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Jiang N, He Y, Wu J, You Q, Zhang R, Cheng M, Liu B, Cai Y, Lyu R, Wu Z. 6-Thioguanine inhibits severe fever with thrombocytopenia syndrome virus through suppression of EGR1. Antiviral Res 2024; 227:105916. [PMID: 38777095 DOI: 10.1016/j.antiviral.2024.105916] [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: 03/15/2024] [Revised: 05/06/2024] [Accepted: 05/18/2024] [Indexed: 05/25/2024]
Abstract
The severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel phlebovirus, recently being officially renamed as Dabie bandavirus, and a causative agent for an emerging infectious disease associated with high fatality. Effective therapeutics and vaccines are lacking and disease pathogenesis is yet to be fully elucidated. In our effort to identify new SFTSV inhibitory molecules, 6-Thioguanine (6-TG) was found to potently inhibit SFTSV infection. 6-TG has been widely used as therapeutic agent since the approval of the Food and Drug Administration in the 1960s. In the current study, we showed that 6-TG was a potent inhibitor of SFTSV infection with 50% effective concentrations (EC50) of 3.465 μM in VeroE6 cells, and 1.848 μM in HUVEC cells. The selectivity index (SI) was >57 in VeroE6 cells and >108 in HUVEC cells, respectively. The SFTSV RNA transcription, protein synthesis, and progeny virions were reduced in a dose dependent manner by the presence of 6-TG in the in vitro infection assay. Further study on the mechanism of the anti-SFTSV activity showed that 6-TG downregulated the production of early growth response gene-1 (EGR1). Using gene silencing and overexpression, we further confirmed that EGR1 was a host restriction factor against SFTSV. Meanwhile, treatment of infected experimental animals with 6-TG inhibited SFTSV infection and alleviated multi-organ dysfunction. In conclusion, we have identified 6-TG as an effective inhibitor of SFTSV replication via the inhibition of EGR1 expression. Further studies are needed to evaluate of 6-TG as a potential therapeutic for treating SFTS.
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Affiliation(s)
- Na Jiang
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Yating He
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Jing Wu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Qiao You
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Rui Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China
| | - Min Cheng
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Bingxin Liu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Yurong Cai
- School of Life Sciences, Ningxia University, Yinchuan, China
| | - Ruining Lyu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China
| | - Zhiwei Wu
- Center for Public Health Research, Medical School, Nanjing University, Nanjing, China; State Key Laboratory of Analytical Chemistry for Life Science, Nanjing University, Nanjing, China; Jiangsu Key Laboratory of Molecular Medicine, Medical School, Nanjing University, Nanjing, China.
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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 Y, Qin LH, Zhang K, Zhang DW, Wang WJ, Xu AM, Qi YJ. Blood urea nitrogen to albumin ratio is a novel predictor of fatal outcome for patients with severe fever with thrombocytopenia syndrome. J Med Virol 2024; 96:e29731. [PMID: 38888065 DOI: 10.1002/jmv.29731] [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: 03/21/2024] [Revised: 05/07/2024] [Accepted: 06/01/2024] [Indexed: 06/20/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is associated with a high death rate and lacks a targeted therapy plan. The ratio of blood urea nitrogen to albumin, known as BAR, is a valuable method for assessing the outlook of various infectious diseases. The objective of this research was to evaluate the effectiveness of BAR in forecasting the outcome of individuals with SFTS. Four hundred and thirty-seven patients with SFTS from two clinical centers were included in this study according to inclusion and exclusion criteria. Clinical characteristics and test parameters of SFTS patients were analyzed between survival and fatal groups. Least absolute shrinkage and selection operator (LASSO) regression and Cox regression suggested that BAR might serve as a standalone prognostic indicator for patients with SFTS in the initial phase (hazard ratio = 18.669, 95% confidence interval [CI]: 8.558-40.725, p < 0.001). And BAR had a better predictive effectiveness in clinical outcomes in patients with SFTS with an AUC of 0.832 (95% CI: 0.788-0.876, p < 0.001), a cutoff value of 0.19, a sensitivity of 0.812, and a specificity of 0.726 compared to C-reactive protein, procalcitonin, and platelet to lymphocyte ratio via receiver operating characteristic curve. KM (Kaplan Meier) curves demonstrated that high level of BAR was associated with poor survival condition in patients with SFTS. Furthermore, the high level of BAR was associated with long hospital stays and test paraments of kidney, liver, and coagulation function in survival patients. So, BAR could be used as a promising early warning biomarker of adverse outcomes in patients with SFTS.
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Affiliation(s)
- Ye Wang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Ling-Han Qin
- Department of Laboratory Medicine, Infection Hospital Area of the First Affiliated Hospital of University of Science and Technology of China (Hefei Infectious Disease Hospital), Hefei, Anhui Province, People's Republic of China
- Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei, Anhui Province, People's Republic of China
| | - Ke Zhang
- Department of Clinical Laboratory, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Da-Wei Zhang
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Wei-Jie Wang
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - A-Man Xu
- Department of General Surgery, First Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province, People's Republic of China
| | - Ying-Jie Qi
- Department of Laboratory Medicine, Infection Hospital Area of the First Affiliated Hospital of University of Science and Technology of China (Hefei Infectious Disease Hospital), Hefei, Anhui Province, People's Republic of China
- Key Laboratory of Anhui Province for Emerging and Reemerging Infectious Diseases, Hefei, Anhui Province, People's Republic of China
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Kuan CY, Ou SC, Chang CC, Kao PL, Tsai RS, Rattanapanadda P, Lin TL, Maeda K, Cheng TL, Lee YJ, Chuang ST, Lin SL, Liu HY, Lin FY, Lin JW, Hsu WL, Chou CC. Epidemiology of Severe Fever with Thrombocytopenia Syndrome in Dogs and Cats in Taiwan. Viruses 2023; 15:2338. [PMID: 38140579 PMCID: PMC10747826 DOI: 10.3390/v15122338] [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: 10/30/2023] [Revised: 11/25/2023] [Accepted: 11/27/2023] [Indexed: 12/24/2023] Open
Abstract
Severe Fever with Thrombocytopenia Syndrome (SFTS), caused by the SFTS Virus (SFTSV), is a global health threat. SFTSV in Taiwan has only been reported in ruminants and wild animals. Thus, we aimed to investigate the infection statuses of dogs and cats, the animals with closer human interactions. Overall, the SFTSV RNA prevalence was 23% (170/735), with dogs showing a 25.9% (111/429) prevalence and cats at 19.3% (59/306) prevalence. Noticeably, the prevalence in stray animals (39.8% 77/193) was significantly higher than in domesticated ones (17.2%, 93/542). Among the four categories analyzed, the highest SFTSV prevalence was found in the stray dogs at 53.9% (120/193), significantly higher than the 24.2% prevalence noted in stray cats. In contrast, domesticated animals exhibited similar prevalence rates, with 17.1% for dogs and 17.2% for cats. It is noteworthy that in the domesticated animal groups, a significantly elevated prevalence (45%, 9/20) was observed among cats exhibiting thrombocytopenia compared to those platelet counts in the reference range (4.8%, 1/21). The high infection rate in stray animals, especially stray dogs, indicated that exposure to various outdoor environments influences the prevalence of infections. Given the higher human interaction with dogs and cats, there is a need for proactive measures to reduce the risk associated with the infection of SFTSV in both animals and humans.
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Affiliation(s)
- Chih-Ying Kuan
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.K.); (S.-C.O.); (C.-C.C.); (R.-S.T.)
| | - Shan-Chia Ou
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.K.); (S.-C.O.); (C.-C.C.); (R.-S.T.)
| | - Chao-Chin Chang
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.K.); (S.-C.O.); (C.-C.C.); (R.-S.T.)
| | - Pei-Ling Kao
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan;
| | - Ruei-Sheng Tsai
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.K.); (S.-C.O.); (C.-C.C.); (R.-S.T.)
| | - Porjai Rattanapanadda
- Food and Drug Administration, Ministry of Public Health, Nonthaburi 11000, Thailand;
| | - Tsai-Lu Lin
- New Taipei City Government Animal Protection and Health Inspection Office, New Taipei City 220066, Taiwan;
| | - Ken Maeda
- National Institute of Infectious Disease, Tokyo 162-8640, Japan;
| | - Tsun-Li Cheng
- Veterinary Medical Teaching Hospital, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan;
| | - Ya-Jane Lee
- Veterinary Hospital, College of Bio-Resources and Agriculture, National Taiwan University, Taipei 10617, Taiwan;
| | - Shih-Te Chuang
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (S.-T.C.); (S.-L.L.)
| | - Shiun-Long Lin
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (S.-T.C.); (S.-L.L.)
| | - Hsien-Yueh Liu
- Department of Animal Healthcare, Hungkuang University, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.)
| | - Fong-Yuan Lin
- Department of Animal Healthcare, Hungkuang University, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.)
| | - Jen-Wei Lin
- Department of Animal Healthcare, Hungkuang University, Taichung 433304, Taiwan; (H.-Y.L.); (J.-W.L.)
| | - Wei-Li Hsu
- Graduate Institute of Microbiology and Public Health, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (C.-Y.K.); (S.-C.O.); (C.-C.C.); (R.-S.T.)
- The iEGG and Animal Biotechnology Center, National Chung Hsing University, Taichung 40227, Taiwan
| | - Chi-Chung Chou
- Department of Veterinary Medicine, College of Veterinary Medicine, National Chung Hsing University, Taichung 40227, Taiwan; (S.-T.C.); (S.-L.L.)
