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Sun Y, Guo B, Yan H, Wu AL, Yao WW, Chen K, Pan JH, Li ZX, Mao HY, Zhang YJ. Patient with severe fever with thrombocytopenia syndrome virus infection and central nervous system disturbance in Dongyang, Zhejiang Province, China, 2017. Virol J 2019; 16:129. [PMID: 31699105 PMCID: PMC6836506 DOI: 10.1186/s12985-019-1230-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 10/01/2019] [Indexed: 11/29/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever that was first described in China in 2011. We report a patient who died of Severe fever with thrombocytopenia syndrome virus (SFTSV) infection, with a rapidly progressive central nervous system (CNS) disturbance, in Dongyang, Zhejiang Province, China, in 2017. Case presentation A 64-year-old man was admitted to hospital after 4 days of fever. SFTSV was detected 1 day after the patient was admitted to hospital. The patient presented with CNS disturbance and died 4 days after admission. Detailed clinical and epidemiological investigations and laboratory tests were conducted. Reduced platelet, white blood cell, lymphocyte, and neutrophil counts, elevated lactate dehydrogenase, creatine kinase, aspartate aminotransferaseand alanine aminotransferase concentrations, and an increased activated partial thromboplastin time were observed. In a phylogenetic analysis, the isolate clustered close to a strain derived from South Korea. Conclusions: This is the first case of SFTSV infection with CNS disturbance in Dongyang, Zhejiang Province, China. The surveillance of suspected cases of SFTS is important in SFTSV endemic regions.
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Affiliation(s)
- Yi Sun
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China
| | - Bin Guo
- Dongyang Center for Disease Control and Prevention, Dongyang, Zhejiang, China
| | - Hao Yan
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China
| | - Ai Lan Wu
- Dongyang Center for Disease Control and Prevention, Dongyang, Zhejiang, China
| | - Wen Wu Yao
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China
| | - Kang Chen
- Dongyang Center for Disease Control and Prevention, Dongyang, Zhejiang, China
| | - Jun Hang Pan
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China
| | - Zhao Xia Li
- Dongyang People's Hospital, Dongyang, Zhejiang, China
| | - Hai Yan Mao
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China
| | - Yan Jun Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, 3399 Binsheng Road, Hangzhou, 310051, Zhejiang, China.
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Zhang L, Sun J, Yan J, Lv H, Chai C, Sun Y, Shao B, Jiang J, Chen Z, Kortekaas J, Zhang Y. Antibodies against severe fever with thrombocytopenia syndrome virus in healthy persons, China, 2013. Emerg Infect Dis 2016; 20:1355-7. [PMID: 25061813 PMCID: PMC4111193 DOI: 10.3201/eid2008.131796] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In June 2013, a subclinical infection with severe fever with thrombocytopenia syndrome virus (SFTSV) was detected in Zhejiang Province, China, prompting seroprevalence studies in 6 districts within the province. Of 986 healthy persons tested, 71 had IgG antibodies against SFTSV. This finding suggests that most natural infections with SFTSV are mild or subclinical.
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Ma T, Sun JM, Chen LF, Shi XG, Liu K, Gong ZY, Chen J, Zhang R, Ren JP, Jiang JM. A pediatric case of severe fever with thrombocytopenia syndrome in Zhejiang Province, China. J Clin Virol 2015; 72:85-7. [PMID: 26469738 DOI: 10.1016/j.jcv.2015.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 08/31/2015] [Accepted: 09/16/2015] [Indexed: 10/22/2022]
Abstract
This report describes a pediatric case of severe fever with thrombocytopenia syndrome (SFTS), which is an emerging disease that is caused by a novel bunyavirus. Interestingly, the previously reported SFTS cases typically involved elderly patients, while our case involved a 5-year-old child from Zhejiang Province, China. In this report, we describe our investigation of the clinical and epidemiological characteristics of this case, to improve our understanding of this emerging disease. Our principle finding was that the present case's clinical symptoms were milder than those that have been reported in adult cases of SFTS. Therefore, we recommend more careful screening of pediatric patients who present with mild symptoms that are consistent with SFTS.
