indispensable to evaluate the prophylactic and therapeutic candidates against severe fever with thrombocytopenia syndrome virus (SFTSV). To develop a suitable mouse model for SFTSV infection, we delivered human dendritic cell-specific ICAM-3-grabbing non-integrin (hDC-SIGN) by adeno-associated virus (AAV2) and validated its susceptibility for SFTSV infection. Western blot and RT-PCR assays confirmed the expression of hDC-SIGN in transduced cell lines and a significantly increased viral infectivity was observed in cells expressing hDC-SIGN. The C57BL/6 mice transduced with AAV2 exhibited a stable hDC-SIGN expression in the organs for 7 days. Upon SFTSV challenge with 1 × 105 FAID50, the mice transduced with rAAV-hDC-SIGN showed a 12.5% mortality and reduced platelet and white blood cell count in accordance with higher viral titer than control group. Liver and spleen samples collected from the transduced mice had pathological signs similar to the IFNAR-/- mice with severe SFTSV infection. Collectively, the rAAV-hDC-SIGN transduced mouse model can be used as an accessible and promising tool for studying the SFTSV pathogenesis and pre-clinical evaluation of vaccines and therapeutics against the SFTSV infection.
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Affiliation(s)
- Ji-Young Park
- College of Veterinary Medicine, Jeonbuk National University, Iksan Campus, 54596, Iksan, Republic of Korea
| | - Sivasankar Chandran
- College of Veterinary Medicine, Jeonbuk National University, Iksan Campus, 54596, Iksan, Republic of Korea
| | - Chamith Hewawaduge
- College of Veterinary Medicine, Jeonbuk National University, Iksan Campus, 54596, Iksan, Republic of Korea
| | - John Hwa Lee
- College of Veterinary Medicine, Jeonbuk National University, Iksan Campus, 54596, Iksan, Republic of Korea.
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Luo N, Li M, Xu M, Shi C, Shi X, Ni R, Chen Y, Zheng L, Tu Y, Hu D, Yu C, Li Q, Lu Y. Research Progress of Fever with Thrombocytopenia Syndrome. INTENSIVE CARE RESEARCH 2023; 3:1-10. [PMID: 37360310 PMCID: PMC10033304 DOI: 10.1007/s44231-023-00035-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a new infectious disease first discovered in Ta-pieh Mountains in central China in 2009. It is caused by a novel bunyavirus infection (SFTSV). Since the first discovery of SFTSV, there have been case reports and epidemiological studies on SFTS in several East Asian countries, such as South Korea, Japan, Vietnam and so on. With the rising incidence of SFTS and the rapid spread of the novel bunyavirus around the world, it is clear that the virus has a pandemic potential and may pose a threat to global public health in the future. Early studies have suggested that ticks are an important medium for the transmission of SFTSV to humans; in recent years, it has been reported that there is also human-to-human transmission. In endemic areas, potential hosts include a variety of livestock and wildlife. When people are infected with SFTV, the main clinical manifestations are high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, liver and kidney function damage, and even MODS, with a mortality rate of about 10-30%. This article reviews the latest progress of novel bunyavirus, including virus transmission vector, virus genotypic diversity and epidemiology, pathogenesis, clinical manifestation and treatment.
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Affiliation(s)
- Ning Luo
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Mengdie Li
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Ming Xu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Chuanchuan Shi
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Xinge Shi
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Rong Ni
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yu Chen
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Liang Zheng
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yuling Tu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Dan Hu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Chunlin Yu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Qingying Li
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
| | - Yibin Lu
- General ICU, Xinyang Central Hospital, Xinyang Key Laboratory of Critical Care Medicine, Xinyang, 464000 Henan China
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Wei X, Li S, Lu Y, Qiu L, Xu N, Guo X, Chen M, Liang H, Cheng D, Zhao L, Hao S, Kou Z, Wen H. Severe fever with thrombocytopenia syndrome virus aerosol infection in C57/BL6 mice. Virology 2023; 581:58-62. [PMID: 36913913 DOI: 10.1016/j.virol.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 03/06/2023]
Abstract
Although secondary cases have become infected with the SFTSV after being in the same space without direct contact with the index case, it has not been experimentally determined if the SFTSV can be transmitted through aerosols. Here, this study aimed to verify if the SFTSV could be transmitted by aerosols. Firstly, we demonstrated that the SFTSV can infect BEAS-2B cells, and SFTSV genomes can be isolate from mild patient's sputum, which provided a foundation for the existence of SFTSV aerosol transmission. Then, we evaluated total antibody production in serum and viral load in tissue of mice infected with SFTSV by aerosols. The results showed that the presence of antibodies is related to the dose of virus infection and the SFTSV preferentially replicates in the lungs of mice following an aerosol exposure. Our study will help update the prevention and treatment guidelines for SFTSV and prevent the spread of the SFTSV in hospitals.
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Affiliation(s)
- Xuemin Wei
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China
| | - Shuhan Li
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China
| | - Yan Lu
- Cheeloo Hospital, Shandong University, Jinan, Shandong Province, China
| | - Ling Qiu
- Department of Infection, Shandong Provincial Public Health Clinical Center, Jinan, Shandong Province, China
| | - Nannan Xu
- Cheeloo Hospital, Shandong University, Jinan, Shandong Province, China
| | - Xianhu Guo
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, China
| | - Mengting Chen
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China
| | - Hao Liang
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China
| | - Dong Cheng
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Li Zhao
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China
| | - Shubin Hao
- Shandong Institute of Medical Device and Pharmaceutical Packaging Inspection, China
| | - Zengqiang Kou
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Hongling Wen
- Department of Virology, School of Public Health, Cheeloo College of Medicine, Shandong University, key laboratory for the prevention and control of infectious diseases (key laboratory of China's "13th Five-Year", Shandong University), Jinan, 250000, Shandong, China.
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Gong L, Zhang Y, Wang J, Xiong Y, Wang J, Wu J, Chen F, Zhu M, Cheng D, Jiang X. Evaluation of a community intervention program on knowledge, attitudes, and practices regarding severe fever with thrombocytopenia syndrome in Anhui Province, China. Front Public Health 2022; 10:891700. [PMID: 36388366 PMCID: PMC9659599 DOI: 10.3389/fpubh.2022.891700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/13/2022] [Indexed: 01/21/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a novel infectious disease with no specific therapeutics and vaccines. We hypothesize that health education in vulnerable people would ameliorate their knowledge, attitudes and practices (KAP) regarding SFTS and reduce its prevalence. Methods A four-stage cluster cross-section study in sixteen community units was performed. Sixteen groups were allocated to the intervention or control groups. A 6 months education program was administrated. The primary outcome was KAP scores 6 months after intervention. Predictors of KAP score changes were also analyzed. Results Eight hundred and fifteen valid questionnaires pre-intervention and 767 ones post-intervention were retreated. No significant differences were found in demographic characteristics and KAP scores before intervention. A significant improvement in KAP score (16.8 ± 4.7 vs. 22.0 ± 4.2, p < 0.001) in the intervention group was observed compare with the controls. Educational level and intervention program were the common predictors of KAP score changes. Conclusions Education improved KAP scores in SFTS vulnerable people which may contribute to the control of the disease.
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Affiliation(s)
- Lei Gong
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Yong Zhang
- Department of Acute Infectious Disease Prevention and Control, Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Jinsheng Wang
- Department of Acute Infectious Disease Prevention and Control, Anqing Municipal Center for Disease Control and Prevention, Anqing, China
| | - Yingying Xiong
- Department of Pediatrics, Affiliated First Hospital, University of Science and Technology of China (USTC), Hefei, China
| | - Jiling Wang
- Department of Respiratory and Critical Medicine, The Second People's Hospital of Hefei, Hefei, China
| | - Jiabing Wu
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Fang Chen
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Meng Zhu
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Donglin Cheng
- Department of Acute Infectious Disease Prevention and Control, Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Xuqin Jiang
- Department of Respiratory and Critical Medicine, Affiliated First Hospital, USTC, Hefei, China,*Correspondence: Xuqin Jiang
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Human-to-human transmission of severe fever with thrombocytopenia syndrome virus through potential ocular exposure to infectious blood. Int J Infect Dis 2022; 123:80-83. [PMID: 35987469 DOI: 10.1016/j.ijid.2022.08.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/08/2022] [Accepted: 08/06/2022] [Indexed: 11/21/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease with high mortality, was first reported in 2009 in China and subsequently endemic to South Korea, Japan, Vietnam, and Myanmar. This disease is transmitted predominantly by tick bites and potentially human-to-human. Personal protective equipments (PPEs) have been recommended to prevent SFTS human-to-human transmission, whereas the specific use of PPEs and the effect on viral transmission have rarely been reported. This report identified a family cluster of six patients with SFTS virus (SFTSV) infection. All five secondary patients had been wearing gloves and masks when exposed to the blood of the index patient, but none of them wore goggles or face shields for eye protection. Ocular route was suggested as a highly possible mode for SFTSV transmission through epidemiological, serological, and phylogenetic analysis. Eye protection should be stressed for clinicians when exposed to blood or bloody secretions.
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Yang T, Huang H, Jiang L, Li J. Overview of the immunological mechanism underlying severe fever with thrombocytopenia syndrome (Review). Int J Mol Med 2022; 50:118. [PMID: 35856413 PMCID: PMC9333902 DOI: 10.3892/ijmm.2022.5174] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 06/14/2022] [Indexed: 11/05/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) has been acknowledged as an emerging infectious disease that is caused by the SFTS virus (SFTSV). The main clinical features of SFTS on presentation include fever, thrombocytopenia, leukocytopenia and gastrointestinal symptoms. The mortality rate is estimated to range between 5-30% in East Asia. However, SFTSV infection is increasing on an annual basis globally and is becoming a public health problem. The transmission cycle of SFTSV remains poorly understood, which is compounded by the pathogenesis of SFTS not being fully elucidated. Since the mechanism underlying the host immune response towards SFTSV is also unclear, there are no effective vaccines or specific therapeutic agents against SFTS, with supportive care being the only realistic option. Therefore, it is now crucial to understand all aspects of the host-virus interaction following SFTSV infection, including the antiviral states and viral evasion mechanisms. In the present review, recent research progress into the possible host immune responses against SFTSV was summarized, which may be useful in designing novel therapeutics against SFTS.