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Huang T, Wang X, Mi Y, Liu T, Li Y, Zhang R, Qian Z, Wen Y, Li B, Sun L, Wu W, Li J, Wang S, Liang M. Identification and Analysis of a Four-Gene Set for Diagnosing SFTS Virus Infection Based on Machine Learning Methods and Its Association with Immune Cell Infiltration. Viruses 2023; 15:2126. [PMID: 37896902 PMCID: PMC10612101 DOI: 10.3390/v15102126] [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: 07/29/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
Severe Fever with thrombocytopenia syndrome (SFTS) is a highly fatal viral infectious disease that poses a significant threat to public health. Currently, the phase and pathogenesis of SFTS are not well understood, and there are no specific vaccines or effective treatment available. Therefore, it is crucial to identify biomarkers for diagnosing acute SFTS, which has a high mortality rate. In this study, we conducted differentially expressed genes (DEGs) analysis and WGCNA module analysis on the GSE144358 dataset, comparing the acute phase of SFTSV-infected patients with healthy individuals. Through the LASSO-Cox and random forest algorithms, a total of 2128 genes were analyzed, leading to the identification of four genes: ADIPOR1, CENPO, E2F2, and H2AC17. The GSEA analysis of these four genes demonstrated a significant correlation with immune cell function and cell cycle, aligning with the functional enrichment findings of DEGs. Furthermore, we also utilized CIBERSORT to analyze the immune cell infiltration and its correlation with characteristic genes. The results indicate that the combination of ADIPOR1, CENPO, E2F2, and H2AC17 genes has the potential as characteristic genes for diagnosing and studying the acute phase of SFTS virus (SFTSV) infection.
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Affiliation(s)
- Tao Huang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Xueqi Wang
- Capital Institute of Pediatrics, Beijing 100020, China;
| | - Yuqian Mi
- Shanxi Academy of Advanced Research and Innovation, Taiyuan 030032, China;
| | - Tiezhu Liu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Yang Li
- Chongqing Research Institute of Big Data, Peking University, Chongqing 400039, China;
| | - Ruixue Zhang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Zhen Qian
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Yanhan Wen
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Boyang Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Lina Sun
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Wei Wu
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Jiandong Li
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Shiwen Wang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
| | - Mifang Liang
- National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases (NITFID), Institute for Viral Disease Control and Prevention, China CDC, Beijing 102206, China; (T.H.); (T.L.); (R.Z.); (Z.Q.); (Y.W.); (B.L.); (L.S.); (W.W.); (J.L.)
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Ai L, Wang W, Teng Z. Advancements in the Worldwide Detection of Severe Fever with Thrombocytopenia Syndrome Virus Infection from 2009 to 2023. China CDC Wkly 2023; 5:687-693. [PMID: 37593140 PMCID: PMC10427339 DOI: 10.46234/ccdcw2023.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/01/2023] [Indexed: 08/19/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a growing concern as an emerging tick-borne infectious disease originating from the SFTS virus (SFTSV), a recent addition to the Phlebovirus genus under the family of bunyaviruses. SFTS is typically identified by symptoms such as fever, thrombocytopenia, leukopenia, and gastrointestinal problems, accompanied by a potentially high case fatality rate. Thus, early and accurate diagnosis is essential for effective treatment and disease management. This review delves into the existing methodologies for SFTS detection, including pathogenic, molecular, and immunological technologies.
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Affiliation(s)
- Lin Ai
- Institute of Microbiology Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Wei Wang
- Institute of Microbiology Laboratory, Shanghai Institute of Preventive Medicine, Shanghai, China
| | - Zheng Teng
- Institute of Microbiology Laboratory, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
- Institute of Microbiology Laboratory, Shanghai Institute of Preventive Medicine, Shanghai, China
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Mekata H, Umeki K, Yamada K, Umekita K, Okabayashi T. Nosocomial Severe Fever with Thrombocytopenia Syndrome in Companion Animals, Japan, 2022. Emerg Infect Dis 2023; 29:614-617. [PMID: 36823498 PMCID: PMC9973679 DOI: 10.3201/eid2903.220720] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In Japan, 2 cats that underwent surgery in a room where a sick dog had been euthanized became ill within 9 days of surgery. Severe fever with thrombocytopenia syndrome virus was detected in all 3 animals; nucleotide sequence identity was 100%. Suspected cause was an uncleaned pulse oximeter probe used for all patients.
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Zhang Q, Liu W, Wang W, Zhang L, Li J, Tang R, Jin J, Chen W, Zhang L. Analysis of spatial-temporal distribution characteristics and natural infection status of SFTS cases in Hefei from 2015 to 2021. Environ Health Prev Med 2023; 28:70. [PMID: 37967947 PMCID: PMC10654213 DOI: 10.1265/ehpm.23-00149] [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: 06/12/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND To analyze the prevalence and spatial-temporal characteristics of severe fever with thrombocytopenia syndrome (SFTS), clustering mode of transmission, and the serological dynamic detection results in multiple areas in Hefei from 2015 to 2021, and to provide the basis for SFTS prevention and control. METHOD Case data were obtained from the Chinese Disease Control and Prevention Information System. Information on the clustering outbreak was obtained from the outbreak investigation and disposal report. Population latent infection rate information was obtained from field sampling in multiple-incidence counties in 2016 and 2021 by multi-stage random sampling. Epi data3.2 and SPSS 16.0 softwares were used to perform a statistical analysis of the data on SFTS cases, and QGIS 3.26 software was used to draw the incidence map with township (street) as unit. RESULTS The an average annual reported incidence rate of SFTS in Hefei from 2015 to 2021 was 0.65/100,000, and the case fatality rate was 9.73%. The overall prevalence of SFTS epidemics in Hefei City showed a fluctuating upward trend from 2015 to 2021 (χ2trends = 103.353, P < 0.001). Chaohu City, Feixi County, Feidong County and Lujiang County ranked the top 4 in the city in terms of average annual incidence rate. The number of epidemic-involved towns (streets) kept increasing ((χ2trend = 47.640, P = 0.000)). Co-exposure to ticks accounted for the majority of clustered outbreaks and also human-to-human outbreaks. Population-based latent infection rate surveys were conducted in four SFTS multi-incidence counties, with 385 people surveyed in 2016 and 403 people surveyed in 2021, increasing the population-based latent infection rate from 6.75% to 10.91%, just as the incidence rate increased. CONCLUSIONS The incidence rate of SFTS in Hefei is obviously regional, with an expanding trend in the extent of the epidemic involved. Co-exposure to ticks accounted for the majority of clustered outbreaks and the latent infection rate cannot be ignored.
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Affiliation(s)
- Qi Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wenwen Liu
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wenjing Wang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Linlin Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Juan Li
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Renshu Tang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wei Chen
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Lei Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
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9
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Wang M, Huang P, Liu W, Tan W, Chen T, Zeng T, Zhu C, Shao J, Xue H, Li J, Yue M. Risk factors of severe fever with thrombocytopenia syndrome combined with central neurological complications: A five-year retrospective case-control study. Front Microbiol 2022; 13:1033946. [PMID: 36406394 PMCID: PMC9668900 DOI: 10.3389/fmicb.2022.1033946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 10/17/2022] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with high mortality rate, especially SFTS combined with central neurological complications. The purpose of this study was to explore risk factors of central neurological complications in SFTS patients. METHODS In this retrospective study, SFTS patients admitted to the First Affiliated Hospital of Nanjing Medical University between January 2017 and December 2021 were enrolled. Based on the presence or absence of central neurological complications, SFTS patients were divided into case group and control group. The patients' laboratory parameters and clinical data were collected for statistical analysis. Receiver operating characteristic (ROC) curve analysis was used to evaluate the prediction accuracy of independent risk factors in identifying SFTS patients with central neurological complications. RESULTS In total, 198 hospitalized SFTS patients with complete medical records, clear etiological diagnosis and clinical outcomes were enrolled in this study. Of these, 74 (37.4%) cases were diagnosed with SFTS with central neurological complications, 29 (39.2%) cases died, and no death occurred in the control group. Multivariate logistic regression analysis revealed pulmonary rales, atrial fibrillation, and high serum SFTSV RNA, lactate dehydrogenase level during the fever stage as independent risk factors for the development of central neurological complications in SFTS patients. ROC curve analysis showed that the area under the ROC curve (AUC) of serum SFTSV RNA and lactate dehydrogenase levels were 0.748 (95%CI: 0.673-0.823, p < 0.001) and 0.864 (95%CI: 0.815-0.914, p < 0.001), respectively, in central neurological complications predicted in SFTS patients. CONCLUSION Severe fever with thrombocytopenia syndrome (SFTS) combined with central neurological complications has high morbidity and mortality and diverse clinical manifestations. Early monitoring of lung signs, electrocardiogram, blood SFTSV RNA, and lactate dehydrogenase levels in SFTS patients may be useful in predicting the occurrence of central neurological complications.
