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Duan Q, Tian X, Pang B, Zhang Y, Xiao C, Yao M, Ding S, Zhang X, Jiang X, Kou Z. Spatiotemporal distribution and environmental influences of severe fever with thrombocytopenia syndrome in Shandong Province, China. BMC Infect Dis 2023; 23:891. [PMID: 38124061 PMCID: PMC10731860 DOI: 10.1186/s12879-023-08899-1] [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: 08/12/2023] [Accepted: 12/12/2023] [Indexed: 12/23/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease discovered in China in 2009. The purpose of this study was to describe the spatiotemporal distribution of SFTS and to identify its environmental influencing factors and potential high-risk areas in Shandong Province, China. METHODS Data on the SFTS incidence from 2010 to 2021 were collected. Spatiotemporal scan statistics were used to identify the time and area of SFTS clustering. The maximum entropy (MaxEnt) model was used to analyse environmental influences and predict high-risk areas. RESULTS From 2010 to 2021, a total of 5705 cases of SFTS were reported in Shandong. The number of SFTS cases increased yearly, with a peak incidence from April to October each year. Spatiotemporal scan statistics showed the existence of one most likely cluster and two secondary likely clusters in Shandong. The most likely cluster was in the eastern region, from May to October 2021. The first secondary cluster was in the central region, from May to October 2021. The second secondary cluster was in the southeastern region, from May to September 2020. The MaxEnt model showed that the mean annual wind speed, NDVI, cattle density and annual cumulative precipitation were the key factors influencing the occurrence of SFTS. The predicted risk map showed that the area of high prevalence was 28,120 km2, accounting for 18.05% of the total area of the province. CONCLUSIONS The spatiotemporal distribution of SFTS was heterogeneous and influenced by multidimensional environmental factors. This should be considered as a basis for delineating SFTS risk areas and developing SFTS prevention and control measures.
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Affiliation(s)
- Qing Duan
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
- Chinese Field Epidemiology Training Program, Chinese Center for Disease Control and Prevention, Beijing, 100050, China
| | - Xueying Tian
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Bo Pang
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Yuwei Zhang
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Chuanhao Xiao
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Mingxiao Yao
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Shujun Ding
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China
| | - Xiaomei Zhang
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
| | - Xiaolin Jiang
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
| | - Zengqiang Kou
- Infectious Disease Prevention and Control Section, Shandong Center for Disease Control and Prevention, Jinan, 250014, China.
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Dong Y, Lin SH, Jiang L, Liu H. Clinical characteristics and risk factors of 267 patients having severe fever with thrombocytopenia syndrome-new epidemiological characteristics of fever with thrombocytopenia syndrome: Epidemiological characteristics of SFTS. Medicine (Baltimore) 2022; 101:e31947. [PMID: 36550925 PMCID: PMC9771163 DOI: 10.1097/md.0000000000031947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE To analyze the epidemiological distribution, clinical characteristics, and prognostic risk factors of patients having severe fever with thrombocytopenia syndrome (SFTS). METHODS We enrolled 790 patients with SFTS divided into the ordinary group and the severe group, analyzed the clinical characteristics, and screened the risk factors of severious patients by univariate logistic regression analysis. RESULTS Most of the 790 patients (SFTS) are farmers (84.56%). The proportion of patients with fieldwork history was 72.41%, of which 21.27% had a clear history of a tick bite and 98.61% were sporadic cases. The annual peak season is from April to November. 16.33% patients were not accompanied by fever. The incidence of severe thrombocytopenia was 47.59%. They were statistically significant between the 2 groups in indicators such as age, hypertension, coronary heart disease, diabetes mellitus, bunyavirus nucleic acid load and mean platelet count (P < .05). Multivariate non conditional Logistic regression analysis showed that the risk factors of the mild patients deteriorating severe disease were age (OR = 1.985, P ≤ .003), diabetes mellitus (OR = 1.702, P ≤ .001), coronary heart disease (OR = 1.381, P ≤ .003), platelet count (OR = 2.592, P ≤ .001), viral nucleic acid loading (OR = 3.908, P ≤ .001). CONCLUSION The incidence population and seasonal distribution characteristics of patients with SFTS are obvious. The risk factors for poor prognosis of severe patients are old age, multiple basic medical histories, high viral load, a serious decrease of mean platelet count, and delay of treatment time.