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Affiliation(s)
- Tao Yang
- Department of Infectious Disease, The First Hospital Affiliated with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Huaying Huang
- Department of Infectious Disease, The First Hospital Affiliated with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Longfeng Jiang
- Department of Infectious Disease, The First Hospital Affiliated with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, P.R. China
| | - Jun Li
- Department of Infectious Disease, The First Hospital Affiliated with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu 210029, P.R. China
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10
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Zhou CM, Qi R, Qin XR, Fang LZ, Han HJ, Lei XY, Yu XJ. Oral and ocular transmission of severe fever with thrombocytopenia syndrome virus. INFECTIOUS MEDICINE 2022; 1:2-6. [PMID: 38074978 PMCID: PMC10699656 DOI: 10.1016/j.imj.2021.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 03/25/2024]
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome virus (SFTSV) is a tick-borne bunyavirus that could cause a severe hemorrhagic fever termed SFTS with a high fatality rate of up to 30%. Importantly, SFTSV is frequently transmitted from person-to-person and patients' blood or excreta are considered as the risk factors for transmission of SFTSV. However, the mechanism of person-to-person transmission of SFTSV is still elusive. METHODS In this study, wild-type (WT) C57BL/6 J mice and a lethal SFTSV mouse model IFNAR-/- A129 mice were utilized to evaluate whether SFTSV could be transmitted via oral or ocular routes. C57BL/6 J mice were inoculated with cell-cultured SFTSV via oral and ocular inoculation. IFNAR-/- A129 mice were inoculated with cell-cultured SFTSV or SFTSV infected mouse acute sera via oral and ocular inoculation. RESULTS We found that SFTSV antibody positive rates in C57BL/6 J mice were 70% (7/10) and 30% (3/10) in the oral inoculation group and ocular inoculation group, respectively on day 21 post SFTSV inoculation. The mortality rates of IFNAR-/- mice with oral and ocular inoculation of cell-cultured SFTSV were 100% and 83.33% (5/6), respectively on day 6 post inoculation. The mortality rates of IFNAR-/- mice with oral and ocular inoculation of SFTSV infected mouse acute serum were 100% and 66.67% (4/6), respectively on day 9 post inoculation. CONCLUSIONS Together, our results show that SFTSV can be transmitted effectively through oral and ocular membrane, suggesting exposure to SFTS positive excreta may be a high-risk factor of nosocomial transmission of SFTSV in hospitals and/or families. Family members and healthcare workers should be protected properly during taking care of SFTS patients to prevent SFTSV nosocomial infection.
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Affiliation(s)
- Chuan-Min Zhou
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Rui Qi
- School of Public Health, Lanzhou University, Lanzhou, Gansu Province, China
| | - Xiang-Rong Qin
- Department of Clinical Laboratory, the Second Hospital of Shandong University, Jinan, Shandong Province, China
| | - Li-Zhu Fang
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Hui-Ju Han
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
| | - Xiao-Ying Lei
- Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xue-Jie Yu
- State Key Laboratory of Virology, School of Public Health, Wuhan University, Wuhan, China
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Li JC, Zhao J, Li H, Fang LQ, Liu W. Epidemiology, clinical characteristics, and treatment of severe fever with thrombocytopenia syndrome. INFECTIOUS MEDICINE 2022; 1:40-49. [PMID: 38074982 PMCID: PMC10699716 DOI: 10.1016/j.imj.2021.10.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 10/25/2021] [Accepted: 10/25/2021] [Indexed: 02/23/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by a novel phlebovirus (SFTS virus, SFTSV) in the family Phenuiviridae of the order Bunyavirales. The disease causes a wide spectrum of clinical signs and symptoms, ranging from mild febrile disease accompanied by thrombocytopenia and/or leukocytopenia to hemorrhagic fever, encephalitis, multiple organ failure, and death. SFTS was first identified in China and was subsequently reported in South Korea and Japan. The case-fatality rate ranges from 2.7% to 45.7%. Older age has been consistently shown to be the most important predictor of adverse disease outcomes. Older age exacerbates disease mainly through dysregulation of host immune cells and uncontrolled inflammatory responses. Tick-to-human transmission is the primary route of human infection with SFTSV, and Haemaphysalis longicornis is the primary tick vector of SFTSV. Despite its high case-fatality rate, vaccines and antiviral therapies for SFTS are not currently available. The therapeutic efficacies of several antiviral agents against SFTSV are currently being evaluated. Ribavirin was initially identified as a potential antiviral therapy for SFTS but was subsequently found to inefficiently improve disease outcomes, especially among patients with high viral loads. Favipiravir (T705) decreased both time to clinical improvement and mortality when administered early in patients with low viral loads. Anti-inflammatory agents including corticosteroids have been proposed to play therapeutic roles. However, the efficacy of other therapeutic modalities, such as convalescent plasma, is not yet clear.
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Affiliation(s)
| | | | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China
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12
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Sarmadi M, Rahimi S, Evensen D, Kazemi Moghaddam V. Interaction between meteorological parameters and COVID-19: an ecological study on 406 authorities of the UK. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:67082-67097. [PMID: 34244943 PMCID: PMC8270239 DOI: 10.1007/s11356-021-15279-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 06/29/2021] [Indexed: 05/22/2023]
Abstract
Understanding the factors affecting COVID-19 transmission is critical in assessing and mitigating the spread of the pandemic. This study investigated the transmissibility and death distribution of COVID-19 and its association with meteorological parameters to study the propagation pattern of COVID-19 in UK regions. We used the reported case and death per capita rate (as of November 13, 2020; before mass vaccination) and long-term meteorological data (temperature, humidity, precipitation, wind speed, and visibility) in 406 UK local authority levels based on publicity available secondary data. We performed correlation and regression analysis between COVID-19 variables and meteorological parameters to find the association between COVID-19 and independent variables. Student's T and Mann-Whitney's tests were used to analyze data. The correlation and regression analyses revealed that temperature, dew point, wind speed, and humidity were the most important factors associated with spread and death of COVID-19 (P <0.05). COVID-19 cases negatively correlated with humidity in areas with high population density, but the inverse in low population density areas. Wind speeds in low visibility areas, which are considered polluted air, may increase the spread of disease (r=0.42, P <0.05) and decrease the spread in high visibility areas (r=-0.16, P <0.05). Among low (T <10°C) and high (T >10°C) temperature areas, the average incidence rates were 2056.86 (95% confidence interval (CI): 1909.49-2204.23) and 1446.76 (95% CI: 1296.71-1596.81). Also, COVID-19 death per capita rates were 81.55 (95% CI: 77.40-85.70) and 69.78 (95% CI: 64.39-75.16) respectively. According to the comprehensive analysis, the spread of disease will be suppressed as the weather warms and humidity and wind speed decrease. Different environmental conditions can increase or decrease spread of the disease due to affecting spread of disease vectors and by altering people's behavior.
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Affiliation(s)
- Mohammad Sarmadi
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran.
| | - Sajjad Rahimi
- Department of Environmental Health Engineering, School of Health, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
- Health Sciences Research Center, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Darrick Evensen
- Department of Politics and International Relations, University of Edinburgh, Edinburgh, EH89LF, UK.
| | - Vahid Kazemi Moghaddam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
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13
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Hu L, Li J, Zhang H, Bian T, Pan J, Li J, Xu X, Gao Y, Chen G, Ye Y, Li J. Predisposing Factors for Person-to-Person Transmission of Severe Fever with Thrombocytopenia Syndrome Bunyavirus. J Hosp Infect 2021; 123:174-178. [PMID: 34767872 DOI: 10.1016/j.jhin.2021.10.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/28/2021] [Accepted: 10/30/2021] [Indexed: 11/16/2022]
Abstract
Person-to-person transmission of severe fever with thrombocytopenia syndrome virus (SFTSV) is a new threat to human health. Here we report an outbreak of nosocomial person-to-person transmission of SFTS. Among eight persons with face-to-face contact distance ≤50 centimeters and/or exposure time ≥30 minutes to the index patient, six became were infected. Only one of the 17 persons with exposure distance ≥ 50 centimeters and exposure time ≤ 30 minutes was infected (75% vs. 6.25%, p <0.001). Epidemiological investigation revealed high viral load, bloody secretions and bleeding, exposure time and distance as the key factors in person-to-person transmission.
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Affiliation(s)
- L Hu
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, China; Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, China
| | - J Li
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - H Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - T Bian
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - J Pan
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - J Li
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, China
| | - X Xu
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Y Gao
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - G Chen
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Y Ye
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
| | - J Li
- Department of Infectious Diseases, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China; Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, China; Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, China.
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14
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Zhang Y, Zhang Y, Xu Y, Huang Y. The associations between fasting blood glucose levels and mortality of SFTS in patients. BMC Infect Dis 2021; 21:761. [PMID: 34353296 PMCID: PMC8343909 DOI: 10.1186/s12879-021-06463-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 07/19/2021] [Indexed: 01/04/2023] Open
Abstract
Objective To identify the correlation between the level of at-admission fasting blood glucose (FBG) with poor outcomes in hospitalized patients suffering from severe fever with thrombocytopenia syndrome (SFTS). Methods Between April 1 and December 1, 2020, the list of hospitalized patients affected with SFTS infection was provided by the Infectious Disease Department at First Affiliated Hospital of Anhui Medical University, followed by the collection of information I.e., gender, age, diabetic history and the level of FBG on admission. Results In this study, a total of 77 patients were included and were categorized into three groups (< 5.6, 5.6–6.9, and ≥ 7.0 mmol/l) on the basis of their glucose level in the blood. The obtained results revealed that among three groups considerable variations were observed in leukocytes, FBG, D-Dimer, aspartate aminotransferase (AST), tumor necrosis factor-α (TNF-α), fibrin degradation products (FDP), and interleukin (IL)-10 level. Correlation analysis indicated a linear negative correlation between PLT and FBG (r = − 0.28, P = 0.01), however, a linear positive correlation was observed between AST, IL10, D-Dimer, and FDP levels and FBG (P-value < 0.05). Multivariate statistical analysis results shown that there was significant difference between group comparison (F = 17.01, P < 0.001) and interaction between group and time (F = 8.48, P < 0.05); but there was no significant difference between time point comparison (F = 0.04, P = 0.96). With the prolongation of time, the changes of FBG were different between survivor group and non-survivor group. The FBG in survival group shown a downward trend; The non-survivor group shown an upward trend. Conclusions Elevated level of FBG has been correlated with hypercoagulability, inflammation, and lower PLT in SFTS patients. The measurement of FBG level can help in evaluating the inflammatory process, hypercoagulability, and prognosis of patients suffering from SFTS. FBG can predict the prognosis of SFTS. It is necessary to pay attention to the role of FBG in the process of treatment in patients with SFTS.
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Affiliation(s)
- Yin Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Rd, Hefei, Anhui Province, China
| | - Yu Zhang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Rd, Hefei, Anhui Province, China
| | - Yuanhong Xu
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Rd, Hefei, Anhui Province, China
| | - Ying Huang
- Department of Clinical Laboratory, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Rd, Hefei, Anhui Province, China.