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Affiliation(s)
- T Ma
- Medical School of Ningbo University, Ningbo 315211, Zhejiang Province, China; Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - J M Sun
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - L F Chen
- Yuyao Centre for Disease Control and Prevention, Yuyao 315400, China
| | - X G Shi
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - K Liu
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - Z Y Gong
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - J Chen
- Yuyao Centre for Disease Control and Prevention, Yuyao 315400, China
| | - R Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - J P Ren
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China
| | - J M Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou 310051, China.
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Gong Z, Gu S, Zhang Y, Sun J, Wu X, Ling F, Shi W, Zhang P, Li D, Mao H, Zhang L, Wen D, Zhou B, Zhang H, Huang Y, Zhang R, Jiang J, Lin J, Xia S, Chen E, Chen Z. Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China. Clin Microbiol Infect 2015; 21:1115-20. [PMID: 26255811 DOI: 10.1016/j.cmi.2015.07.024] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 07/27/2015] [Accepted: 07/28/2015] [Indexed: 11/20/2022]
Abstract
Some clusters of severe fever with thrombocytopenia syndrome virus (SFTSV) infection were reported in China as of 2010. However, to date, there has been no epidemiologic evidence of aerosol transmission of SFTSV. Epidemiologic investigations were conducted after a cluster of 13 cases of SFTSV in May 2014. A total of 13 cases, including 11 confirmed cases and one clinically diagnosed case, were identified besides the case of the index patient. The index patient experienced onset of SFTSV on 23 April and died on 1 May. The patients with secondary cases had onset from 10 to 16 May, peaking on 13 May. Moreover, eight secondary cases occurred in family members of the index patient, and the other five cases occurred in neighbors of the index patient. According to epidemiologic investigations, patients 1, 3, 4, 5, 6, 7, 9 and 12 contracted the disease through contact with blood of the index patient. Notably, patients 8 and 10 did not have a history of contact with the blood of the index patient, but they stayed in the mourning hall for hours. SFTSV could be transmitted from person to person by direct contact and/or aerosol transmission, and it is important to consider aerosol transmission as a possible transmission route.
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Affiliation(s)
- Z Gong
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - S Gu
- Anji Centre for Disease Control and Prevention, Anji, China
| | - Y Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - J Sun
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - X Wu
- Anji Centre for Disease Control and Prevention, Anji, China
| | - F Ling
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - W Shi
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - P Zhang
- Huzhou Municipal Centre for Disease Control and Prevention, Huzhou, China
| | - D Li
- National Institute for Viral Disease Control and Prevention, Beijing, China
| | - H Mao
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - L Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - D Wen
- Huzhou Municipal Centre for Disease Control and Prevention, Huzhou, China
| | - B Zhou
- Anji Centre for Disease Control and Prevention, Anji, China
| | - H Zhang
- Anji Centre for Disease Control and Prevention, Anji, China
| | - Y Huang
- Anji Centre for Disease Control and Prevention, Anji, China
| | - R Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - J Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - J Lin
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China
| | - S Xia
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - E Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
| | - Z Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, China.
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Genetic Susceptibility Is One of the Determinants for Severe Fever with Thrombocytopenia Syndrome Virus Infection and Fatal Outcome: An Epidemiological Investigation. PLoS One 2015. [PMID: 26207638 PMCID: PMC4514768 DOI: 10.1371/journal.pone.0132968] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease in China and case-fatality rate of SFTS is very high (approximately 10%). However, genetic susceptibility for SFTS virus (SFTSV) infection and fatal outcome of SFTSV infection in humans are unclear. In this study, we investigated the clinical, laboratory and epidemiological features of SFTS in a cluster of three sisters who died of SFTSV infection between late April and mid-May 2014. Before disease onset, two of the sisters (Case A and case B) had common exposure history for ticks by working together in a field to pick tea leaves from April 8 to April 12. The third sister (Case C) did not live or work together with case A and B, but had ticks in her living environment. SFTSV RNA sequences were amplified from three cases were not identical, suggesting that the three sisters were most likely infected with SFTSV through tick bite rather than through person-to-person transmission of SFTSV. The sequence of SFTSV from case C was identical to SFTSV sequences from 3 groups of ticks collected around the residential area of case C. Seroprevalence of SFTSV IgG antibody among healthy population in the area where the patients resided was 4.05% (3/74). The majority of SFTSV infections were mild cases and all three sisters died of SFTSV infection suggested that they were highly susceptible to SFTSV. Our findings indicated that genetic susceptibility was a risk factor for SFTSV infection and fatal outcome.