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Affiliation(s)
- Min Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Peng Huang
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Wei Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
- State Key Lab Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Weilong Tan
- Department of Infectious Disease Prevention and Control, Eastern Theater Command Centers for Disease Control and Prevention, Nanjing, China
| | - Tianyan Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Tian Zeng
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Chuanlong Zhu
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department Infectious and Tropical Diseases, The Second Affiliation Hospital of Hainan Medical University, Haikou, China
| | - Jianguo Shao
- Department of Gastroenterology, Nantong Third People’s Hospital Affiliated to Nantong University, Nantong, China
| | - Hong Xue
- Department of Hepatology, Nantong Third People’s Hospital Affiliated to Nantong University, Nantong, China
| | - Jun Li
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China
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10
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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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11
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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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12
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Wei Y, Wang Z, Kang L, He L, Sheng N, Qin J, Ma S, Xu H, Hu L, Zou G, Gao Y, Li J. NLR, A Convenient Early-Warning Biomarker of Fatal Outcome in Patients With Severe Fever With Thrombocytopenia Syndrome. Front Microbiol 2022; 13:907888. [PMID: 35814714 PMCID: PMC9262381 DOI: 10.3389/fmicb.2022.907888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/16/2022] [Indexed: 12/04/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that greatly threatens public health. This study aimed to examine a convenient early-warning biomarker of fatal outcomes in patients with SFTS to reduce mortality. Methods A retrospective cohort study was performed, and patients with confirmed SFTS were enrolled in the top two hospitals in Anhui Province, China from 1 May 2016 to 31 October 2019. The clinical symptoms, laboratory indicators, and treatment data of patients with SFTS were evaluated. All patients with SFTS were followed up till 28 days from the start of admission. The laboratory indicators that could be used to predict the fatal outcome were identified. Results A total of 228 patients with SFTS were enrolled, 177 patients were enrolled in the survival group, and 51 patients in the death group. The median age of all 228 patients with SFTS was 63 years. Five laboratory indicators (SFTSV viral load, neutrophil to lymphocyte ratio (NLR), aspartate transaminase (AST)/alanine aminotransferase (ALT), ALT, and blood urea nitrogen (BUN)) were identified as the predicting factors of the fatal outcome of patients with SFTS. The area under the receiver operating characteristic (ROC) curve (AUC) of SFTSV viral load was the highest (0.919), then NLR (0.849), followed by AST/ALT (0.758), AST (0.738), and BUN (0.709). The efficacy of SFTVS viral load and NLR in predicting fatal outcomes was significantly higher than AST/ALT, AST, and BUN. The Kaplan–Meier survival curves show that the case fatality rate was significantly increased in patients whose SFTSV viral load was higher than 500,000 or NLR higher than 2.0. Gamma-globulin treatment showed a significant difference between the survival group and the death group, and the duration of gamma-globulin that had been proposed should not be <3 days. Conclusion The SFTSV viral load and NLR showed great efficacy in predicting the fatal outcome of patients with SFTS, and NLR is a convenient and efficient early-warning biomarker that helps healthcare workers focus on patients with high risks of fatal outcomes. The efficacy of gamma-globulin provided a new idea for the treatment of SFTS, which needs further analysis in future studies.
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Affiliation(s)
- Yuanyuan Wei
- Department of Hospital Infection Prevention and Control, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
| | - Zilong Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Luyang Kang
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lingling He
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Nan Sheng
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiangfeng Qin
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Shuangshuang Ma
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Honghai Xu
- Department of Pathology, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lifen Hu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Guizhou Zou
- Department of Infectious Diseases, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yufeng Gao
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- *Correspondence: Yufeng Gao
| | - Jiabin Li
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Jiabin Li
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13
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Wang M, Tan W, Li J, Fang L, Yue M. The Endless Wars: Severe Fever With Thrombocytopenia Syndrome Virus, Host Immune and Genetic Factors. Front Cell Infect Microbiol 2022; 12:808098. [PMID: 35782112 PMCID: PMC9240209 DOI: 10.3389/fcimb.2022.808098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/10/2022] [Indexed: 01/10/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging arboviral infectious disease with a high rate of lethality in susceptible humans and caused by severe fever with thrombocytopenia syndrome bunyavirus (SFTSV). Currently, neither vaccine nor specific antiviral drugs are available. In recent years, given the fact that both the number of SFTS cases and epidemic regions are increasing year by year, SFTS has become a public health problem. SFTSV can be internalized into host cells through the interaction between SFTSV glycoproteins and cell receptors and can activate the host immune system to trigger antiviral immune response. However, SFTSV has evolved multiple strategies to manipulate host factors to create an optimal environment for itself. Not to be discounted, host genetic factors may be operative also in the never-ending winning or losing wars. Therefore, the identifications of SFTSV, host immune and genetic factors, and their interactions are critical for understanding the pathogenic mechanisms of SFTSV infection. This review summarizes the updated pathogenesis of SFTS with regard to virus, host immune response, and host genetic factors to provide some novel perspectives of the prevention, treatment, as well as drug and vaccine developments.
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Affiliation(s)
- Min Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weilong Tan
- Department of Infection Disease, Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
| | - Jun Li
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liqun Fang
- State Key Lab Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- *Correspondence: Liqun Fang, ; Ming Yue,
| | - Ming Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Liqun Fang, ; Ming Yue,
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14
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Saijo M. Severe fever with thrombocytopenia syndrome, a viral hemorrhagic fever, endemic to Japan: achievements and directions to the future in the scientific and medical research. Jpn J Infect Dis 2022; 75:217-227. [PMID: 35354707 DOI: 10.7883/yoken.jjid.2021.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A novel infectious disease, severe fever with thrombocytopenia syndrome (SFTS) caused by a novel bunyavirus, with high case fatality rate (CFR) was reported by Chinese scientists in 2011. The causative virus, Dabie bandavirus [former SFTS virus (SFTSV)] belonged to the Bandavirus genus (former Phlebovirus genus) of Phenuiviridae family (former Bunyaviridae family). SFTS was also reported to be endemic to South Korea and Japan in 2013. Humans are infected with SFTSV through bites by ticks such as Haemophysalis longicornis and Amblyomma testidinarium. However, it was reported that domesticated animals such as cats and dogs were also infected with SFTSV probably through tick bites in living environment and show the SFTS-like symptoms with high CFR. Furthermore, there have been the cases of SFTS patients, who were infected with SFTSV through close contacts with sick cats or dogs. The high CFR in patients with SFTS is approximately 30% in Japan. SFTSV is circulating in nature between some species of ticks and animals. There are always the risks of SFTSV infection for human populations living in the endemic areas. Therefore, development of specific therapies and vaccines is an urgent need to reduce the number of fatal SFTS patients.
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Affiliation(s)
- Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, Japan
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15
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Bae S, Chang HH, Kim SW, Kim Y, Wang E, Kim CK, Choi E, Lim B, Park S, Chae H, Jeon H. Nosocomial outbreak of severe fever with thrombocytopenia syndrome among healthcare workers in a single hospital in Daegu, Korea: Nosocomial SFTS outbreak among healthcare workers. Int J Infect Dis 2022; 119:95-101. [PMID: 35358725 DOI: 10.1016/j.ijid.2022.03.048] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 03/21/2022] [Accepted: 03/23/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In August 2020, 17 healthcare workers (HCWs) were simultaneously diagnosed with severe fever with thrombocytopenia syndrome (SFTS) at a university hospital in Daegu, Republic of Korea. METHODS An epidemiologic investigation using questionnaires was conducted for all suspected HCWs who had viral infection symptoms or who had the possibility of exposure to the index patient. RESULTS A total of 17 HCWs infected with the SFTS virus (SFTSV) (28.8%) were identified among the 59 HCWs who had contact with the patient. Operating a bag valve mask during cardiopulmonary resuscitation (CPR) (OR 7.50, 95% CI 1.75-41.07), cardiac massage during CPR (OR 12.00, 95% CI 1.76-241.94), exposure to the patient's body fluids (OR 7.43, 95% CI 1.91-34.69), and shorter individual hospital work experience periods (OR 6.79, 95% CI 1.70-32.10) were significantly associated with SFTS infection in the univariate analysis. However, exposure to body fluids was found to be the only statistically significant risk factor when multivariate analysis was conducted (OR 6.27. 95% CI 1.23-42.81, p = 0.036). CONCLUSIONS This finding illustrates the importance of wearing appropriate personal protective equipment in treatment areas and when conducting any medical procedures, including CPR for patients with SFTS, and any procedure that involves potential exposure to body fluids.