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Yamanaka A, Kirino Y, Fujimoto S, Ueda N, Himeji D, Miura M, Sudaryatma PE, Sato Y, Tanaka H, Mekata H, Okabayashi T. Direct Transmission of Severe Fever with Thrombocytopenia Syndrome Virus from Domestic Cat to Veterinary Personnel. Emerg Infect Dis 2021; 26:2994-2998. [PMID: 33219655 PMCID: PMC7706950 DOI: 10.3201/eid2612.191513] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Two veterinary personnel in Japan were infected with severe fever with thrombocytopenia syndrome virus (SFTSV) while handling a sick cat. Whole-genome sequences of SFTSV isolated from the personnel and the cat were 100% identical. These results identified a nosocomial outbreak of SFTSV infection in an animal hospital without a tick as a vector.
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16
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Vaccine Development for Severe Fever with Thrombocytopenia Syndrome. Viruses 2021; 13:v13040627. [PMID: 33917632 PMCID: PMC8067456 DOI: 10.3390/v13040627] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), which is caused by SFTS virus (SFTSV), is a tick-borne emerging zoonosis with a high case-fatality rate. At present, there is no approved SFTS vaccine, although the development of a vaccine would be one of the best strategies for preventing SFTS. This article focused on studies aimed at establishing small animal models of SFTS that are indispensable for evaluating vaccine candidates, developing these vaccine candidates, and establishing more practical animal models for evaluation. Innate immune-deficient mouse models, a hamster model, an immunocompetent ferret model and a cat model have been developed for SFTS. Several vaccine candidates for SFTS have been developed, and their efficacy has been confirmed using these animal models. The candidates consist of live-attenuated virus-based, viral vector-based, or DNA-based vaccines. SFTS vaccines are expected to be used for humans and companion dogs and cats. Hence for practical use, the vaccine candidates should be evaluated for efficacy using not only nonhuman primates but also dogs and cats. There is no practical nonhuman primate model of SFTS; however, the cat model is available to evaluate the efficacy of these candidate SFTS vaccines on domesticated animals.
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17
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Fang X, Hu J, Peng Z, Dai Q, Liu W, Liang S, Li Z, Zhang N, Bao C. Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome bunyavirus human-to-human transmission. PLoS Negl Trop Dis 2021; 15:e0009037. [PMID: 33930022 PMCID: PMC8087050 DOI: 10.1371/journal.pntd.0009037] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 12/07/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) was listed as one of the most severe infectious disease by world health organization in 2017. It can mostly be transmitted by tick bite, while human-to-human transmission has occurred on multiple occasions. This study aimed to explore the epidemiological and clinical characteristics and make risk analysis of SFTS human-to-human transmission. METHODS Descriptive and spatial methods were employed to illustrate the epidemiological and clinical characteristics of SFTS human-to-human transmission. The risk of SFTS human-to-human transmission was accessed through secondary attack rate (SAR) and basic reproductive number (R0). Logistic regression analysis was used to identify the associated risk factors. RESULTS A total of 27 clusters of SFTS human-to-human transmission were reported in China and South Korea during 1996-2019. It mainly occurred among elder people in May, June and October in central and eastern China. The secondary cases developed milder clinical manifestation and better outcome than the index cases. The incubation period was 10.0 days (IQR:8.0-12.0), SAR was 1.72%-55.00%, and the average R0 to be 0.13 (95%CI:0.11-0.16). Being blood relatives of the index case, direct blood/bloody secretion contact and bloody droplet contact had more risk of infection (OR = 6.35(95%CI:3.26-12.37), 38.01 (95%CI,19.73-73.23), 2.27 (95%CI,1.01-5.19)). CONCLUSIONS SFTS human-to-human transmission in China and South Korea during 1996-2019 had obvious spatio-temporal distinction. Ongoing assessment of this transmission risk is crucial for public health authorities though it continues to be low now.
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Affiliation(s)
- Xinyu Fang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Zhihang Peng
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Qigang Dai
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Wendong Liu
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Shuyi Liang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Zhifeng Li
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Nan Zhang
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention (Jiangsu institution of Public health), Nanjing, China
- School of Public Health, Nanjing Medical University, Nanjing, China
- NHC Key laboratory of Enteric Pathogenic Microbiology, Nanjing, China
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18
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Xu Y, Shao M, Liu N, Tang J, Gu Q, Dong D. Invasive pulmonary aspergillosis is a frequent complication in patients with severe fever with thrombocytopenia syndrome: A retrospective study. Int J Infect Dis 2021; 105:646-652. [PMID: 33640568 DOI: 10.1016/j.ijid.2021.02.088] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 02/10/2021] [Accepted: 02/23/2021] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES Invasive pulmonary aspergillosis (IPA) usually occurs in immunocompromised hosts. It has recently been reported that patients with severe fever with thrombocytopenia syndrome (SFTS) can also develop IPA. The aim of this study was to determine the incidence of IPA in SFTS patients and to investigate the relevant clinical, imaging, and laboratory characteristics. METHODS A retrospective review was conducted of all patients with SFTS admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing City, China, between January 2016 and December 2019. The patients were divided into two groups according to whether they had IPA: the IPA group and the non-IPA group. Data on clinical manifestations, laboratory findings, imaging characteristics, treatments, and outcomes were collected and analysed. RESULTS A total of 91 SFTS patients were included, of whom 29 (31.9%) developed IPA. In-hospital mortality (22.0%) was higher in the IPA group than in the non-IPA group. Univariate logistic regression showed that diabetes, cough, wheezing, amylase level, vasopressor use, encephalopathy, and intensive care unit transfer were risk factors for the development of IPA. Multivariate logistic regression analysis identified wheezing as an independent predictor of IPA in SFTS patients. CONCLUSIONS SFTS combined with IPA is associated with high morbidity and mortality. It is necessary to strengthen screening for fungal infections after admission in SFTS patients. However, whether early antifungal prophylaxis should be administered needs further investigation.
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Affiliation(s)
- Ying Xu
- Department of Intensive Care Unit, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Mingran Shao
- Department of Radiology, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Ning Liu
- Department of Intensive Care Unit, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Jian Tang
- Department of Intensive Care Unit, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Qin Gu
- Department of Intensive Care Unit, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
| | - Danjiang Dong
- Department of Intensive Care Unit, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China.
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19
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Wang F, Wu Y, Jiao J, Wang J, Ge Z. Risk Factors and Clinical Characteristics of Severe Fever with Thrombocytopenia Syndrome. Int J Gen Med 2021; 13:1661-1667. [PMID: 33408503 PMCID: PMC7779285 DOI: 10.2147/ijgm.s292735] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 12/10/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study was to investigate the clinical characteristics and laboratory parameters of severe fever with thrombocytopenia syndrome (SFTS). Patients and Methods A detailed retrospective analysis of clinical records for SFTS patients was conducted. Fifty-one cases confirmed SFTS virus infected were enrolled. The clinical characteristics and laboratory parameters between survivors and non-survivors were analyzed. Results All patients aged between 30 and 80 years were farmers or residing in wooded and hilly areas. All patients occurred between April and October. The major clinical manifestations were fever, fatigue, diarrhea, myalgia, nausea and vomiting. Conscious disturbance, lymph node enlargement and hemorrhage were common. Fatal outcome occurred in 31.4% (16/51) of patients. Compared with survivors group, in non-survivors group, the proportion of consciousness disturbance, age, the levels of AST, LDH, Bun, Cr, PT and APTT were significantly increased, and PLT was significantly decreased. The age, PLT, AST, LDH, Cr, PT and APTT were the risk factors for fatal outcomes. Moreover, the age (OR, 1.245; 95% CI, 1.052–1.474) and APTT (OR, 1.095; 95% CI, 1.005–1.192) were the independent risk factors for fatal outcomes. Heteromorphic lymphocyte and hemophagocytosis could be found in SFTS patients, especially the proportion of finding hemophagocytosis was significantly higher in non-survivors group compared with survivors group. Conclusion These results suggest SFTS is a systemic infection, the age and APTT can be used as potential predictors referring to severe SFTS cases.
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Affiliation(s)
- Fei Wang
- Department of Hematology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Institute of Hematology Southeast University, Nanjing 210009, People's Republic of China
| | - Yunjuan Wu
- Department of Rheumatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, People's Republic of China
| | - Jie Jiao
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, People's Republic of China
| | - Jun Wang
- Department of Hematology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Institute of Hematology Southeast University, Nanjing 210009, People's Republic of China
| | - Zheng Ge
- Department of Hematology (Key Department of Jiangsu Medicine), Zhongda Hospital, Medical School, Southeast University, Institute of Hematology Southeast University, Nanjing 210009, People's Republic of China
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20
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Sun JM, Wu HX, Lu L, Liu Y, Mao ZY, Ren JP, Yao WW, Qu HH, Liu QY. Factors associated with spatial distribution of severe fever with thrombocytopenia syndrome. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141522. [PMID: 32846249 DOI: 10.1016/j.scitotenv.2020.141522] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) was firstly identified in mainland China in 2009 and the geographic distribution has expanded in recent years. In this study, we constructed ecological niche models (ENM) of SFTS with meteorological factors, environmental factor, and density of domestic animals using MaxEnt. We found four significant associated factors including altitude, yearly average temperature, yearly accumulated precipitation, and yearly average relative humidity which accounted for 94.1% percent contribution. SFTS occurrence probability was high when altitude was between -100 m and 100 m, and the probability was nearly 0 when altitude was beyond 3000 m. Response curves of SFTS to the yearly average temperature, yearly accumulated precipitation, and yearly average relative humidity were all reversed V-shape. SFTS occurrence probability was high where the yearly average temperature, yearly accumulated precipitation, and yearly relative humidity were 12.5-17.5 °C, 700-2250 mm and 63-82%, respectively. ENMs predicted that the potential high-risk areas were mainly distributed in eastern areas and central areas of China. But there were some predicted potential high-risk areas where no SFTS case was reported up to date. More researches should be done to make clear whether SFTS case had occurred in these areas.
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Affiliation(s)
- Ji-Min Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Hai-Xia Wu
- State Key Laboratory of 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, China
| | - Liang Lu
- State Key Laboratory of 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, China
| | - Ying Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | | | - Jiang-Ping Ren
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Wen-Wu Yao
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Hong-Hua Qu
- Qilu Hospital of Shandong University, China.
| | - Qi-Yong Liu
- State Key Laboratory of 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, China.
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21
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Li J, Li S, Yang L, Cao P, Lu J. Severe fever with thrombocytopenia syndrome virus: a highly lethal bunyavirus. Crit Rev Microbiol 2020; 47:112-125. [PMID: 33245676 DOI: 10.1080/1040841x.2020.1847037] [Citation(s) in RCA: 52] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel bunyavirus. Since 2007, SFTS disease has been reported in China with high fatality rate up to 30%, which drew high attention from Centre for Disease Control and Prevention and government. SFTSV is endemic in the centra l and eastern China, Korea and Japan. There also have been similar cases reported in Vietnam. The number of SFTSV infection cases has a steady growth in these years. As SFTSV could transmitted from person to person, it will expose the public to infectious risk. In 2018 annual review of the Blueprint list of priority diseases, World Health Organisation has listed SFTSV infection as prioritised diseases for research and development in emergency contexts. However, the pathogenesis of SFTSV remains largely unclear. Currently, there are no specific therapeutics or vaccines to combat infections of SFTSV. This review discusses recent findings of epidemiology, transmission pathway, pathogenesis and treatments of SFTS disease.