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Yoshikawa T, Shimojima M, Fukushi S, Tani H, Fukuma A, Taniguchi S, Singh H, Suda Y, Shirabe K, Toda S, Shimazu Y, Nomachi T, Gokuden M, Morimitsu T, Ando K, Yoshikawa A, Kan M, Uramoto M, Osako H, Kida K, Takimoto H, Kitamoto H, Terasoma F, Honda A, Maeda K, Takahashi T, Yamagishi T, Oishi K, Morikawa S, Saijo M. Phylogenetic and Geographic Relationships of Severe Fever With Thrombocytopenia Syndrome Virus in China, South Korea, and Japan. J Infect Dis 2015; 212:889-98. [PMID: 25762790 DOI: 10.1093/infdis/jiv144] [Citation(s) in RCA: 105] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 02/19/2015] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne acute infectious disease caused by the SFTS virus (SFTSV). SFTS has been reported in China, South Korea, and Japan as a novel Bunyavirus. Although several molecular epidemiology and phylogenetic studies have been performed, the information obtained was limited, because the analyses included no or only a small number of SFTSV strains from Japan. METHODS The nucleotide sequences of 75 SFTSV samples in Japan were newly determined directly from the patients' serum samples. In addition, the sequences of 7 strains isolated in vitro were determined and compared with those in the patients' serum samples. More than 90 strains that were identified in China, 1 strain in South Korea, and 50 strains in Japan were phylogenetically analyzed. RESULTS The viruses were clustered into 2 clades, which were consistent with the geographic distribution. Three strains identified in Japan were clustered in the Chinese clade, and 4 strains identified in China and 26 in South Korea were clustered in the Japanese clade. CONCLUSIONS Two clades of SFTSV may have evolved separately over time. On rare occasions, the viruses were transmitted overseas to the region in which viruses of the other clade were prevalent.
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Affiliation(s)
- Tomoki Yoshikawa
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Masayuki Shimojima
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Shuetsu Fukushi
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Hideki Tani
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Aiko Fukuma
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Satoshi Taniguchi
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Harpal Singh
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Yuto Suda
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
| | - Komei Shirabe
- Yamaguchi Prefectural Institute of Public Health and Environment
| | - Shoichi Toda
- Yamaguchi Prefectural Institute of Public Health and Environment
| | - Yukie Shimazu
- Hiroshima Prefectural Technology Research Institute, Public Health and Environment Center
| | - Taro Nomachi
- Miyazaki Prefectural Institute for Public Health and Environment
| | - Mutsuyo Gokuden
- Kagoshima Prefectural Institute for Environmental Research and Public Health
| | | | - Katsuyuki Ando
- Saga Prefectural Institute of Public Health and Pharmaceutical Research
| | - Akira Yoshikawa
- Nagasaki Prefectural Institute for Environmental Research and Public Health, Omura-shi
| | - Miki Kan
- Ehime Prefectural Institute of Public Health and Environmental Science, Matsuyama-shi
| | - Marina Uramoto
- Tokushima Prefectural Public Health, Pharmaceutical and Environmental Sciences Centre
| | - Hideo Osako
- Kumamoto Prefectural Institute of Public Health and Environmental Science, Uto-shi
| | - Kouji Kida
- Okayama Prefectural Institute for Public Health and Environmental Science
| | - Hirokazu Takimoto
- Shimane Prefectural Institute of Public Health and Environmental Science, Matsue-shi
| | - Hiroaki Kitamoto
- Public Health Science Research Center, Hyogo Prefectural Institute of Public Health and Consumer Sciences, Hyogo-ku Kobe-shi
| | - Fumio Terasoma
- Wakayama Prefectural Research Center of Environment and Public Health
| | - Akiko Honda
- Oita Prefectural Institute of Health and Environment
| | - Ken Maeda
- Laboratory of Veterinary Microbiology, Joint Faculty of Veterinary Medicine, Yamaguchi University
| | - Toru Takahashi
- Department of Hematology, Yamaguchi Grand Medical Center, Hofu-shi
| | - Takuya Yamagishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Tokyo, Japan
| | - Masayuki Saijo
- Special Pathogens Laboratory, Department of Virology I, National Institute of Infectious Diseases