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Affiliation(s)
- Sohyun Bae
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun-Ha Chang
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Shin-Woo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
| | - Yoonjung Kim
- Division of Infectious Diseases, Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea
| | - EunByeol Wang
- Division of Viral diseases, Korea Disease Control and Prevention Agency
| | - Chi Kyeong Kim
- Division of Viral diseases, Korea Disease Control and Prevention Agency
| | - Eunji Choi
- Division of Viral diseases, Korea Disease Control and Prevention Agency
| | - Bohyun Lim
- Division of Control for Zoonotic and Vector borne Disease, Korea Disease Control and Prevention Agency
| | - Sookkyung Park
- Division of Control for Zoonotic and Vector borne Disease, Korea Disease Control and Prevention Agency
| | - Hwajin Chae
- Infection Control Office, Kyungpook National University Hospital, Daegu, Korea
| | - Hyeyoung Jeon
- Infection Control Office, Kyungpook National University Hospital, Daegu, Korea
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16
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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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17
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Wang L, Xu Y, Zhang S, Bibi A, Xu Y, Li T. The AST/ALT Ratio (De Ritis Ratio) Represents an Unfavorable Prognosis in Patients in Early-Stage SFTS: An Observational Cohort Study. Front Cell Infect Microbiol 2022; 12:725642. [PMID: 35211422 PMCID: PMC8861437 DOI: 10.3389/fcimb.2022.725642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 01/10/2022] [Indexed: 11/23/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS), a widely prevalent infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV) that carries with it a high mortality rate, has emerged to be a public health concern. This study aimed to investigate the epidemiological and clinical characteristics of patients infected with SFTSV, seeking novel prognostic risk factors for SFTS. Methods In this retrospective and cross-sectional study, confirmed SFTS patients from the First Affiliated Hospital of Anhui Medical University were enrolled from September 1, 2019, to December 12, 2020. Cases were analyzed for epidemiological, demographic, clinical, and laboratory data. Logistic regression models were used to assess the association between predictors and outcome variables. A generalized additive mixed model (GAMM) was conducted to analyze the trending shift of aspartate aminotransferase/alanine transaminase-ratio (AST/ALT-ratio) and platelet (PLT) in SFTS patients treated with ribavirin. p values ≤ 0.05 were considered statistically significant. Results Clinical and laboratory results of 107 hospitalized patients with SFTSV infection were retrospectively described. The mean age at onset of disease was 60.38 ± 11.29 years old and the ratio between male and female was 1:1.2. Fever and thrombocytopenia are hallmark features of SFTS. Furthermore, multiple cases also experienced neurological complications, gastrointestinal/skeletal muscle symptoms together with other non-specific clinical manifestations; laboratory dataset outcomes reported dysregulated levels for routine blood biomarkers, coagulation function, and biochemistry. Overall, 107 patients were segregated into two groups according to patient condition at the clinical endpoint (survivors/non-survivors). SFTS survivors had a higher level of PLT- counts, total protein (TP), and estimated glomerular filtration rate (eGFR), while levels of activated partial thromboplastin time (APTT), thrombin time (TT), D-dimer (D-D), fibrinogen degradation products (FDP), ALT, AST, AST/ALT-ratio, creatinine (Cr), creatine phosphokinase (CK) and procalcitonin (PCT) was higher in non-survivors. Results from univariate Cox regression revealed that elevated levels of FDP, TT, AST/ALT-ratio, PCT, as well as decreased eGFR level and presence of central nervous system symptoms (CNS), were significant predictors for SFTS prognostic, results from multivariate logistic regression analysis in three adjusted models showed AST/ALT-ratio and PCT were independent risk factors for the prognosis of SFTS patients. Kaplan–Meier survival analysis showed that SFTS patients with AST/ALT-ratio >2.683 were associated with a shorter futime (means survival time), therefore indicating an unfavorable prognosis. Treatment with ribavirin could increase PLT count while decreasing AST/ALT-ratio within SFTS patients. Conclusion SFTS is an emerging infectious disease, possibly leading to multiple-organ injury; AST/ALT-ratio was an independent risk factor for the prognosis of SFTS patients. Further investigation should be performed in order to gain more knowledge on this disease and guide clinical management.
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Affiliation(s)
| | | | | | | | | | - Tao Li
- *Correspondence: Tao Li, ; Yuanhong Xu,
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18
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Sun J, Min YQ, Li Y, Sun X, Deng F, Wang H, Ning YJ. Animal Model of Severe Fever With Thrombocytopenia Syndrome Virus Infection. Front Microbiol 2022; 12:797189. [PMID: 35087498 PMCID: PMC8787146 DOI: 10.3389/fmicb.2021.797189] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/29/2021] [Indexed: 12/30/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), an emerging life-threatening infectious disease caused by SFTS bunyavirus (SFTSV; genus Bandavirus, family Phenuiviridae, order Bunyavirales), has been a significant medical problem. Currently, there are no licensed vaccines or specific therapeutic agents available and the viral pathogenesis remains largely unclear. Developing appropriate animal models capable of recapitulating SFTSV infection in humans is crucial for both the study of the viral pathogenic processes and the development of treatment and prevention strategies. Here, we review the current progress in animal models for SFTSV infection by summarizing susceptibility of various potential animal models to SFTSV challenge and the clinical manifestations and histopathological changes in these models. Together with exemplification of studies on SFTSV molecular mechanisms, vaccine candidates, and antiviral drugs, in which animal infection models are utilized, the strengths and limitations of the existing SFTSV animal models and some important directions for future research are also discussed. Further exploration and optimization of SFTSV animal models and the corresponding experimental methods will be undoubtedly valuable for elucidating the viral infection and pathogenesis and evaluating vaccines and antiviral therapies.
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Affiliation(s)
- Jiawen Sun
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Yuan-Qin Min
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Yunjie Li
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Xiulian Sun
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Fei Deng
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Hualin Wang
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
| | - Yun-Jia Ning
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, China
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19
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IRIE M, MIYOSHI T, HIRAMOTO A, HIRATA M, TAKANOSU M, PARK ES, MAEDA K. Diagnosis of severe fever with thrombocytopenia syndrome (SFTS) in a cat with clinical findings resembling lymphoma. J Vet Med Sci 2022; 84:675-679. [PMID: 35400672 PMCID: PMC9177391 DOI: 10.1292/jvms.21-0519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
A two-year-old male domestic cat showed lethargy, tonic-clonic convulsion, and mucosal jaundice. Upon admission, blood examination indicated severe neutropenia and thrombocytopenia, and
ultrasonography revealed diffuse splenomegaly with a honeycomb appearance and abdominal lymph nodes enlargement in addition to a decrease in cardiac blood flow indicating a shock condition.
Cytology of the spleen showed a cell population composed of immature large lymphoid cells with distinct nucleoli, suggesting lymphoma. The cat received symptomatic treatments but died four
hours later. Reverse transcriptase polymerase chain reaction assay of the spleen sample indicated the presence of severe fever with thrombocytopenia syndrome (SFTS) virus S gene segment.
Clinical features of this case that was diagnose as SFTS were similar to lymphoma. Therefore, pet owners and veterinary workers should be protected against infection of SFTS.
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Affiliation(s)
| | | | | | | | | | | | - Ken MAEDA
- National Institute of Infectious Diseases
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20
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Li S, Ye M, Chen Y, Zhang Y, Li J, Liu W, Li H, Peng K. Screening of a Small Molecule Compound Library Identifies Toosendanin as an Inhibitor Against Bunyavirus and SARS-CoV-2. Front Pharmacol 2021; 12:735223. [PMID: 34858173 PMCID: PMC8632254 DOI: 10.3389/fphar.2021.735223] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/18/2021] [Indexed: 01/04/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne virus causing serious infectious disease with a high case-fatality of up to 50% in severe cases. Currently, no effective drug has been approved for the treatment of SFTSV infection. Here, we performed a high-throughput screening of a natural extracts library for compounds with activities against SFTSV infection. Three hit compounds, notoginsenoside Ft1, punicalin, and toosendanin were identified for displaying high anti-SFTSV efficacy, in which, toosendanin showed the highest inhibition potency. Mechanistic investigation indicated that toosendanin inhibited SFTSV infection at the step of virus internalization. The anti-viral effect of toosendanin against SFTSV was further verified in mouse infection models, and the treatment with toosendanin significantly reduced viral load and histopathological changes in vivo. The antiviral activity of toosendanin was further expanded to another bunyavirus and the emerging SARS-CoV-2. This study revealed a broad anti-viral effect of toosendanin and indicated its potential to be developed as an anti-viral drug for clinical use.
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Affiliation(s)
- Shufen Li
- State Key Laboratory of Virology, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Meidi Ye
- State Key Laboratory of Virology, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Yuanqiao Chen
- State Key Laboratory of Virology, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
| | - Yulan Zhang
- State Key Laboratory of Virology, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China
| | - Jiachen Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Ke Peng
- State Key Laboratory of Virology, Center for Biosafety Mega-Science, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, China.,Savaid Medical School, University of Chinese Academy of Sciences, Beijing, China
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21
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Vectors, Hosts, and the Possible Risk Factors Associated with Severe Fever with Thrombocytopenia Syndrome. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:8518189. [PMID: 34777671 PMCID: PMC8580678 DOI: 10.1155/2021/8518189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/26/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease caused by infection with the SFTS virus (SFTSV). SFTS has become a crucial public health concern because of the heavy burden, lack of vaccines, effective therapies, and high-fatality rate. Evidence suggests that SFTSV circulates between ticks and animals in nature and is transmitted to humans by tick bites. In particular, ticks have been implicated as vectors of SFTSV, where domestic or wild animals may play as the amplifying hosts. Many studies have identified antigens and antibodies against SFTSV in various animals such as sheep, goats, cattle, and rodents. Besides, person-to-person transmission through contact with blood or mucous of an infected person has also been reported. In this study, we reviewed the literature and summarized the vectors and hosts associated with SFTS and the possible risk factors.