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Affiliation(s)
- Jing Li
- NHC Key Laboratory of Carcinogenesis, Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,Department of Microbiology, School of Basic Medical Sciences, Central South University, Changsha, China.,China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Shen Li
- NHC Key Laboratory of Carcinogenesis, Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,Department of Microbiology, School of Basic Medical Sciences, Central South University, Changsha, China.,China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Li Yang
- NHC Key Laboratory of Carcinogenesis, Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,Department of Microbiology, School of Basic Medical Sciences, Central South University, Changsha, China.,China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Pengfei Cao
- NHC Key Laboratory of Carcinogenesis, Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,Department of Microbiology, School of Basic Medical Sciences, Central South University, Changsha, China.,China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
| | - Jianhong Lu
- NHC Key Laboratory of Carcinogenesis, Department of Hematology, Xiangya Hospital, Central South University, Changsha, China.,Department of Microbiology, School of Basic Medical Sciences, Central South University, Changsha, China.,China-Africa Research Center of Infectious Diseases, Central South University, Changsha, China
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Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Hefei of Anhui Province: a population-based surveillance study from 2011 to 2018. Eur J Clin Microbiol Infect Dis 2020; 40:929-939. [DOI: 10.1007/s10096-020-04098-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022]
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23
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Risk factors for person-to-person transmission of severe fever with thrombocytopenia syndrome. Infect Control Hosp Epidemiol 2020; 42:582-585. [PMID: 33161921 DOI: 10.1017/ice.2020.1258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To determine the risk factors for person-to-person transmission of severe fever with thrombocytopenia syndrome (SFTS). DESIGN Studies reporting the person-to-person transmission or cluster infection of SFTS were identified and included for risk-factor analyses. METHODS Risk factors were investigated by analyzing characteristics of index patients who caused cluster infection and correlation between exposure history and secondary infection. RESULTS Analyses of 23 clusters of SFTS infections indicated that all index patients died and that they all had a symptom of bleeding 24 hours before death. Of 89 secondary cases, 82% had been exposed to the index patients' blood. The blood-contact-specific secondary attack rate was 62.4% (73 of 117). The risk relative value was 25 (95% CI, 15-42); thus, the probability of a person getting infected was 25 times more likely when they had contacted blood than when they had not. CONCLUSION Exposure to blood of SFTS patients is the highest risk factor for person-to-person infection with SFTSV. SFTS patients' families and healthcare workers should be educated to handle SFTS patients properly and safely to prevent the spread of SFTSV.
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24
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Huang XY, He ZQ, Wang BH, Hu K, Li Y, Guo WS. Severe fever with thrombocytopenia syndrome virus: a systematic review and meta-analysis of transmission mode. Epidemiol Infect 2020; 148:e239. [PMID: 32993819 PMCID: PMC7584033 DOI: 10.1017/s0950268820002290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.
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Affiliation(s)
- X. Y. Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Z. Q. He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - B. H. Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - K. Hu
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Y. Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - W. S. Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
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Zhang R, Li Y, Zhang AL, Wang Y, Molina MJ. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proc Natl Acad Sci U S A 2020; 117:14857-14863. [PMID: 32527856 PMCID: PMC7334447 DOI: 10.1073/pnas.2009637117] [Citation(s) in RCA: 693] [Impact Index Per Article: 173.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Various mitigation measures have been implemented to fight the coronavirus disease 2019 (COVID-19) pandemic, including widely adopted social distancing and mandated face covering. However, assessing the effectiveness of those intervention practices hinges on the understanding of virus transmission, which remains uncertain. Here we show that airborne transmission is highly virulent and represents the dominant route to spread the disease. By analyzing the trend and mitigation measures in Wuhan, China, Italy, and New York City, from January 23 to May 9, 2020, we illustrate that the impacts of mitigation measures are discernable from the trends of the pandemic. Our analysis reveals that the difference with and without mandated face covering represents the determinant in shaping the pandemic trends in the three epicenters. This protective measure alone significantly reduced the number of infections, that is, by over 78,000 in Italy from April 6 to May 9 and over 66,000 in New York City from April 17 to May 9. Other mitigation measures, such as social distancing implemented in the United States, are insufficient by themselves in protecting the public. We conclude that wearing of face masks in public corresponds to the most effective means to prevent interhuman transmission, and this inexpensive practice, in conjunction with simultaneous social distancing, quarantine, and contact tracing, represents the most likely fighting opportunity to stop the COVID-19 pandemic. Our work also highlights the fact that sound science is essential in decision-making for the current and future public health pandemics.
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Affiliation(s)
- Renyi Zhang
- Department of Atmospheric Sciences, Texas A&M University, College Station, TX 77843;
- Department of Chemistry, Texas A&M University, College Station, TX 77843
| | - Yixin Li
- Department of Chemistry, Texas A&M University, College Station, TX 77843
| | - Annie L Zhang
- Department of Chemistry, College of Natural Sciences, The University of Texas at Austin, Austin, TX 78712
| | - Yuan Wang
- Division of Geological and Planetary Sciences, California Institute of Technology, Pasadena, CA 91125
| | - Mario J Molina
- Department of Chemistry and Biochemistry, University of California San Diego, La Jolla, CA 92093
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26
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Akagi K, Miyazaki T, Oshima K, Umemura A, Shimada S, Morita K, Senju H, Tashiro M, Takazono T, Saijo T, Kurihara S, Sekino M, Yamamoto K, Imamura Y, Izumikawa K, Yanagihara K, Uda A, Morikawa S, Yoshikawa T, Kurosu T, Shimojima M, Saijo M, Mukae H. Detection of viral RNA in diverse body fluids in an SFTS patient with encephalopathy, gastrointestinal bleeding and pneumonia: a case report and literature review. BMC Infect Dis 2020; 20:281. [PMID: 32295538 PMCID: PMC7160946 DOI: 10.1186/s12879-020-05012-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/01/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that commonly has a lethal course caused by the tick-borne Huaiyangshan banyang virus [former SFTS virus (SFTSV)]. The viral load in various body fluids in SFTS patients and the best infection control measure for SFTS patients have not been fully established. CASE PRESENTATION A 79-year-old man was bitten by a tick while working in the bamboo grove in Nagasaki Prefecture in the southwest part of Japan. Due to the occurrence of impaired consciousness, he was referred to Nagasaki University Hospital for treatment. The serum sample tested positive for SFTSV-RNA in the genome amplification assay, and he was diagnosed with SFTS. Furthermore, SFTSV-RNA was detected from the tick that had bitten the patient. He was treated with multimodal therapy, including platelet transfusion, antimicrobials, antifungals, steroids, and continuous hemodiafiltration. His respiration was assisted with mechanical ventilation. On day 5, taking the day on which he was hospitalized as day 0, serum SFTSV-RNA levels reached a peak and then decreased. However, the cerebrospinal fluid collected on day 13 was positive for SFTSV-RNA. In addition, although serum SFTSV-RNA levels decreased below the detectable level on day 16, he was diagnosed with pneumonia with computed tomography. SFTSV-RNA was detected in the bronchoalveolar lavage fluid on day 21. By day 31, he recovered consciousness completely. The pneumonia improved by day 51, but SFTSV-RNA in the sputum remained positive for approximately 4 months after disease onset. Strict countermeasures against droplet/contact infection were continuously conducted. CONCLUSIONS Even when SFTSV genome levels become undetectable in the serum of SFTS patients in the convalescent phase, the virus genome remains in body fluids and tissues. It may be possible that body fluids such as respiratory excretions become a source of infection to others; thus, careful infection control management is needed.
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Affiliation(s)
- Kazumasa Akagi
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.,Present Address: Department of Respiratory Medicine, Nagasaki Prefecture Shimabara Hospital, Nagasaki, Japan
| | - Taiga Miyazaki
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan. .,Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | - Kazuhiro Oshima
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.,Present Address: Department of Internal Medicine, Goto Central Hospital, Nagasaki, Japan
| | - Asuka Umemura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.,Present Address: Department of Respiratory Medicine, Sasebo City General Hospital, Sasebo, Japan
| | - Satoshi Shimada
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan
| | - Hiroaki Senju
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Masato Tashiro
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Nagasaki University Infection Control and Education Centre, Nagasaki University Hospital, Nagasaki, Japan
| | - Takahiro Takazono
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan.,Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomomi Saijo
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Shintaro Kurihara
- Nagasaki University Infection Control and Education Centre, Nagasaki University Hospital, Nagasaki, Japan
| | - Motohiro Sekino
- Division of Intensive Care, Nagasaki University Hospital, Nagasaki, Japan
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Yoshifumi Imamura
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
| | - Koichi Izumikawa
- Department of Infectious Diseases, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.,Nagasaki University Infection Control and Education Centre, Nagasaki University Hospital, Nagasaki, Japan
| | - Katsunori Yanagihara
- Department of Laboratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Akihiko Uda
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomoki Yoshikawa
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Takeshi Kurosu
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Shimojima
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Tokyo, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki, Japan
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Spatial-temporal characteristics of severe fever with thrombocytopenia syndrome and the relationship with meteorological factors from 2011 to 2018 in Zhejiang Province, China. PLoS Negl Trop Dis 2020; 14:e0008186. [PMID: 32255791 PMCID: PMC7164674 DOI: 10.1371/journal.pntd.0008186] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 04/17/2020] [Accepted: 03/01/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Zhejiang Province has the fifth-highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in China. While the top four provinces are all located in northern and central China, only Zhejiang Province is located in the Yangtze River Delta region of southeast China. This study was undertaken to identify the epidemiological characteristics of SFTS in Zhejiang from 2011 to 2018. METHODS The epidemic data from SFTS cases in Zhejiang Province from January 2011 to December 2018 were obtained from the China Information Network System of Disease Prevention and Control. Meteorological data were collected from the China Meteorological Data Sharing Service System. A multivariate time series model was used to analyze the heterogeneity of spatial-temporal transmission of the disease. Random forest analysis was performed to detect the importance of meteorological factors and the dose-response association of the incidence of SFTS with these factors. RESULTS In total, 412 SFTS cases (49 fatal) were reported from January 2011 to December 2018 in Zhejiang Province, China. The number of SFTS cases and the number of affected counties increased year by year. The case fatality rate in Zhejiang Province was 11.89%, which was the highest in China. Elderly patients and farmers were the most affected. The total effect values of the autoregressive component, spatiotemporal component and endemic component of the model in all ranges were 0.4580, 0.0377 and 0.0137, respectively. There was obvious heterogeneity across counties for the mean values of the spatiotemporal component and the autoregressive component. The autoregressive component was obviously the main factor driving the occurrence of SFTS, followed by the spatiotemporal component. The importance scores of the monthly mean pressure, mean temperature, mean relative humidity, mean two-minute wind speed, duration of sunshine and precipitation were 10.64, 8.34, 8.16, 6.37, 5.35 and 2.81, respectively. The relationship between these factors and the incidence of SFTS is complicated and nonlinear. A suitable range of meteorological factors for this disease was also detected. CONCLUSIONS The autoregressive and spatiotemporal components played an important role in driving the transmission of SFTS. Targeted preventive efforts should be made in different areas based on the main component contributing to the epidemic. For most areas, early measures several months ahead of the suitable season for the occurrence of SFTS should be implemented. The level of reporting and diagnosis of this disease should be further improved.