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Zhang L, Ye L, Ojcius DM, Lou X, Wang C, feng C, Sun Y, Wang Z, Li S, Zhang Y. Characterization of severe fever with thrombocytopenia syndrome in rural regions of Zhejiang, China. PLoS One 2014; 9:e111127. [PMID: 25356556 PMCID: PMC4214719 DOI: 10.1371/journal.pone.0111127] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 09/18/2014] [Indexed: 11/18/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) infections have recently been found in rural regions of Zhejiang. A severe fever with thrombocytopenia syndrome (SFTS) surveillance and sero-epidemiological investigation was conducted in the districts with outbreaks. During the study period of 2011–2014, a total of 51 SFTSV infection cases were identified and the case fatality rate was 12% (6/51). Ninety two percent of the patients (47/51) were over 50 years of age, and 63% (32/51) of laboratory confirmed cases occurred from May to July. Nine percent (11/120) of the serum samples from local healthy people without symptoms were found to be positive for antibodies to the SFTS virus. SFTSV strains were isolated by culture using Vero, and the whole genomic sequences of two SFTSV strains (01 and Zhao) were sequenced and submitted to the GenBank. Homology analysis showed that the similarity of the target nucleocapsid gene from the SFTSV strains from different geographic areas was 94.2–100%. From the constructed phylogenetic tree, it was found that all the SFTSV strains diverged into two main clusters. Only the SFTSV strains from the Zhejiang (Daishan) region of China and the Yamaguchi, Miyazakj regions of Japan, were clustered into lineage II, consistent with both of these regions being isolated areas with similar geographic features. Two out of eight predicted linear B cell epitopes from the nucleocapsid protein showed mutations between the SFTSV strains of different clusters, but did not contribute to the binding ability of the specific SFTSV antibodies. This study confirmed that SFTSV has been circulating naturally and can cause a seasonal prevalence in Daishan, China. The results also suggest that the molecular characteristics of SFTSV are associated with the geographic region and all SFTSV strains can be divided into two genotypes.
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Affiliation(s)
- Lei Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
- Department of Civil and Environmental Engineering, University of Alberta, Edmonton, AB, Canada
| | - Ling Ye
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - David M. Ojcius
- Health Sciences Research Institute and School of Natural Sciences, University of California Merced, Merced, California, United States of America
| | - Xiuyu Lou
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Chengwei Wang
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - Cen feng
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Yi Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
| | - Zhongfa Wang
- Center for Disease Control and Prevention of Daishan, Zhoushan, Zhejiang, P.R. China
| | - Shibo Li
- Zhoushan Hospital, Zhoushan, Zhejiang, P.R. China
| | - Yanjun Zhang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, P.R. China
- * E-mail:
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Discrimination of novel bunyavirus infection using routine laboratory test. Clin Microbiol Infect 2014; 21:204.e1-7. [PMID: 25658566 DOI: 10.1016/j.cmi.2014.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 05/25/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
Abstract
The wide epidemic and high case fatality rate have made severe fever with thrombocytopenia syndrome (SFTS) a significant public health problem. The diagnosis and discrimination of SFTS virus (SFTSV) infection at an early stage of the disease is important for treatment choice. A prospective study was performed in an SFTS reference hospital during 2011-2013. Suspected SFTS patients were recruited and prospectively observed. Comparison between SFTSV-positive and -negative patients was made to identify the parameters that were related to positive detection by discriminant and classification tree analysis. A total of 538 SFTSV-positive and 396 negative patients were recruited and observed. Multiple logistic regression models demonstrated the significant parameters associated with positive detection, including decreased platelet counts and elevated aspartate aminotransferase (AST) level during the first stage (1∼4 days), decreased white blood cell and platelet counts, elevated creatine kinase (CK) and AST levels during the second stage (5∼7 days), and older age, decreased consciousness and elevated CK and AST during the third stage (8-11 days). The classification trees disclosed that the significant predictors for positive SFTSV detection were AST >50.6 U/L and AST/alanine transaminase (ALT) >1.3 at the first stage, CK >257 U/L or 57.7 U/L < CK ≤98.5 U/L with AST/ALT >1.6 at the second stage, as well as CK >630.7 U/L or 114.3 U/L < CK ≤630.7 U/L with decreased consciousness at the third stage. In making the clinically probable diagnosis of SFTS, the supplementation of AST and CK evaluations might remarkably improve the diagnostic capacity of routine laboratory tests, while the leukopenia is of limited use.