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22
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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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23
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Hu L, Kong Q, Liu Y, Li J, Bian T, Ma X, Ye Y, Li J. Time Course of Severe Fever With Thrombocytopenia Syndrome Virus and Antibodies in Patients by Long-Term Follow-Up Study, China. Front Microbiol 2021; 12:744037. [PMID: 34712212 PMCID: PMC8546325 DOI: 10.3389/fmicb.2021.744037] [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: 07/19/2021] [Accepted: 09/15/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The objective was to describe the changes of severe fever with thrombocytopenia syndrome virus (SFTSV) and antibody in the disease course and explore the relationship between antibody titers and patients’ prognosis. Methods: The levels of SFTSV, virus-specific immunoglobulin M (IgM), immunoglobulin G (IgG) titers, and cytokines in 37 patients with severe fever with thrombocytopenia syndrome (SFTS) were measured dynamically by real-time PCR and ELISA during the disease course; IgG titers were followed up in 53 cases. The correlation analysis of antibody titers with individual serum cytokines was calculated using the Spearman test. Results: The average time of SFTSV duration in individual serum was 22.45 ± 7.6 days from onset. We found SFTSV turned negative within the 10th day from the onset in two patients. SFTSV-specific IgM seroconversion occurred as early as within 3 days from the onset, increased gradually within the first 2 months, decreased gradually 3 months later, and disappeared after 6 months in all the patients. The average time of SFTSV-specific IgG antibody seroconversion was at 17 days from onset in the patients; the time was later in severe cases than in mild cases (23 ± 1.4 vs. 14.3 ± 1.0 days, p < 0.0001). IgG titers were maintained at the peak levels during the periods from 6 months to 1 year and decreased from the second year gradually. Severe cases had higher IgG levels than mild cases and also had a slower decreasing trend. During follow-up, only one lost IgG antibody 7 years later; no chronic infection and sequela were found among the 53 patients. None of the patients had SFTSV reinfection even if they were bitten by ticks again. The correlation analysis showed a positive relationship between inflammatory factors and IgG antibody levels. Conclusion: IgM antibody has important value in early diagnosis of SFTS. A moderate inflammatory response is beneficial for production and duration of IgG antibodies.
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Affiliation(s)
- Lifen Hu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
| | - Qinxiang Kong
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Yanyan Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
| | - Jiajia Li
- Anhui Center for Surveillance of Bacterial Resistance, Hefei, China
| | - Tingting Bian
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuejiao Ma
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Ye
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiabin Li
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, China.,Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, Hefei, China
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24
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Cunliffe AJ, Askew PD, Stephan I, Iredale G, Cosemans P, Simmons LM, Verran J, Redfern J. How Do We Determine the Efficacy of an Antibacterial Surface? A Review of Standardised Antibacterial Material Testing Methods. Antibiotics (Basel) 2021; 10:1069. [PMID: 34572650 PMCID: PMC8472414 DOI: 10.3390/antibiotics10091069] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 08/31/2021] [Accepted: 09/01/2021] [Indexed: 11/16/2022] Open
Abstract
Materials that confer antimicrobial activity, be that by innate property, leaching of biocides or design features (e.g., non-adhesive materials) continue to gain popularity to combat the increasing and varied threats from microorganisms, e.g., replacing inert surfaces in hospitals with copper. To understand how efficacious these materials are at controlling microorganisms, data is usually collected via a standardised test method. However, standardised test methods vary, and often the characteristics and methodological choices can make it difficult to infer that any perceived antimicrobial activity demonstrated in the laboratory can be confidently assumed to an end-use setting. This review provides a critical analysis of standardised methodology used in academia and industry, and demonstrates how many key methodological choices (e.g., temperature, humidity/moisture, airflow, surface topography) may impact efficacy assessment, highlighting the need to carefully consider intended antimicrobial end-use of any product.
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Affiliation(s)
- Alexander J. Cunliffe
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK;
| | - Peter D. Askew
- (Industrial Microbiological Services Ltd.) IMSL, Pale Lane, Hartley Whitney, Hants RG27 8DH, UK; (P.D.A.); (G.I.)
| | - Ina Stephan
- (Bundesanstalt für Materialforschung und -prüfung) BAM, Unter den Eichen 87, 12205 Berlin, Germany;
| | - Gillian Iredale
- (Industrial Microbiological Services Ltd.) IMSL, Pale Lane, Hartley Whitney, Hants RG27 8DH, UK; (P.D.A.); (G.I.)
| | | | - Lisa M. Simmons
- Department of Engineering, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK;
| | - Joanna Verran
- Department of Life Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK;
| | - James Redfern
- Department of Natural Sciences, Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, UK;
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25
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Wang W, Zhang A, Wu Q, Zhu L, Yang J. Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome in southern Anhui Province, 2011-2020. Jpn J Infect Dis 2021; 75:133-139. [PMID: 34470972 DOI: 10.7883/yoken.jjid.2021.391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever, and the causative pathogen, the SFTS virus (SFTSV), was first discovered in China in 2010. In this study, a retrospective analysis of 86 patients that diagnosed with SFTS from two five-year periods (2011-2015 and 2016-2020) that was performed to explore the changes in epidemiology, clinical characteristics, laboratory parameters and prognosis between those two periods. The results showed that there were significant differences in age, the proportion of farmers, geographical distribution, the incidence of multiple organ dysfunction, the decrease in thrombocyte count, and the elevations of serum AST and lipase levels between the two groups (p<0.05). Additionally, the case-fatality rate in the 2016-2020 group (16.7%) was higher than that in the 2011-2015 group (6.25%), although the difference was not significant. Our study shows that SFTS is broadly distributed across Anhui Province. The mortality rate is high. May to July was the peak of the epidemic, and farmers constituted a high-risk group. In recent years, thrombocytopenia has become more serious, and multiple organ dysfunction is more common. Clinicians need to further strengthen their knowledge of the changing epidemiological and clinical characteristics of this disease.
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Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, China
| | - Aiping Zhang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, China
| | - Qiongle Wu
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, China
| | - Lingling Zhu
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, China
| | - Jinsun Yang
- Department of Infectious Diseases, Yijishan Hospital of Wannan Medical College, China
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26
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Hu L, Kong Q, Yue C, Xu X, Xia L, Bian T, Liu Y, Zhang H, Ma X, Yin H, Sun Q, Gao Y, Ye Y, Li J. Early-Warning Immune Predictors for Invasive Pulmonary Aspergillosis in Severe Patients With Severe Fever With Thrombocytopenia Syndrome. Front Immunol 2021; 12:576640. [PMID: 34025635 PMCID: PMC8138034 DOI: 10.3389/fimmu.2021.576640] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 04/19/2021] [Indexed: 11/13/2022] Open
Abstract
Aspergillus-related disease was confirmed to be associated with immune disorders in patients, severe patients with severe fever with thrombocytopenia syndrome (SFTS) infected by novel phlebovirus were confirmed to have severe immune damage including cellular immunosuppression and cytokine storms. Secondary invasive pulmonary aspergillosis (IPA) in severe SFTS patients can increase fatality rate. This study investigated early-warning predictive factors of secondary IPA in severe SFTS patients. Receiver operating characteristic analysis was used to assess the value of immune parameters to predict IPA in SFTS patients. The cut-off values of CD4+ and CD8+ T-cell counts to predict IPA were 68 and 111 cells/mm3, with sensitivities of 82.6% and 72%, and specificities of 56.7% and 83.3%, respectively. Cut-off values of IL-6, TNF-α, IL-8, and IL-10 to predict IPA incidence in critically ill SFTS patients were 99 pg/mL, 63 pg/mL, 120 pg/mL, and 111 pg/mL, with sensitivities of 90.0%, 86.7%, 83.3% and 90.0% and specificities of 80.4%, 71.7%, 82.6% and 65.2%, respectively. Lower CD4+ and CD8+ T-cells counts, higher levels of IL-6, TNF-α, IL-8 and IL-10, higher incidence of pancreatic and renal damage, early antibacterial therapy of carbapenems, and intensive care unit admission were risk factors of IPA in SFTS patients. Multivariate logistic regression analysis indicated counts of CD4+ T-cells <68 cells/mm3 combined with CD8+ T-cells <111 cells/mm3 (odds ratio [OR] 0.218, 95% confidence interval [CI] 0.059–0.803, p=0.022), IL-6 >99 pg/ml combined with IL-10 >111 pg/ml (OR 17.614, 95% CI 2.319–133.769, p=0.006), and brain natriuretic peptide level >500 pg/ml (OR 13.681, 95% CI 1.994–93.871, p=0.008) were independent risk factors for IPA in SFTS patients. The mortality in the IPA group was significantly higher than in the non-IPA group (p=0.001). Early antifungal treatment of IPA patients was significantly associated with improved survival (log-rank, p=0.022). Early diagnosis of IPA and antifungal treatment can improve the prognosis of SFTS patients. Besides, we speculate SFTS may be as a host factor for IPA.