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28
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Yoo JR, Kim SH, Kim YR, Lee KH, Oh WS, Heo ST. Application of therapeutic plasma exchange in patients having severe fever with thrombocytopenia syndrome. Korean J Intern Med 2019; 34:902-909. [PMID: 29117665 PMCID: PMC6610197 DOI: 10.3904/kjim.2016.194] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 05/02/2017] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND/AIMS Severe fever with thrombocytopenia syndrome (SFTS) is a viral hemorrhagic fever with a high fatality rate. However, effective treatments for SFTS cases not responded to supportive therapy have not been established. Herein, we introduced the therapeutic plasma exchange (TPE) in SFTS patients in a tertiary hospital between 2013 and 2015. METHODS TPE was performed in patients with rapidly progressing SFTS. Clinical, laboratory, and virological parameters were compared before and after TPE. RESULTS Among 27 confirmed SFTS patients, two patients were treated with TPE and ribavirin combination in May 2013, then, 14 patients with rapidly progressing SFTS patients were treated with only TPE from June 2013 to September 2015: their median age was 58 years (interquartile range, 50 to 70) and eight (57.1%) were male. Body temperature, pressure-adjusted heart rate, white blood cell and platelet counts, coagulation profile, serum creatinine, and multiple organ dysfunction score improved immediately after TPE. In addition, the mean cyclic threshold value of real-time reverse transcriptase polymerase chain reaction for SFTS virus after TPE (mean ± standard deviation, 31.3 ± 2.9) was significantly higher than that before TPE (26.5 ± 2.9; p < 0.001), indicating that serum viral loads decreased after TPE. Finally, 13 of 14 TPE-treated patients (92.8%) recovered from rapidly progressing SFTS without sequelae. CONCLUSION SFTS patients treated with TPE showed improvements in clinical, laboratory, and virological parameters. These results suggest that TPE would be a therapeutic modality as rescue therapy in patients with rapidly progressing SFTS.
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Affiliation(s)
- Jeong Rae Yoo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Sun Hyung Kim
- Department of Laboratory Medicine, Jeju National University School of Medicine, Jeju, Korea
| | - Young Ree Kim
- Department of Laboratory 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
| | - Won Sup Oh
- Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea
- Correspondence to Sang Taek Heo, M.D. Division of Infectious Diseases, Department of Internal Medicine, Jeju National University School of Medicine, 15 Aran 13- gil, Jeju 63241, Korea Tel: +82-64-754-8151 Fax: +82-64-717-1131 E-mail:
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29
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Hu J, Li Z, Cai J, Liu D, Zhang X, Jiang R, Guo X, Liu D, Zhang Y, Cui L, Shen J, Zhu F, Bao C. A Cluster of Bunyavirus-Associated Severe Fever With Thrombocytopenia Syndrome Cases in a Coastal Plain Area in China, 2015: Identification of a Previously Unidentified Endemic Region for Severe Fever With Thrombocytopenia Bunyavirus. Open Forum Infect Dis 2019; 6:ofz209. [PMID: 31211156 PMCID: PMC6559278 DOI: 10.1093/ofid/ofz209] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 05/03/2019] [Indexed: 11/13/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a typical tick-borne, natural focal disease. The natural foci of SFTS were considered to exist in hilly and mountainous areas before 2015. A cluster of 3 patients exposed to a patient with a fulminant disease consistent with SFTS occurred from July to August 2015 in Dongtai County, which is characterized by alluvial plains; this prompted investigation. Methods The epidemiological, clinical, and laboratory features of 4 patients in the cluster were analyzed. Serum samples from the indigenous healthy population and native domesticated animals were collected to conduct laboratory tests, along with small wild animals and ticks. Results In 3 secondary case patients, high fever, thrombocytopenia and leukopenia developed within 8-13 days after contact with blood or bloody secretions from the index patient; SFTS was then diagnosed by means of reverse-transcription polymerase chain reaction. Genomic sequencing and analysis of S and L segments of 2 viral strains isolated from 2 secondary case patients showed that they shared 99.8%-99.9% homology in nucleotide sequence. The seroprevalences among indigenous healthy population, native livestock, native poultry, and small wild animals was 0.74%, 17.54%, 6.67%, and 1.12%, respectively. Three questing ticks, 61 feeding ticks, and 178 small wild animals were collected in August 2015. Survey on tick density and seasonal fluctuation in 2016 showed that ticks were active from March to October. All ticks were identified as Haemaphysalis longicornis. Severe fever with thrombocytopenia bunyavirus (SFTSV)-specific RNA was detected in the ticks collected in 2016, and the minimum SFTSV infection rate in these ticks was 0.54% (1 of 185).Wild mammals and ticks collected in August 2015 tested negative for SFTSV-specific RNA. Conclusions Aside from hilly or mountainous area, a coastal plain was identified as the natural foci of SFTSV in Dongtai County, China. The involvement of migration in the evolution of SFTSV might lead to a transregional transmission event of SFTSV.
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Affiliation(s)
- Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Zhifeng Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Jiaping Cai
- Dongtai County Center for Disease Control and Prevention
| | - Donglin Liu
- Dongtai County Center for Disease Control and Prevention
| | - Xuefeng Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Renjie Jiang
- Yancheng Municipal Center for Disease Control and Prevention, Dongtai, China
| | - Xilin Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Dapeng Liu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Yufu Zhang
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Lunbiao Cui
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Jinjin Shen
- Yancheng Municipal Center for Disease Control and Prevention, Dongtai, China
| | - Fengcai Zhu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing
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30
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Yoo JR, Choi JH, Kim YR, Lee KH, Heo ST. Occupational Risk of Severe Fever With Thrombocytopenia Syndrome in Healthcare Workers. Open Forum Infect Dis 2019; 6:ofz210. [PMID: 31139678 PMCID: PMC6527088 DOI: 10.1093/ofid/ofz210] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/01/2019] [Indexed: 12/22/2022] Open
Abstract
We identified a healthcare-associated infection of severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV), transmitted through direct blood contact with an index case. Following further epidemiological and clinical investigations, we identified SFTSV seropositivity in 2 healthcare workers and 2 family members, who were positive for anti-SFTSV immunoglobin G. It is important to prevent SFTSV transmission by early diagnosis of SFTS and universal precautions.
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Affiliation(s)
- Jeong Rae Yoo
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
| | - Jae Hong Choi
- Department of Pediatrics, Jeju National University Hospital, Jeju, Republic of Korea
| | - Young Ree Kim
- Department of Laboratory Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Keun Hwa Lee
- Department of Microbiology and Immunology, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Sang Taek Heo
- Department of Internal Medicine, Jeju National University Hospital, Jeju, Republic of Korea
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31
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Yuan S, Chan JFW, Ye ZW, Wen L, Tsang TGW, Cao J, Huang J, Chan CCY, Chik KKH, Choi GKY, Cai JP, Yin F, Chu H, Liang M, Jin DY, Yuen KY. Screening of an FDA-Approved Drug Library with a Two-Tier System Identifies an Entry Inhibitor of Severe Fever with Thrombocytopenia Syndrome Virus. Viruses 2019; 11:v11040385. [PMID: 31027241 PMCID: PMC6520937 DOI: 10.3390/v11040385] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 04/23/2019] [Accepted: 04/24/2019] [Indexed: 12/27/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne bunyavirus that causes severe disease in humans with case-fatality rates of up to 30%. There are currently very limited treatment options for SFTSV infection. We conducted a drug repurposing program by establishing a two-tier test system to rapidly screen a Food and Drug Administration- (FDA)-approved drug library for drug compounds with anti-SFTSV activity in vitro. We identified five drug compounds that inhibited SFTSV replication at low micromolar concentrations, including hexachlorophene, triclosan, regorafenib, eltrombopag, and broxyquinoline. Among them, hexachlorophene was the most potent with an IC50 of 1.3 ± 0.3 µM and a selectivity index of 18.7. Mechanistic studies suggested that hexachlorophene was a virus entry inhibitor, which impaired SFTSV entry into host cells by interfering with cell membrane fusion. Molecular docking analysis predicted that the binding of hexachlorophene with the hydrophobic pocket between domain I and domain III of the SFTSV Gc glycoprotein was highly stable. The novel antiviral activity and mechanism of hexachlorophene in this study would facilitate the use of hexachlorophene as a lead compound to develop more entry inhibitors with higher anti-SFTSV potency and lower toxicity.
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Affiliation(s)
- Shuofeng Yuan
- State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou 571101, China, and The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Zi-Wei Ye
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Lei Wen
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Terance Gi-Wai Tsang
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Jianli Cao
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Jingjing Huang
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Chris Chun-Yiu Chan
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Kenn Ka-Heng Chik
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Garnet Kwan-Yue Choi
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Jian-Piao Cai
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Feifei Yin
- Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou 571101, China, and The University of Hong Kong, Pokfulam, Hong Kong, China.
- Department of Pathogen Biology, Hainan Medical University, Haikou 571101, China.
- Key Laboratory of Translational Tropical Medicine, Hainan Medical University, Haikou 571101, China.
| | - Hin Chu
- State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Mifang Liang
- Key Laboratory for Medical Virology and National Institute for Viral Disease Control and Prevention, Chinese Centre for Disease Control and Prevention, Beijing 102206, China.
| | - Dong-Yan Jin
- School of Biomedical Sciences, The University of Hong Kong, Pokfulam, Hong Kong, China.
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Carol Yu Centre for Infection, Department of Microbiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong, China.
- Hainan Medical University-The University of Hong Kong Joint Laboratory of Tropical Infectious Diseases, Hainan Medical University, Haikou 571101, China, and The University of Hong Kong, Pokfulam, Hong Kong, China.
- The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The University of Hong Kong, Pokfulam, Hong Kong, China.