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Ecological niche modeling for predicting the potential risk areas of severe fever with thrombocytopenia syndrome. Int J Infect Dis 2014; 26:1-8. [PMID: 24981427 DOI: 10.1016/j.ijid.2014.04.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Revised: 03/17/2014] [Accepted: 04/09/2014] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus. The spatial distribution has continued to expand, while the areas at potential high risk of SFTS have, to date, remained unclear. METHODS Using ecological factors as predictors, the MaxEnt model was first trained based on the locations of human SFTS occurrence in Shandong Province. The risk prediction map of China was then created by projecting the training model onto the whole country. The performance of the model was assessed using the known locations of disease occurrence in China. RESULTS The key environmental factors affecting SFTS occurrence were temperature, precipitation, land cover, normalized difference vegetation index (NDVI), and duration of sunshine. The risk prediction maps suggested that central, southwestern, northeastern, and the eastern coast of China are potential areas at high risk of SFTS. CONCLUSIONS The potential high risk SFTS areas are distributed widely in China. The epidemiological surveillance system should be enhanced in these high risk regions.
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Sun J, Chai C, Lv H, Lin J, Wang C, Chen E, Zhang Y, Chen Z, Liu S, Gong Z, Jiang J. Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Zhejiang Province, China. Int J Infect Dis 2014; 25:180-5. [PMID: 24947422 DOI: 10.1016/j.ijid.2014.02.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 02/25/2014] [Accepted: 02/25/2014] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVES To summarize the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Zhejiang Province, China. METHODS A standardized questionnaire was used to collect information on demographic features, exposure history, clinical symptoms, and timelines of medical visits. Descriptive statistics were used to analyze the characteristics of SFTS. RESULTS A total of 65 cases of SFTS were identified in Zhejiang Province from 2011 to 2013, of whom 34 were male and 31 were female. The median age was 66 years and 60 cases occurred in persons aged ≥ 50 years. The majority (91%) of SFTS cases occurred between May and August. With regard to exposure history, patients had pursued outdoor activities (63%), had a history of exposure to a tick (68%) or tick bite (29%), bred domestic animals (31%), or had a history of exposure to a mouse (57%), and some patients had a multi-exposure history. Approximately 98.46% of patients were hospitalized, and symptoms of the illness included fever (98%), fatigue (71%), chills (51%), etc. Two family clusters occurred, although there was no person-to-person transmission. CONCLUSIONS In Zhejiang Province, SFTS is prevalent between May and August among elderly persons who live in hilly areas, and clinical features are not specific. More emphasis should be given to this disease and further training of medical personnel should be carried out to prevent misdiagnosis.
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Affiliation(s)
- Jimin Sun
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Chengliang Chai
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Huakun Lv
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Junfen Lin
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Chengwei Wang
- Daishan Centre for Disease Control and Prevention, Daishan, China
| | - Enfu Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Yanjun Zhang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhiping Chen
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Shelan Liu
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China
| | - Zhenyu Gong
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China.
| | - Jianmin Jiang
- Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, 310051, China.