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Affiliation(s)
- Lifen Hu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qinxiang Kong
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Chengcheng Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xihai Xu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Lingling Xia
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Tingting Bian
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yanyan Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Hui Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Xuejiao Ma
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Huafa Yin
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Qiulin Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yufeng Gao
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Ying Ye
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Jiabin Li
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, China.,Department of Infectious Diseases, Chaohu Hospital of Anhui Medical University, Hefei, China
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27
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Li H, Jiang XM, Cui N, Yuan C, Zhang SF, Lu QB, Yang ZD, Xin QL, Song YB, Zhang XA, Liu HZ, Du J, Fan XJ, Yuan L, Yuan YM, Wang Z, Wang J, Zhang L, Zhang DN, Wang ZB, Dai K, Bai JY, Hao ZN, Fan H, Fang LQ, Xiao G, Yang Y, Peng K, Wang HQ, Li JX, Zhang LK, Liu W. Clinical effect and antiviral mechanism of T-705 in treating severe fever with thrombocytopenia syndrome. Signal Transduct Target Ther 2021; 6:145. [PMID: 33859168 PMCID: PMC8050330 DOI: 10.1038/s41392-021-00541-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 01/24/2021] [Accepted: 02/27/2021] [Indexed: 11/08/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) is an emerging tick-borne virus with high fatality and an expanding endemic. Currently, effective anti-SFTSV intervention remains unavailable. Favipiravir (T-705) was recently reported to show in vitro and in animal model antiviral efficacy against SFTSV. Here, we conducted a single-blind, randomized controlled trial to assess the efficacy and safety of T-705 in treating SFTS (Chinese Clinical Trial Registry website, number ChiCTR1900023350). From May to August 2018, laboratory-confirmed SFTS patients were recruited from a designated hospital and randomly assigned to receive oral T-705 in combination with supportive care or supportive care only. Fatal outcome occurred in 9.5% (7/74) of T-705 treated patients and 18.3% (13/71) of controls (odds ratio, 0.466, 95% CI, 0.174-1.247). Cox regression showed a significant reduction in case fatality rate (CFR) with an adjusted hazard ratio of 0.366 (95% CI, 0.142-0.944). Among the low-viral load subgroup (RT-PCR cycle threshold ≥26), T-705 treatment significantly reduced CFR from 11.5 to 1.6% (P = 0.029), while no between-arm difference was observed in the high-viral load subgroup (RT-PCR cycle threshold <26). The T-705-treated group showed shorter viral clearance, lower incidence of hemorrhagic signs, and faster recovery of laboratory abnormities compared with the controls. The in vitro and animal experiments demonstrated that the antiviral efficacies of T-705 were proportionally induced by SFTSV mutation rates, particularly from two transition mutation types. The mutation analyses on T-705-treated serum samples disclosed a partially consistent mutagenesis pattern as those of the in vitro or animal experiments in reducing the SFTSV viral loads, further supporting the anti-SFTSV effect of T-705, especially for the low-viral loads.
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Affiliation(s)
- Hao Li
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Xia-Ming Jiang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China
| | - Ning Cui
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Chun Yuan
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Shao-Fei Zhang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Qing-Bin Lu
- School of Public Health, Peking University, Beijing, P. R. China
| | - Zhen-Dong Yang
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Qin-Lin Xin
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China
| | - Ya-Bin Song
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Xiao-Ai Zhang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Hai-Zhou Liu
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China
| | - Juan Du
- School of Public Health, Peking University, Beijing, P. R. China
| | - Xue-Juan Fan
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Lan Yuan
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Yi-Mei Yuan
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Zhen Wang
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Juan Wang
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Lan Zhang
- The 154 Hospital, People's Liberation Army, Xinyang, Henan, P. R. China
| | - Dong-Na Zhang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Zhi-Bo Wang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Ke Dai
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Jie-Ying Bai
- Institute of Molecular Medicine, Peking University, Beijing, P. R. China
| | - Zhao-Nian Hao
- Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P. R. China
| | - Hang Fan
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Li-Qun Fang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Gengfu Xiao
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China
| | - Yang Yang
- Department of Biostatistics and Emerging Pathogens Institute, University of Florida, Gainesville, FL, USA
| | - Ke Peng
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China
| | - Hong-Quan Wang
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China
| | - Jian-Xiong Li
- Department of Cancer, People's Liberation Army General Hospital, Beijing, P. R. China.
| | - Lei-Ke Zhang
- State Key Laboratory of Virology, Wuhan Institute of Virology, Center for Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan, Hubei, P. R. China.
| | - Wei Liu
- Beijing Institute of Microbiology and Epidemiology, State Key Laboratory of Pathogen and Biosecurity, Beijing, P. R. China.
- Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing, P. R. China.
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28
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Sano S, Fukushi S, Yamada S, Harada S, Kinoshita H, Sugimoto S, Yoshikawa T, Kurosu T, Takamatsu Y, Shimojima M, Toda S, Hamada Y, Fujisawa N, Sugimoto T, Saijo M. Development of an RT-LAMP Assay for the Rapid Detection of SFTS Virus. Viruses 2021; 13:v13040693. [PMID: 33923720 PMCID: PMC8073756 DOI: 10.3390/v13040693] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 11/16/2022] Open
Abstract
Detection of severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) during the early phase of the disease is important for appropriate treatment, infection control, and prevention of further transmission. The reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a nucleic acid amplification method that amplifies the target sequence under isothermal conditions. Here, we developed an RT-LAMP with a novel primer/probe set targeting a conserved region of the SFTSV L segment after extraction of viral RNA (standard RT-LAMP). Both the Chinese and Japanese SFTSV strains, including various genotypes, were detected by the standard RT-LAMP. We also performed RT-LAMP using the same primer/probe set but without the viral RNA extraction step (called simplified RT-LAMP) and evaluated the diagnostic efficacy. The sensitivity and specificity of the simplified RT-LAMP were 84.9% (45/53) and 89.5% (2/19), respectively. The simplified RT-LAMP can detect SFTSV in human sera containing >103.5 copies/mL viral RNA. The two RT-LAMP positive but quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) negative samples were positive in the conventional RT-PCR, suggesting that there was no false positive reaction in the RT-LAMP. Both the standard and simplified RT-LAMP are useful for detecting the SFTSV genome in patients during the early phase of the disease.
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Affiliation(s)
- Shiori Sano
- Eiken Chemical Co., Ltd., 4-19-9 Taito, Taito-ku, Tokyo 110-8408, Japan;
| | - Shuetsu Fukushi
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
- Correspondence: ; Tel.: +81-3-5285-1111; Fax: +81-3-5285-1180
| | - Souichi Yamada
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Shizuko Harada
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Hitomi Kinoshita
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Satoko Sugimoto
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Tomoki Yoshikawa
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Takeshi Kurosu
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Yuki Takamatsu
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Masayuki Shimojima
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
| | - Shoichi Toda
- Yamaguchi Prefectural Institute of Public Health and Environment, 2-5-67 Aoi Yamaguchi, Yamaguchi 753-0821, Japan;
| | - Yuka Hamada
- Kagoshima Prefectural Institute for Environmental Research and Public Health, 11-40, Kinko-cho, Kagoshima City, Kagoshima 892-0836, Japan;
| | - Naoki Fujisawa
- Shimane Prefectural Institute of Public Health and Environmental Science, 582-1, Nishihamasada-cho, Matsue, Shimane 690-0122, Japan;
| | - Takayuki Sugimoto
- Miyazaki Prefectural Institute for Public Health and Environment, 2-3-2, Gakuenkibanadainishi, Miyazaki City, Miyazaki 889-2155, Japan;
| | - Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan; (S.Y.); (S.H.); (H.K.); (S.S.); (T.Y.); (T.K.); (Y.T.); shimoji-@nih.go.jp (M.S.); (M.S.)
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29
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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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Pathological Characteristics of a Patient with Severe Fever with Thrombocytopenia Syndrome (SFTS) Infected with SFTS Virus through a Sick Cat's Bite. Viruses 2021; 13:v13020204. [PMID: 33572914 PMCID: PMC7912689 DOI: 10.3390/v13020204] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 12/13/2022] Open
Abstract
A woman in her fifties showed symptoms of fever, loss of appetite, vomiting, and general fatigue 2 days after she was bitten by a sick cat, which had later died, in Yamaguchi prefecture, western Japan, in June 2016. She subsequently died of multiorgan failure, and an autopsy was performed to determine the cause of death. However, the etiological pathogens were not quickly identified. The pathological features of the patient were retrospectively re-examined, and the pathology of the regional lymph node at the site of the cat bite was found to show necrotizing lymphadenitis with hemophagocytosis. The pathological features were noted to be similar to those of patients reported to have severe fever with thrombocytopenia syndrome (SFTS). Therefore, the lymph node section was retrospectively tested immunohistochemically, revealing the presence of the SFTS virus (SFTSV) antigen. The sick cat showed similar symptoms and laboratory findings similar to those shown in human SFTS cases. The patient had no history of tick bites, and did not have skin lesions suggestive of these. She had not undertaken any outdoor activities. It is highly possible that the patient was infected with SFTSV through the sick cat’s bite. If a patient gets sick in an SFTS-endemic region after being bitten by a cat, SFTS should be considered in the differential diagnosis.
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31
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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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32
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Mendoza CA, Yamaoka S, Tsuda Y, Matsuno K, Weisend CM, Ebihara H. The NF-κB inhibitor, SC75741, is a novel antiviral against emerging tick-borne bandaviruses. Antiviral Res 2020; 185:104993. [PMID: 33296695 DOI: 10.1016/j.antiviral.2020.104993] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 11/12/2020] [Accepted: 12/03/2020] [Indexed: 11/28/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) and Heartland virus (HRTV) cause viral hemorrhagic fever-like illnesses in humans due to an aberrant host inflammatory response, which contributes to pathogenesis. Here, we established two separate minigenome (MG) systems based on the M-segment of SFTSV and HRTV. Following characterization of both systems for SFTSV and HRTV, we used them as a platform to screen potential compounds that inhibit viral RNA synthesis. We demonstrated that the NF-κB inhibitor, SC75741, reduces viral RNA synthesis of SFTSV and HRTV using our MG platform and validated these results using infectious SFTSV and HRTV. These results may lead to the use of MG systems as potential screening systems for the identification of antiviral compounds and yield novel insights into host-factors that could play role in bandavirus transcription and replication.