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Zhang D, Sun C, Yu H, Li J, Liu W, Li Z, Bao C, Liu D, Zhang N, Zhu F, Hu J. Environmental Risk Factors and Geographic Distribution of Severe Fever with Thrombocytopenia Syndrome in Jiangsu Province, China. Vector Borne Zoonotic Dis 2019; 19:758-766. [PMID: 30994412 DOI: 10.1089/vbz.2018.2425] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging natural focus, tick-borne disease caused by a novel bunyavirus named SFTS virus (SFTSV). The main purpose of this study was to analyze the environmental risk factors and geographic distribution of SFTS natural foci in Jiangsu Province. A retrospective space-time analysis by SaTScan software was used to detect clusters at the town level. The maximum entropy modeling method was applied to construct the ecological niche model and analyze the environmental risk factors, and then to draw the predicted risk map. The performance of the model was assessed using the area under the curve (AUC) and known occurrence locations. During the years 2010-2016, a total of 140 laboratory-confirmed indigenous SFTS cases occurred in Jiangsu Province, with 66 occurrence locations. The reported number of SFTS cases increased year by year and SFTS cases occurred from April to October with a peak between May and August each year. Three clusters detected by space-time scan statistical analysis were connected together and shared the similar ecological environmental characteristic of hilly landscape. Fifteen environmental variables with different percent contribution can influence the ecological niche model in different degrees, whereas slope (suitable range: 0.1-4) and maximum temperature of warmest month (suitable range: 32.8-34.2°C) as the key environmental factors contributed 46.1% and 23.2%, respectively. The model had high accuracy on prediction with the averaged training AUC of 0.926. Within a predicted risk map, potential areas at high risk and 10 previously unidentified endemic regions were recognized. The distribution of SFTS natural foci was under the influence of multidimensional environmental factors. Slope and maximum temperature of warmest month were the key environmental risk factors. These results provide a valuable basis for the selection of prevention and control strategies, and the identification of potential risk areas.
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Affiliation(s)
- Dawei Zhang
- School of Public Health, Southeast University, Nanjing, China
| | - Changkui Sun
- Department of Remote Sensing Imagery, Provincial Geomatics Center of Jiangsu, Nanjing, China
| | - Huiyan Yu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jingxin Li
- 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
| | - Zhifeng Li
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial 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
| | - Dapeng Liu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Nan Zhang
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Fengcai Zhu
- School of Public Health, Southeast University, Nanjing, China.,Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Jianli Hu
- Department of Acute Infectious Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
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Qi R, Qin XR, Wang L, Han HJ, Cui F, Yu H, Liu JW, Yu XJ. Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome. PLoS Negl Trop Dis 2019; 13:e0007308. [PMID: 30925154 PMCID: PMC6457554 DOI: 10.1371/journal.pntd.0007308] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/10/2019] [Accepted: 03/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with a high fatality rate and high frequency of person-to-person transmission and is caused by SFTSV, a tick-borne Phlebovirus. Because SFTS has similar clinical manifestations and epidemic characters (such as spatial and temporal distributions) with hemorrhagic fever with renal syndrome (HFRS) in China, we reason that SFTS patients might be misdiagnosed as HFRS. Methodology/principal findings Acute-phase sera of 128 clinically diagnosed HFRS patients were retrospectively analyzed for Hantavirus IgM antibodies with ELISA. Hantavirus-negative patients’ sera were further analyzed for SFTSV IgM antibodies with ELISA. ELISA showed that 73 of 128 (57.0%) of clinically diagnosed HFRS patients were IgM antibody positive to Hantaviruses. Among the 55 Hantavirus-IgM negative patients, four (7.3%) were IgM antibody positive to SFTSV. The results indicated that the four SFTS patients were misdiagnosed as HFRS. The misdiagnosed SFTS patients had clinical manifestations common to HFRS and were unable to be differentiated from HFRS clinically. Conclusions Our study showed that SFTS patients could be clinically misdiagnosed as HFRS. The misdiagnosis of SFTS as HFRS causes particular concern because it may increase the risk of death of SFTS patients and person-to-person transmission of SFTSV without proper care for and isolation of SFTS patients. SFTS were clinically misdiagnosed as HFRS. It could cause particular concern in China. Physicians could not rely heavily on the exposure history. Both SFTS and HFRS patients are treated based on the clinical diagnosis in China. Laboratory confirmation of both diseases is not performed in clinical hospitals and the patients’ blood was usually submitted to a local or provincial center for disease control and prevention. In most cases the confirmation diagnosis is to provide retrospective information rather than to guide clinical therapy. Therefore, physicians need to carefully differentiate SFTS and HFRS patients because the fatality of SFTS is much higher than HFRS and SFTS is easily spread from person to person by contacting infected blood or even through aerosol.
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Affiliation(s)
- Rui Qi
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xiang-rong Qin
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Ling Wang
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hui-ju Han
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hao Yu
- Fudan University School of Medicine, Shanghai, China
| | - Jian-wei Liu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xue-jie Yu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
- * E-mail: ,
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Transmission routes of the virus causing viral hemorrhagic fever: Extreme precautions are prudent but high-quality evidence must be gathered. Infect Control Hosp Epidemiol 2019; 40:608-609. [PMID: 30895919 DOI: 10.1017/ice.2019.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Miyamoto S, Ito T, Terada S, Eguchi T, Furubeppu H, Kawamura H, Yasuda T, Kakihana Y. Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report. BMC Infect Dis 2019; 19:266. [PMID: 30885147 PMCID: PMC6423866 DOI: 10.1186/s12879-019-3904-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/13/2019] [Indexed: 01/08/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral infectious disease with high mortality. It causes multiple organ dysfunction; however, myocarditis has never been reported as a complication with SFTS. Case presentation A 62-year-old previously healthy woman developed fever, fatigue, diarrhea, and a mild consciousness disorder. She visited a local clinic, and laboratory data showed leukocytopenia, thrombocytopenia, and elevation of the aspartate aminotransferase level. She was transferred to Kagoshima University Hospital and diagnosed as having SFTS by real-time reverse transcription polymerase chain reaction. Subsequently, her blood pressure gradually decreased despite fluid resuscitation and vasopressor administration. Based on elevated toroponin I levels in serum, a transient diffuse left ventricular hypokinesis and wall thickening in echocardiography, diffuse ST elevation in electrocardiography, and exclusion of other heart diseases, she was diagnosed as having fulminant myocarditis. After hemodynamic support with inotropic agents, she recovered near normal cardiac function. She was discharged to home on day 28. Conclusions We report the first case of fulminant myocarditis associated with SFTS.
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Affiliation(s)
- Shotaro Miyamoto
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takashi Ito
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Shinsaku Terada
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tomohiro Eguchi
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hiroaki Furubeppu
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hideki Kawamura
- Department of Infection Control and Prevention, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tomotsugu Yasuda
- Division of Intensive Care Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yasuyuki Kakihana
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.,Division of Intensive Care Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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36
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Seroprevalence of severe fever with thrombocytopenia syndrome virus antibodies among inhabitants of Dachen Island, eastern China. Ticks Tick Borne Dis 2019; 10:647-650. [PMID: 30826250 DOI: 10.1016/j.ttbdis.2019.02.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Revised: 02/13/2019] [Accepted: 02/21/2019] [Indexed: 11/27/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) has been emerging and has caused many human cases in China, Japan and Korea. Some studies speculated that SFTSV was transmitted with bird migration among these countries. Notably, SFTS cases have been identified in a Chinese island named Dachen which is situated southwest of Japan and Korea. In this study, we conducted a serum survey of SFTSV antibodies among inhabitants of the island. A total of 439 serum specimens were collected in June 2018. All serum samples were tested for total antibodies and IgM antibody with double-antigen sandwich ELISA method. The rates of seropositivity for SFTSV total antibodies and IgM antibody were 3.0% (95% CI 1.4-4.6) and 0.5% (2/439), respectively. The median age of all participants was 61 years and all seropositive samples were all from inhabitants aged >50 years. The differences of seroprevalence between different gender groups and different age groups were not significant. However, seroprevalence varied significantly among different villages (P = 0.033). Our results showed that some inhabitants of Dachen Island had been infected with SFTSV, and some ticks and host animals of the island carry SFTSV. Comprehensive measures should be conducted to prevent the occurrence of SFTS cases in the island.
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Jung IY, Choi W, Kim J, Wang E, Park SW, Lee WJ, Choi JY, Kim HY, Uh Y, Kim YK. Nosocomial person-to-person transmission of severe fever with thrombocytopenia syndrome. Clin Microbiol Infect 2019; 25:633.e1-633.e4. [PMID: 30677496 DOI: 10.1016/j.cmi.2019.01.006] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 01/10/2019] [Accepted: 01/12/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES This study is an epidemiologic investigation of nosocomial severe fever with thrombocytopenia syndrome virus (SFTSV) transmission among healthcare workers (HCWs) after contact with an index patient. The aim of this study was to determine whether exposure to blood or bloody respiratory secretion is associated with human-to-human transmission of SFTSV. METHODS Eleven days after the index patient died, two HCWs who had close exposure to the patient presented with typical symptoms of SFTS. An epidemiological investigation was conducted on all 25 HCWs who had been in close contact with the index patient. Clinical and laboratory data were collected, and transmission rate before and after the index patient had haemorrhagic manifestations was analysed. RESULTS Among 25 HCWs who had direct contact with the index patient, five HCWs were confirmed to have SFTS. All five HCWs had contact to blood or bloody respiratory secretions of the index patient without adequate use of personal protective equipment (PPE). No HCW with contact before haemorrhagic manifestations of the index patient contracted SFTS. Overall, the transmission rate was higher for HCWs who had contact after the index patient had haemorrhagic manifestations (33.3%, five of 15 HCWs, vs. 0%, zero of ten HCWs, p 0.041). CONCLUSIONS In HCWs who are inadequately protected, person-to-person transmission of SFTSV may be associated with contact with blood or bloody respiratory secretions. Therefore, universal precaution and full PPE is highly recommended for protection against SFTSV when there are signs of bleeding.
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Affiliation(s)
- I Y Jung
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - W Choi
- Division of Arboviruses, National Institute of Health, Korea Center for Disease Control & Prevention, Chungcheongbuk-do, South Korea
| | - J Kim
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - E Wang
- Division of Arboviruses, National Institute of Health, Korea Center for Disease Control & Prevention, Chungcheongbuk-do, South Korea
| | - S-W Park
- Division of Arboviruses, National Institute of Health, Korea Center for Disease Control & Prevention, Chungcheongbuk-do, South Korea
| | - W-J Lee
- Division of Arboviruses, National Institute of Health, Korea Center for Disease Control & Prevention, Chungcheongbuk-do, South Korea
| | - J Y Choi
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - H Y Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Y Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Y K Kim
- Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, South Korea.
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38
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Aerosol transmission of severe fever with thrombocytopenia syndrome virus during resuscitation. Infect Control Hosp Epidemiol 2018; 40:238-241. [PMID: 30565531 DOI: 10.1017/ice.2018.330] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
We investigated potential nosocomial aerosol transmission of severe fever with thrombocytopenia syndrome virus (SFTSV) with droplet precautions. During aerosol generating procedures, SFTSV was be transmitted from person to person through aerosols. Thus, airborne precautions should be added to standard precautions to avoid direct contact and droplet transmission.