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11
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Seroprevalence of severe fever with thrombocytopenia syndrome virus in southeastern China and analysis of risk factors. Epidemiol Infect 2014; 143:851-6. [PMID: 24866248 PMCID: PMC4411641 DOI: 10.1017/s0950268814001319] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) has been prevalent for some time in China and it was first identified in 2010. However, the seroprevalence of SFTSV in the general population in southeastern China and risk factors associated with the infection are currently unclear. Blood samples were collected from seven counties across Zhejiang province and tested for the presence of SFTSV-specific IgG antibodies by ELISA. A total of 1380 blood samples were collected of which 5·51% were seropositive for SFTSV with seroprevalence varying significantly between sites. Seroprevalence of SFTSV in people who were family members of the patient, lived in the same village as the patient, or lived in a different village than the patient varied significantly. There was significant difference in seroprevalence between participants who bred domestic animals and participants who did not. Domestic animals are probably potential reservoir hosts and contact with domestic animals may be a transmission route of SFTSV.
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12
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Liu S, Chai C, Wang C, Amer S, Lv H, He H, Sun J, Lin J. Systematic review of severe fever with thrombocytopenia syndrome: virology, epidemiology, and clinical characteristics. Rev Med Virol 2013; 24:90-102. [PMID: 24310908 PMCID: PMC4237196 DOI: 10.1002/rmv.1776] [Citation(s) in RCA: 135] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Revised: 10/19/2013] [Accepted: 11/04/2013] [Indexed: 01/12/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) was firstly discovered in China in 2010, followed by several reports from many other countries worldwide. SFTS virus (SFTSV) has been identified as the causative agent of the disease and has been recognized as a public health threat. This novel Bunyavirus belongs to the Phlebovirus genus in the family Bunyaviridae. This review also describes the different aspects of virology, pathogenesis, epidemiology, and clinical symptoms on the basis of the published article surveillance data and phylogenetic analyses of viral sequences of large, medium, and small segments retrieved from database using mega 5.05, simplot 3.5.1, network 4.611, and epi information system 3.5.3 software. SFTS presents with fever, thrombocytopenia, leukocytopenia, and considerable changes in several serum biomarkers. The disease has 10 ∼ 15% mortality rate, commonly because of multiorgan dysfunction. SFTSV is mainly reported in the rural areas of Central and North-Eastern China, with seasonal occurrence from May to September, mainly targeting those of ≥50 years of age. A wide range of domesticated animals, including sheep, goats, cattle, pigs, dogs, and chickens have been proven seropositive for SFTSV. Ticks, especially Haemaphysalis longicornis, are suspected to be the potential vector, which have a broad animal host range in the world. More studies are needed to elucidate the vector–animal–human ecological cycle, the pathogenic mechanisms in high level animal models and vaccine development. © 2013 The Authors. Reviews in Medical Virology published by John Wiley & Sons, Ltd.
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Affiliation(s)
- Shelan Liu
- Department of Infectious Diseases, Zhejiang Provincial Centre for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
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Zivcec M, Safronetz D, Feldmann H. Animal models of tick-borne hemorrhagic Fever viruses. Pathogens 2013; 2:402-21. [PMID: 25437041 PMCID: PMC4235721 DOI: 10.3390/pathogens2020402] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 05/03/2013] [Accepted: 05/09/2013] [Indexed: 12/22/2022] Open
Abstract
Tick-borne hemorrhagic fever viruses (TBHFV) are detected throughout the African and Eurasian continents and are an emerging or re-emerging threat to many nations. Due to the largely sporadic incidences of these severe diseases, information on human cases and research activities in general have been limited. In the past decade, however, novel TBHFVs have emerged and areas of endemicity have expanded. Therefore, the development of countermeasures is of utmost importance in combating TBHFV as elimination of vectors and interrupting enzootic cycles is all but impossible and ecologically questionable. As in vivo models are the only way to test efficacy and safety of countermeasures, understanding of the available animal models and the development and refinement of animal models is critical in negating the detrimental impact of TBHFVs on public and animal health.
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Affiliation(s)
- Marko Zivcec
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg R3E 0J9, Canada.
| | - David Safronetz
- Laboratory of Virology Division of Intramural Research, National Institute Allergy and Infectious Disease, National Institutes of Health, Rocky Mountain Laboratories, Hamilton 59840, Montana, USA.
| | - Heinz Feldmann
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg R3E 0J9, Canada.
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