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Affiliation(s)
- Crystal A Mendoza
- Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN, 55905, USA
| | - Satoko Yamaoka
- Mayo Clinic, Department of Molecular Medicine, Rochester, MN, 55905, USA
| | - Yoshimi Tsuda
- Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, 060-8638, Japan
| | - Keita Matsuno
- Unit of Risk Analysis and Management, Hokkaido University Research Center for Zoonosis Control, Sapporo, Hokkaido, 001-0020, Japan; International Collaboration Unit, Research Center for Zoonosis Control, Hokkaido University, Sapporo, Hokkaido, 001-0020, Japan
| | - Carla M Weisend
- Mayo Clinic, Department of Molecular Medicine, Rochester, MN, 55905, USA
| | - Hideki Ebihara
- Mayo Clinic, Department of Molecular Medicine, Rochester, MN, 55905, USA.
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33
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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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Park SC, Park JY, Choi JY, Lee SG, Eo SK, Oem JK, Tark DS, You M, Yu DH, Chae JS, Kim B. Pathogenicity of severe fever with thrombocytopenia syndrome virus in mice regulated in type I interferon signaling: Severe fever with thrombocytopenia and type I interferon. Lab Anim Res 2020; 36:38. [PMID: 33102200 PMCID: PMC7579947 DOI: 10.1186/s42826-020-00070-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/11/2020] [Indexed: 12/16/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonotic disease, which causes high fever, thrombocytopenia, and death in humans and animals in East Asian countries. The pathogenicity of SFTS virus (SFTSV) remains unclear. We intraperitoneally infected three groups of mice: wild-type (WT), mice treated with blocking anti-type I interferon (IFN)-α receptor antibody (IFNAR Ab), and IFNAR knockout (IFNAR−/−) mice, with four doses of SFTSV (KH1, 5 × 105 to 5 × 102 FAID50). The WT mice survived all SFTSV infective doses. The IFNAR Ab mice died within 7 days post-infection (dpi) with all doses of SFTSV except that the mice were infected with 5 × 102 FAID50 SFTSV. The IFNAR−/− mice died after infection with all doses of SFTSV within four dpi. No SFTSV infection caused hyperthermia in any mice, whereas all the dead mice showed hypothermia and weight loss. In the WT mice, SFTSV RNA was detected in the eyes, oral swabs, urine, and feces at 5 dpi. Similar patterns were observed in the IFNAR Ab and IFNAR−/− mice after 3 dpi, but not in feces. The IFNAR Ab mice showed viral shedding until 7 dpi. The SFTSV RNA loads were higher in organs of the IFNAR−/− mice compared to the other groups. Histopathologically, coagulation necrosis and mononuclear inflammatory cell infiltration in the liver and white pulp atrophy in the spleen were seen as the main lesions in the IFN signaling lacking mice. Immunohistochemically, SFTSV antigens were mainly detected in the marginal zone of the white pulp of the spleen in all groups of mice, but more viral antigens were observed in the spleen of the IFNAR−/− mice. Collectively, the IFN signaling-deficient mice were highly susceptible to SFTSV and more viral burden could be demonstrated in various excreta and organs of the mice when IFN signaling was inhibited.
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Affiliation(s)
- Seok-Chan Park
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea
| | - Jun Young Park
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea.,Korea Zoonosis Research Institute, Jeonbuk National University, Iksan, 54531 Republic of Korea
| | - Jin Young Choi
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea
| | - Sung-Geun Lee
- Korea Zoonosis Research Institute, Jeonbuk National University, Iksan, 54531 Republic of Korea
| | - Seong Kug Eo
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea.,Korea Zoonosis Research Institute, Jeonbuk National University, Iksan, 54531 Republic of Korea
| | - Jae-Ku Oem
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea
| | - Dong-Seob Tark
- Korea Zoonosis Research Institute, Jeonbuk National University, Iksan, 54531 Republic of Korea
| | - Myungjo You
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea
| | - Do-Hyeon Yu
- College of Veterinary Medicine, Gyeongsang National University, Jinju, 52828 Republic of Korea
| | - Joon-Seok Chae
- Laboratory of Veterinary Internal Medicine, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 Republic of Korea
| | - Bumseok Kim
- College of Veterinary Medicine, Jeonbuk National University, Iksan, 54596 Republic of Korea.,Korea Zoonosis Research Institute, Jeonbuk National University, Iksan, 54531 Republic of Korea
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35
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Kang JG, Cho YK, Han SW, Jeon K, Choi H, Kim JH, Cho NH, Choi KS, Chae JS. Molecular and Serological Investigation of Severe Fever with Thrombocytopenia Syndrome Virus in Cats. Vector Borne Zoonotic Dis 2020; 20:916-920. [PMID: 32831006 DOI: 10.1089/vbz.2020.2649] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis in China, the Republic of Korea (ROK), and Japan. The presence of the SFTS virus (SFTSV) in companion, livestock, and wild animals has been reported. Recently, human SFTS-like clinical symptoms in cats and cheetahs have been reported in Japan. Therefore, the prevalence of the SFTSV gene or antibody in cats is important for public health as well as veterinary medicine. Materials and Methods: Sera were collected from 201 feral and house cats in the ROK in 2017. Samples were analyzed for the presence of the SFTSV gene after RT-nested PCR amplification and for anti-SFTSV antibodies after enzyme linked immunosorbent assay. Results: Eight (4.0%) and nine (4.5%) of 201 cat sera were found to be positive for the SFTSV gene and anti-SFTSV nucleocapsid protein antibodies, respectively. Specifically, 5.9% feral and 2.0% house cats were positive for the SFTSV gene, and 6.9% feral and 2.0% house cats were positive for anti-SFTSV antibodies. All sequences of the SFTSV S segment obtained were included in Japanese/Korean SFTSV clades, as opposed to the Chinese clade. Conclusions: This study constitutes the first serological study of SFTSV in house and feral cats in the ROK. Evidence of SFTSV in companion animals indicates that SFTSV can circulate in homes and that more intensive precautions and education measures are needed for companion animal guardians and veterinarians.
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Affiliation(s)
- Jun-Gu Kang
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
- Institute of Endemic Diseases, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Yoon-Kyung Cho
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Sun-Woo Han
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
| | - Kyeongseok Jeon
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hooncheol Choi
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jong-Ho Kim
- 24 Hours Smart Animal Medical Center, Seoul, Republic of Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kyoung-Seong Choi
- Department of Animal Science and Biotechnology, College of Ecology and Environmental Science, Kyungpook National University, Sangju, Republic of Korea
| | - Joon-Seok Chae
- Laboratory of Veterinary Internal Medicine, BK21 Plus Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, Republic of Korea
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36
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He Z, Wang B, Li Y, Du Y, Ma H, Li X, Guo W, Xu B, Huang X. Severe fever with thrombocytopenia syndrome: a systematic review and meta-analysis of epidemiology, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. BMC Infect Dis 2020; 20:575. [PMID: 32758175 PMCID: PMC7409422 DOI: 10.1186/s12879-020-05303-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 07/27/2020] [Indexed: 12/29/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with the high case-fatality rate, and lack of vaccines. We aimed to systematically analysed the epidemiological characteristics, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. Methods Documents on SFTS were collected by searching the Chinese National Knowledge Infrastructure, Wan Fang Data, PubMed, Embase, and Web of Science databases from 2011 to 2018. Meta-analysis was performed by using Review Manager and Stata software. Results Twenty-five articles involving 4143 cases were included. Diarrhea (odds ratio (OR) =1.60, 95% confidence interval (CI): 1.06 to 2.42, P = 0.02), and vomiting (OR = 1.56, 95% CI: 1.01 to 2.39, P = 0.04) on admission were associated with the fatal outcomes of SFTS. Compared to patients with mild symptoms, patients with severe symptoms had significantly elevated levels of lactic acid dehydrogenase (standard mean difference (SMD) =1.27, 95% CI: 0.59 to 1.94), alanine aminotransferase (SMD = 0.55, 95% CI: 0.24 to 0.85), aspirate aminotransferase (SMD = 1.01, 95% CI: 0.69 to 1.32), and creatine kinase (SMD = 1.04, 95% CI: 0.74 to 1.33) but had reduced platelet counts (SMD = -0.87, 95% CI: − 1.16 to − 0.58) and albumin levels (SMD = -1.00, 95% CI: − 1.32 to − 0.68). The risk factors for poor prognosis included age (mean difference (MD) =6.88, 95% CI: 5.41 to 8.35) and farming (OR = 2.01, 95% CI: 1.06 to 3.80). For the risk factors of contracting SFTS, the incidence of SFTS related to tick bites was 24% [95% CI: 0.18 to 0.31]. The pooled case-fatality rate of SFTS patients was 18% [95% CI: 0.16 to 0.21]. Conclusions China is the country with the highest incidence of SFTS. May to July was the peak of the epidemic, and farmers were a high-risk group. The risk factor for SFTS included age (poor prognosis) and tick bites (contracting SFTS). Patients with severe diarrhea and vomiting symptoms on admission should be noted. Clinicians could use routine laboratory parameters and clinical symptoms as references for clinically suspected cases, classification of SFTS, and timely treatment, especially in basic hospitals.
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Affiliation(s)
- Zhiquan He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bohao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Yanhua Du
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Hongxia Ma
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Xingle Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Wanshen Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bianli Xu
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xueyong Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China. .,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China.