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39
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Hu J, Shi C, Li Z, Guo X, Qian Y, Tan W, Li X, Qi X, Su X, Zhou M, Wang H, Jiao Y, Bao C. A cluster of cases of severe fever with thrombocytopenia syndrome bunyavirus infection in China, 1996: A retrospective serological study. PLoS Negl Trop Dis 2018; 12:e0006603. [PMID: 29940000 PMCID: PMC6034904 DOI: 10.1371/journal.pntd.0006603] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/06/2018] [Accepted: 06/08/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND A cluster of eleven patients, including eight family members and three healthcare workers with fever and thrombocytopenia occurred in Yixing County, Jiangsu Province, China, from October to November 1996. However, the initial investigation failed to identify its etiology. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), which was first discovered in 2009. The discovery of novel SFTSV resulted in our consideration to test SFTSV on the remaining samples of this cluster in September 2010. METHODOLOGY/PRINCIPAL FINDINGS We retrospectively analyzed the epidemiological and clinical data of this cluster. The first case, one 55-year-old man with fulminant hemorrhagic diseases, died on October 14, 1996. His younger brother (the second case) developed similar hemorrhagic diseases after nursing him and then died on November 3. From November 4 to November 15, nine other patients, including six family members and three medical staffs, developed fever and thrombocytopenia after exposure to the second case. The sera of six patients were collected on November 24, 1996. IgM antibodies against SFTSV were detected in all of the six patients' sera using enzyme-linked immunosorbent assay (ELISA), while IgG antibodies were detected in one patient's serum using an indirect immunofluorescence assay (IFA). We also found that IgG antibodies against SFTSV were still detected in four surviving patients' sera 14 years after illness onset. CONCLUSIONS AND SIGNIFICANCE The mysterious pathogen of the cluster in 1996 was proved to be SFTSV on the basis of its epidemiological data, clinical data and serological results. It suggests that SFTSV has been circulating in China for more than 10 years before being identified in 2009, and SFTSV IgG antibodies can persist for up to 14 years.
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Affiliation(s)
- Jianli Hu
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Chao Shi
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, China
| | - Zhifeng Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiling Guo
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Yanhua Qian
- Wuxi Municipal Center for Disease Control and Prevention, Wuxi, China
| | - Wenwen Tan
- Yixing County Center for Disease Control and Prevention, Yixing, China
| | - Xian Li
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xian Qi
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Xiaoju Su
- Zhangzhu Township Health Center, Yixing, China
| | - Minghao Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Hua Wang
- Jiangsu Provincial Commission of Health and Family Planning, Nanjing, China
| | - Yongjun Jiao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- * E-mail: (CB); (YJ)
| | - Changjun Bao
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
- * E-mail: (CB); (YJ)
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Sun JM, Lu L, Liu KK, Yang J, Wu HX, Liu QY. Forecast of severe fever with thrombocytopenia syndrome incidence with meteorological factors. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 626:1188-1192. [PMID: 29898525 DOI: 10.1016/j.scitotenv.2018.01.196] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 01/11/2018] [Accepted: 01/19/2018] [Indexed: 06/08/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is emerging and some studies reported that SFTS incidence was associated with meteorological factors, while no report on SFTS forecast models was reported up to date. In this study, we constructed and compared three forecast models using autoregressive integrated moving average (ARIMA) model, negative binomial regression model (NBM), and quasi-Poisson generalized additive model (GAM). The dataset from 2011 to 2015 were used for model construction and the dataset in 2016 were used for external validity assessment. All the three models fitted the SFTS cases reasonably well during the training process and forecast process, while the NBM model forecasted better than other two models. Moreover, we demonstrated that temperature and relative humidity played key roles in explaining the temporal dynamics of SFTS occurrence. Our study contributes to better understanding of SFTS dynamics and provides predictive tools for the control and prevention of SFTS.
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Affiliation(s)
- Ji-Min Sun
- State Key Laboratory of 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, Beijing, China
| | - Liang Lu
- State Key Laboratory of 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, Beijing, China
| | - Ke-Ke Liu
- State Key Laboratory of 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, Beijing, China
| | - Jun Yang
- State Key Laboratory of 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, Beijing, China
| | - Hai-Xia Wu
- State Key Laboratory of 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, Beijing, China
| | - Qi-Yong Liu
- State Key Laboratory of 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, Beijing, China.
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Li S, Li Y, Wang Q, Yu X, Liu M, Xie H, Qian L, Ye L, Yang Z, Zhang J, Zhu H, Zhang W. Multiple organ involvement in severe fever with thrombocytopenia syndrome: an immunohistochemical finding in a fatal case. Virol J 2018; 15:97. [PMID: 29848330 PMCID: PMC5977472 DOI: 10.1186/s12985-018-1006-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 05/21/2018] [Indexed: 01/03/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS bunyavirus (SFTSV), a tick borne bunyavirus. However, Immunohistochemistry of SFTS patients are not well studied. Methods We obtained multiple of tissues from a fatal case with SFTS, including blood, lungs, kidneys, heart, and spleen. The blood samples were used to isolate the causative agent for detection of viral RNA and further expression of recombinant viral protein as primary antibody. Immunohistochemistry of the heart, lungs, spleen and kidneys was used to characterize the viral antigen in tissue sections. Results A 79-year-old man, together with his wife, was admitted because of fever. Both patients were diagnosed with SFTS by the positive SFTSV RNA in the blood. The gentleman died of multiple organ failure 8 days after hospitalization. However, his wife recovered and was discharged. Immunohistochemistry indicated that SFTSV antigens were present in all studied organs including the heart, kidney, lung and spleen, of which the spleen presented with the highest amount of SFTSV antigens. The kidney was next while the heart and lungs showed lower amount of SFTSV antigens. Conclusions SFTSV can direct infect multiple organs, resulting in multiple organ failure and ultimately in an unfavorable outcome. Electronic supplementary material The online version of this article (10.1186/s12985-018-1006-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shibo Li
- Department of Infectious Diseases, Zhoushan Hospital, Wenzhou Medical University, Zhejiang, China.
| | - Yang Li
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiujing Wang
- Department of Infectious Diseases, Zhoushan Hospital, Zhejiang, China
| | - Xuewen Yu
- Department of Infectious Diseases, Zhoushan Hospital, Wenzhou Medical University, Zhejiang, China
| | - Miaomiao Liu
- School of Public Health, Jining medical University, Jining, Shandong, China
| | - Haibo Xie
- Department of Critical Care Medicine, Maternal and Child Health Hospital, Zhoushan, Zhejiang, China
| | - Liyong Qian
- Department of Pathology, Zhoushan Hospital, Zhejiang, China
| | - Ling Ye
- Daishan Centers for Disease Control and Prevention, Zhoushan, Zhejiang, China
| | - Zhejuan Yang
- Department of Infectious Diseases, Zhoushan Hospital, Zhejiang, China
| | - Jianjing Zhang
- The First people's hospital of Daishan, Zhoushan, Zhejiang, China
| | - Huimin Zhu
- Department of Infectious Diseases, Zhoushan Hospital, Wenzhou Medical University, Zhejiang, China
| | - Wenhong Zhang
- Department of Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, China
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Sun J, Lu L, Wu H, Yang J, Liu K, Liu Q. Spatiotemporal patterns of severe fever with thrombocytopenia syndrome in China, 2011-2016. Ticks Tick Borne Dis 2018; 9:927-933. [PMID: 29606619 DOI: 10.1016/j.ttbdis.2018.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 03/05/2018] [Accepted: 03/23/2018] [Indexed: 12/13/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is emerging and the number of SFTS cases have increased year by year in China. However, spatiotemporal patterns and trends of SFTS are less clear up to date. In order to explore spatiotemporal patterns and predict SFTS incidences, we analyzed temporal trends of SFTS using autoregressive integrated moving average (ARIMA) model, spatial patterns, and spatiotemporal clusters of SFTS cases at the county level based on SFTS data in China during 2011-2016. We determined the optimal time series model was ARIMA (2, 0, 1) × (0, 0, 1)12 which fitted the SFTS cases reasonably well during the training process and forecast process. In the spatial clustering analysis, the global autocorrelation suggested that SFTS cases were not of random distribution. Local spatial autocorrelation analysis of SFTS identified foci mainly concentrated in Hubei Province, Henan Province, Anhui Province, Shandong Province, Liaoning Province, and Zhejiang Province. A most likely cluster including 21 counties in Henan Province and Hubei Province was observed in the central region of China from April 2015 to August 2016. Our results will provide a sound evidence base for future prevention and control programs of SFTS such as allocation of the health resources, surveillance in high-risk regions, health education, improvement of diagnosis and so on.
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Affiliation(s)
- Jimin Sun
- State Key Laboratory of 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, Beijing, China; Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Liang Lu
- State Key Laboratory of 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, Beijing, China
| | - Haixia Wu
- State Key Laboratory of 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, Beijing, China
| | - Jun Yang
- State Key Laboratory of 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, Beijing, China
| | - Keke Liu
- State Key Laboratory of 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, Beijing, China
| | - Qiyong Liu
- State Key Laboratory of 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, Beijing, China.
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Gong L, Song DD, Wu JB, Cao MH, Su B, Sun Y, Lyu Y, Zhang L, Wang F, He YX, Wang JS. Human-to-human transmissions of severe fever with thrombocytopenia syndrome virus in Anhui province, 2010-2017. Clin Microbiol Infect 2018; 24:920-922. [PMID: 29559391 DOI: 10.1016/j.cmi.2018.03.014] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Revised: 03/10/2018] [Accepted: 03/10/2018] [Indexed: 11/30/2022]
Affiliation(s)
- L Gong
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China.
| | - D D Song
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China
| | - J B Wu
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China
| | - M H Cao
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China
| | - B Su
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China
| | - Y Sun
- Anhui Provincial Center for Disease Control and Prevention, Anhui, China
| | - Y Lyu
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - L Zhang
- Hefei Municipal Center for Disease Control and Prevention, Hefei, China
| | - F Wang
- Wuhu Municipal Center for Disease Control and Prevention, Wuhu, China
| | - Y X He
- Tongling Municipal Center for Disease Control and Prevention, Tongling, China
| | - J S Wang
- Anqing Municipal Center for Disease Control and Prevention, Anqing, China
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44
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Sun J, Lu L, Yang J, Liu K, Wu H, Liu Q. Association between Severe Fever with Thrombocytopenia Syndrome Incidence and Ambient Temperature. Am J Trop Med Hyg 2018; 98:1478-1483. [PMID: 29557340 DOI: 10.4269/ajtmh.17-0991] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is emerging in China. To explore the lagged effects and nonlinear association between temperature and SFTS, we collected data on ambient temperature and SFTS cases and analyzed the data using a distributed lag nonlinear model. A total of 1,933 SFTS cases were reported in the study area from 2011 to 2015. Our study revealed a nonlinear relationship between weekly temperature and SFTS. The exposure-response curve was an approximately reversed U-shaped peak at 23°C. High temperatures had acute and short-term effects, whereas low temperatures had persistent and long-term effects. The effects of lower temperatures (1.62°C and 6.97°C) could last 24 weeks, but the effect of 29.30°C was not significant at lag 8 weeks. Our results provide information to better understand the effect of temperature variation on SFTS and may have policy implications for disease prevention and control.