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Chen R, Kou ZQ, Wang XR, Li SH, Zhang HL, Liu ZW, Cheng D, Wang ZY, Yu XJ, Wen HL. Severe fever with thrombocytopenia syndrome virus infection during pregnancy in C57/BL6 mice causes fetal damage. PLoS Negl Trop Dis 2020; 14:e0008453. [PMID: 32730341 PMCID: PMC7392217 DOI: 10.1371/journal.pntd.0008453] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 06/04/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel tick-borne phlebovirus, which is listed in the most dangerous pathogens by the World Health Organization, and has 12-30% fatality rates. SFTSV antibodies were reported in minks that experienced abortion or reproductive failure. The aim of this study was to determine whether SFTSV infection causes an adverse pregnancy outcome in the fetus using a pregnant mouse model. METHODOLOGY/PRINCIPAL FINDINGS We found SFTSV in the fetus after infection in pregnant mice, and some dams showed adverse pregnancy outcomes after infection with SFTSV including placental damage, fetal reabsorption, and fetal intrauterine growth restriction (IUGR). SFTSV had obvious tropism characteristics in the placenta, especially in the labyrinth. In early-gestation, pregnant mice infected with SFTSV had fetal IUGR and a high viral load in the fetus. The virus widely spread in infected fetuses, including the hindbrain, thymus, heart, spinal cord, and liver. CONCLUSIONS Our study demonstrated that SFTSV was vertically transmitted to the fetus through the placental barrier of immunocompetent mice, and resulted in adverse pregnancy outcomes.
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Affiliation(s)
- Rui Chen
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Zeng-qiang Kou
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Xiao-rui Wang
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Shu-han Li
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Hai-lu Zhang
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Zi-wei Liu
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Dong Cheng
- Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
| | - Zhi-yu Wang
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
| | - Xue-Jie Yu
- Wuhan University School of Health Sciences, Wuhan, China
| | - Hong-ling Wen
- Department of Microbiological Laboratory Technology, 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, Shandong Province, China
- * E-mail:
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38
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Vaccination with single plasmid DNA encoding IL-12 and antigens of severe fever with thrombocytopenia syndrome virus elicits complete protection in IFNAR knockout mice. PLoS Negl Trop Dis 2020; 14:e0007813. [PMID: 32196487 PMCID: PMC7112229 DOI: 10.1371/journal.pntd.0007813] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 04/01/2020] [Accepted: 02/07/2020] [Indexed: 02/01/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease caused by SFTS virus (SFTSV) infection. Despite a gradual increase of SFTS cases and high mortality in endemic regions, no specific viral therapy nor vaccine is available. Here, we developed a single recombinant plasmid DNA encoding SFTSV genes, Gn and Gc together with NP-NS fusion antigen, as a vaccine candidate. The viral antigens were fused with Fms-like tyrosine kinase-3 ligand (Flt3L) and IL-12 gene was incorporated into the plasmid to enhance cell-mediated immunity. Vaccination with the DNA provides complete protection of IFNAR KO mice upon lethal SFTSV challenge, whereas immunization with a plasmid without IL-12 gene resulted in partial protection. Since we failed to detect antibodies against surface glycoproteins, Gn and Gc, in the immunized mice, antigen-specific cellular immunity, as confirmed by enhanced antigen-specific T cell responses, might play major role in protection. Finally, we evaluated the degree of protective immunity provided by protein immunization of the individual glycoprotein, Gn or Gc. Although both protein antigens induced a significant level of neutralizing activity against SFTSV, Gn vaccination resulted in relatively higher neutralizing activity and better protection than Gc vaccination. However, both antigens failed to provide complete protection. Given that DNA vaccines have failed to induce sufficient immunogenicity in human trials when compared to protein vaccines, optimal combinations of DNA and protein elements, proper selection of target antigens, and incorporation of efficient adjuvant, need to be further investigated for SFTSV vaccine development. Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infection endemic to East Asia including China, Korea, and Japan. Gradual rise of disease incidence and relatively high mortality have become a serious public health problem in the endemic countries. In this study, we developed a recombinant plasmid DNA encoding four antigens, Gn, Gc, NP, and NS, of SFTS virus (SFTSV) as a vaccine candidate. In order to enhance cell-mediated immunity, the viral antigens were fused with Flt3L and IL-12 gene was incorporated into the plasmid. Immunization with the DNA vaccine provides complete protection against lethal SFTSV infection in IFNAR KO mice. Antigen-specific T cell responses might play a major role in the protection since we observed enhanced T cell responses specific to the viral antigens but failed to detect neutralizing antibody in the immunized mice. When we immunized with either viral glycoprotein, Gn protein induced relatively higher neutralizing activity and better protection against SFTSV infection than Gc antigen, but neither generated complete protection. Therefore, an optimal combination of DNA and protein elements, as well as proper selection of target antigens, might be required to produce an effective SFTSV vaccine.
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39
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Immune Modulation and Immune-Mediated Pathogenesis of Emerging Tickborne Banyangviruses. Vaccines (Basel) 2019; 7:vaccines7040125. [PMID: 31547199 PMCID: PMC6963857 DOI: 10.3390/vaccines7040125] [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: 08/31/2019] [Revised: 09/17/2019] [Accepted: 09/18/2019] [Indexed: 12/21/2022] Open
Abstract
In the last decade, the emergence of several, novel tickborne viruses have caused significant disease in humans. Of interest are the tickborne banyangviruses: Severe fever with thrombocytopenia syndrome virus (SFTSV), Heartland virus (HRTV), and Guertu virus (GTV). SFTSV and HRTV infection in humans cause viral hemorrhagic fever-like disease leading to mortality rates ranging from 6–30% of the cases. The systemic inflammatory response syndrome (SIRS) associated with SFTSV infection is hypothesized to contribute significantly to pathology seen in patients. Despite the severe disease caused by HRTV and SFTSV, there are no approved therapeutics or vaccines. Investigation of the immune response during and following infection is critical to the generation of fully protective vaccines and/or supportive treatments, and overall understanding of viral immune evasion mechanisms may aid in the development of a new class of therapeutics.
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40
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Natural severe fever with thrombocytopenia syndrome virus infection in domestic cats in Japan. Vet Microbiol 2019; 236:108346. [PMID: 31500732 DOI: 10.1016/j.vetmic.2019.06.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/25/2019] [Accepted: 06/30/2019] [Indexed: 12/25/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a recently discovered emerging infectious disease. A zoonotic disease with a high fatality rate in human beings, clinical information on SFTS virus (SFTSV) infection in animals is important. Since 2017, we have diagnosed 24 client-owned cats living in western Japan with SFTS, by genetic and serological testing. In this study, we characterized the clinical features of SFTS in cats and their associated risk factors, by evaluating the clinical parameters retrospectively. A phylogenetic analysis on SFTSV was also conducted. There were no obvious tendencies in age or sex, outdoor cats were commonly at risk of SFTSV infection. All infected cats showed acute onset of clinical signs including anorexia and lethargy, while 68.2% of the cats showed fever and 41.7% showed vomiting. The case fatality rate was 62.5%. Thrombocytopenia, leukopenia, and elevated serum total bilirubin, serum amyloid A, and creatinine phosphokinase concentration were the characteristic findings in the first clinical blood examination. Phylogenic analysis revealed that regional clustered viruses infect both humans and cats. For pet owners and animal hospitals, SFTS in small animals could be an important public health issue.
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41
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Vandegrift KJ, Kapoor A. The Ecology of New Constituents of the Tick Virome and Their Relevance to Public Health. Viruses 2019; 11:v11060529. [PMID: 31181599 PMCID: PMC6630940 DOI: 10.3390/v11060529] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Revised: 05/07/2019] [Accepted: 05/29/2019] [Indexed: 01/19/2023] Open
Abstract
Ticks are vectors of several pathogens that can be transmitted to humans and their geographic ranges are expanding. The exposure of ticks to new hosts in a rapidly changing environment is likely to further increase the prevalence and diversity of tick-borne diseases. Although ticks are known to transmit bacteria and viruses, most studies of tick-borne disease have focused upon Lyme disease, which is caused by infection with Borrelia burgdorferi. Until recently, ticks were considered as the vectors of a few viruses that can infect humans and animals, such as Powassan, Tick-Borne Encephalitis and Crimean–Congo hemorrhagic fever viruses. Interestingly, however, several new studies undertaken to reveal the etiology of unknown human febrile illnesses, or to describe the virome of ticks collected in different countries, have uncovered a plethora of novel viruses in ticks. Here, we compared the virome compositions of ticks from different countries and our analysis indicates that the global tick virome is dominated by RNA viruses. Comparative phylogenetic analyses of tick viruses from these different countries reveals distinct geographical clustering of the new tick viruses. Some of these new tick RNA viruses (notably severe fever with thrombocytopenia syndrome virus and Heartland virus) were found to be associated with serious human diseases. Their relevance to public health remains unknown. It is plausible that most of these newly identified tick viruses are of endogenous origin or are restricted in their transmission potential, but the efforts to identify new tick viruses should continue. Indeed, future research aimed at defining the origin, the ecology and the spillover potential of this novel viral biodiversity will be critical to understand the relevance to public health.
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Affiliation(s)
- Kurt J Vandegrift
- The Center for Infectious Disease Dynamics, Department of Biology, The Pennsylvania State University, University Park, PA 16802, USA.
| | - Amit Kapoor
- Center for Vaccines and Immunity, Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA.
- Department of Pediatrics, Ohio State University, Columbus, OH 43205, USA.
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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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