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Affiliation(s)
- Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.,State Key Laboratory of 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, Beijing, China
| | - Liang Lu
- State Key Laboratory of 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, Beijing, China
| | - Jun Yang
- State Key Laboratory of 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, Beijing, China
| | - Keke Liu
- State Key Laboratory of 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, Beijing, China
| | - Haixia Wu
- State Key Laboratory of 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, Beijing, China
| | - Qiyong Liu
- State Key Laboratory of 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, Beijing, China
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45
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Abstract
Ticks are important vectors for the transmission of pathogens including viruses. The viruses carried by ticks also known as tick-borne viruses (TBVs), contain a large group of viruses with diverse genetic properties and are concluded in two orders, nine families, and at least 12 genera. Some members of the TBVs are notorious agents causing severe diseases with high mortality rates in humans and livestock, while some others may pose risks to public health that are still unclear to us. Herein, we review the current knowledge of TBVs with emphases on the history of virus isolation and identification, tick vectors, and potential pathogenicity to humans and animals, including assigned species as well as the recently discovered and unassigned species. All these will promote our understanding of the diversity of TBVs, and will facilitate the further investigation of TBVs in association with both ticks and vertebrate hosts.
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Affiliation(s)
- Junming Shi
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Zhihong Hu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Fei Deng
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
| | - Shu Shen
- State Key Laboratory of Virology, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
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46
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Ryu BH, Kim JY, Kim T, Kim MC, Kim MJ, Chong YP, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH. Extensive severe fever with thrombocytopenia syndrome virus contamination in surrounding environment in patient rooms. Clin Microbiol Infect 2018; 24:911.e1-911.e4. [PMID: 29355730 DOI: 10.1016/j.cmi.2018.01.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/03/2018] [Accepted: 01/07/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease in Korea and China. Although there is previous evidence of person-to-person transmission via direct contact with body fluids, the role of environmental contamination by SFTS virus (SFTSV) in healthcare settings has not been established. We therefore investigated the contamination of the healthcare environment by SFTSV. METHODS We investigated the possible contamination of hospital air and surfaces with SFTSV transmission by collecting air and swabbing environmental surface samples in two hospitals treating six SFTS patients between March and September 2017. The samples were tested using real-time RT-PCR for SFTS M and S segments. RESULTS Of the six SFTS patients, four received mechanical ventilation and three died. Five rooms were occupied by those using mechanical ventilation or total plasma exchange therapy in isolation rooms without negative pressure and one room was occupied by a patient bedridden due to SFTS. SFTSV was detected in 14 (21%) of 67 swab samples. Five of 24 swab samples were obtained from fomites including stethoscopes, and 9 of 43 were obtained from fixed structures including doorknobs and bed guardrails. Some samples from fixed structures such as television monitors and sink tables were obtained in areas remote from the patients. SFTSV RNA was not detected in five air samples from three patients' rooms. CONCLUSIONS Our data suggest that SFTSV contamination was extensive in surrounding environments in SFTS patients' rooms. Therefore, more strict isolation methods and disinfecting procedures should be considered when managing SFTS patients.
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Affiliation(s)
- B-H Ryu
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Y Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - T Kim
- Division of Infectious Diseases, Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Republic of Korea
| | - M-C Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea; Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - M J Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y-P Chong
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-O Lee
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-H Choi
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Y S Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J H Woo
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - S-H Kim
- Department of Infectious Diseases, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Republic of Korea.
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47
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Two confirmed cases of severe fever with thrombocytopenia syndrome with pneumonia: implication for a family cluster in East China. BMC Infect Dis 2017; 17:537. [PMID: 28774267 PMCID: PMC5541732 DOI: 10.1186/s12879-017-2645-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/27/2017] [Indexed: 12/03/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) was first reported in China in 2011. Human-to-human transmission of the virus occurred occasionally in family clusters. However, pneumonia as an onset syndrome was not common in most SFTS cases. Our aim is to report a family cluster of SFTS with clinical manifestation of pneumonia in Shanghai. Methods Epidemiologic investigations were conducted when a family cluster of severe fever with thrombocytopenia syndrome virus (SFTSV) infection was identified in Shanghai in June 2016. Samples were collected from two secondary cases and two close contacts with fever. SFTSV was detected by Real-Time reverse transcription polymerase chain reaction (RT-PCR). Results There were two confirmed STFS cases and one potential index case. The potential index case became ill on 21 May and died on 31 May. Case A had onset from 4 to 23 June and case B from 8 June to 25 June. All the three cases experienced pneumonia at the early stage of SFTSV infection. Three (3) out of thirty two (32) close contacts had symptoms of fever or cough but were detected STFSV negative by real-time RT-PCR. According to epidemiologic investigations, the potential index case had outdoor activities on a nearby hill. A tick bite could have been the reason for the SFTSV infection in the potential index case as ticks were found both in grassland or shrubs on the hill and also found on mice caught in her house. Both cases A and B had provided bedside care for the potential index case without any protection and had contacted with blood and other body fluids. Conclusion It was a family cluster of SFTSV infection imported from Jiangsu province located in the east of China. We suggested to become alert to atypical SFTSV infected cases.
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48
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Wang GS, Wang JB, Tian FL, Zhang HJ, Yin FF, Xu C, Xu D, Huang YT, Yu XJ. Severe Fever with Thrombocytopenia Syndrome Virus Infection in Minks in China. Vector Borne Zoonotic Dis 2017; 17:596-598. [PMID: 28654374 DOI: 10.1089/vbz.2017.2115] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We analyzed the seroprevalence of tick-borne severe fever with thrombocytopenia syndrome virus (SFTSV) in farm-raised minks using double antigen ELISA (enzyme-linked immunosorbent assay) kit and indicated that 8.4% (15/178) of the minks had antibodies to the nucleoprotein of SFTSV and 72.7% (8/11) of mink farms had minks positive to SFTSV. The ELISA results were further confirmed by presence of neutralization to SFTSV in the mink sera. Our results suggested that minks were widely infected with SFTSV in China.
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Affiliation(s)
- Gui-Sheng Wang
- 1 School of Life Sciences, Shandong University , Jinan, China .,2 Shandong Provincial Center for Animal Disease Control and Prevention , Jinan, China
| | - Jin-Bao Wang
- 1 School of Life Sciences, Shandong University , Jinan, China
| | - Fu-Lin Tian
- 2 Shandong Provincial Center for Animal Disease Control and Prevention , Jinan, China
| | - Hua-Jie Zhang
- 3 Weihai City Center for Animal Disease Control and Prevention , Weihai, China
| | - Fei-Fei Yin
- 3 Weihai City Center for Animal Disease Control and Prevention , Weihai, China
| | - Cong Xu
- 2 Shandong Provincial Center for Animal Disease Control and Prevention , Jinan, China
| | - Dong Xu
- 3 Weihai City Center for Animal Disease Control and Prevention , Weihai, China
| | - Yu-Ting Huang
- 4 School of Public Health, Shandong University , Jinan, China
| | - Xue-Jie Yu
- 5 Wuhan University School of Health Sciences , Wuhan, China .,6 Department of Pathology, University of Texas Medical Branch , Galveston, Texas
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49
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Zhan J, Wang Q, Cheng J, Hu B, Li J, Zhan F, Song Y, Guo D. Current status of severe fever with thrombocytopenia syndrome in China. Virol Sin 2017; 32:51-62. [PMID: 28251515 DOI: 10.1007/s12250-016-3931-1] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Accepted: 02/20/2017] [Indexed: 12/13/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by SFTS virus (SFTSV). SFTSV is associated with a high mortality rate and has been reported in China, South Korea and Japan. SFTSV undergoes rapid changes owing to evolution, gene mutations, and reassortment between different strains of SFTSV. In this review, we summarize the recent cases and general properties of SFTS, focusing on the epidemiology, genetic diversity, clinical features, and diagnostics of SFTSV in China. From 2010 to October 2016, SFTS cases were reported in 23 provinces of China, with increased numbers yearly. Infection and death cases are mainly found in central China, where the Haemaphysalis longicornis ticks are spread. The national average mortality rate of SFTS infection was 5.3%, with higher risk to elder people. The main epidemic period was from May to July, with a peak in May. Thus, SFTS reminds a significant public health problem, and development of prophylactic vaccines and effective antiviral drugs will be highly needed.
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Affiliation(s)
- Jianbo Zhan
- Wuhan University School of Basic Medical Sciences, Wuhan, 430072, China.,Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Qin Wang
- Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Jing Cheng
- Wuhan University of Science and Technology, Wuhan, 430081, China
| | - Bing Hu
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Jing Li
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China
| | - Faxian Zhan
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
| | - Yi Song
- Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, China.
| | - Deyin Guo
- Wuhan University School of Basic Medical Sciences, Wuhan, 430072, China.
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50
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Wang L, Zou Z, Hou C, Liu X, Jiang F, Yu H. Score risk model for predicting severe fever with thrombocytopenia syndrome mortality. BMC Infect Dis 2017; 17:42. [PMID: 28061758 PMCID: PMC5219703 DOI: 10.1186/s12879-016-2111-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/10/2016] [Indexed: 02/02/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality in East Aisa, especially in China. To predict the prognosis of SFTS precisely is important in clinical practice. Methods From May 2013 to November 2015, 233 suspected SFTS patients were tested for SFTS virus using RT-PCR. Cox regression model was utilized to comfirm independent risk factors for mortality. A risk score model for mortality was constructed based on regression coefficient of risk factors. Log-rank test was used to evaluate the significance of this model. Results One hundred seventy-four patients were confirmed with SFTS, of which 40 patients died (23%). Baseline age, serum aspartate aminotransferase (AST) and serum creatinine (sCr) level were independent risk factors of mortality. The area under ROC curve (AUCs) of these parameters for predicting death were 0.771, 0.797 and 0.764, respectively. And hazard ratio (HR) were 1.128, 1.002 and 1.013, respectively. The cutoff value of the risk model was 10. AUC of the model for predicting mortality was 0.892, with sensitivity and specificity of 82.5 and 86.6%, respectively. Log-rank test indicated strong statistical significance (×2 = 88.35, p < 0.001). Conclusions This risk score model may be helpful to predicting the prognosis of SFTS patients.
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Affiliation(s)
- Li Wang
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China.
| | - Zhiqiang Zou
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Chunguo Hou
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Xiangzhong Liu
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Fen Jiang
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Hong Yu
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
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