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Affiliation(s)
- Yu Dong
- Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong First Medical University, P.R.China
| | - Shao-hua Lin
- Department of Infectious Disease, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Ling Jiang
- Department of Clinical Laboratory Center, Rongcheng Hospital Affiliated to Shandong First Medical University, Rongcheng, P.R.China
| | - Hui Liu
- Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong University, Jinan, P.R.China
- * Correspondence: Hui Liu, Department of Gastroenterology, Shandong, Provincial hospital affiliated to Shandong University, Jinan 250021, P.R.China (e-mail: )
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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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Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med 2021; 53:713-722. [PMID: 33953322 PMCID: PMC8178303 DOI: 10.1038/s12276-021-00610-1] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 01/11/2021] [Indexed: 02/03/2023] Open
Abstract
An emerging infectious disease first identified in central China in 2009, severe fever with thrombocytopenia syndrome (SFTS) was found to be caused by a novel phlebovirus. Since SFTSV was first identified, epidemics have occurred in several East Asian countries. With the escalating incidence of SFTS and the rapid, worldwide spread of SFTSV vector, it is clear this virus has pandemic potential and presents an impending global public health threat. In this review, we concisely summarize the latest findings regarding SFTSV, including vector and virus transmission, genotype diversity and epidemiology, probable pathogenic mechanism, and clinical presentation of human SFTS. Ticks most likely transmit SFTSV to animals including humans; however, human-to-human transmission has been reported. The majority of arbovirus transmission cycle includes vertebrate hosts, and potential reservoirs include a variety of both domestic and wild animals. Reports of the seroprevalence of SFTSV in both wild and domestic animals raises the probability that domestic animals act as amplifying hosts for the virus. Major clinical manifestation of human SFTS infection is high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and a high case-fatality rate. Several animal models were developed to further understand the pathogenesis of the virus and aid in the discovery of therapeutics and preventive measures.
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Affiliation(s)
- Mark Anthony Casel
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Su Jin Park
- Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea.
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Vaccine Development for Severe Fever with Thrombocytopenia Syndrome. Viruses 2021; 13:v13040627. [PMID: 33917632 PMCID: PMC8067456 DOI: 10.3390/v13040627] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/03/2021] [Accepted: 04/06/2021] [Indexed: 11/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), which is caused by SFTS virus (SFTSV), is a tick-borne emerging zoonosis with a high case-fatality rate. At present, there is no approved SFTS vaccine, although the development of a vaccine would be one of the best strategies for preventing SFTS. This article focused on studies aimed at establishing small animal models of SFTS that are indispensable for evaluating vaccine candidates, developing these vaccine candidates, and establishing more practical animal models for evaluation. Innate immune-deficient mouse models, a hamster model, an immunocompetent ferret model and a cat model have been developed for SFTS. Several vaccine candidates for SFTS have been developed, and their efficacy has been confirmed using these animal models. The candidates consist of live-attenuated virus-based, viral vector-based, or DNA-based vaccines. SFTS vaccines are expected to be used for humans and companion dogs and cats. Hence for practical use, the vaccine candidates should be evaluated for efficacy using not only nonhuman primates but also dogs and cats. There is no practical nonhuman primate model of SFTS; however, the cat model is available to evaluate the efficacy of these candidate SFTS vaccines on domesticated animals.
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Park ES, Fujita O, Kimura M, Hotta A, Imaoka K, Shimojima M, Saijo M, Maeda K, Morikawa S. Diagnostic system for the detection of severe fever with thrombocytopenia syndrome virus RNA from suspected infected animals. PLoS One 2021; 16:e0238671. [PMID: 33507990 PMCID: PMC7842937 DOI: 10.1371/journal.pone.0238671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 12/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome virus (SFTSV) causes severe hemorrhagic fever in humans and cats. Clinical symptoms of SFTS-infected cats resemble those of SFTS patients, whereas SFTS-contracted cats have high levels of viral RNA loads in the serum and body fluids. Due to the risk of direct infection from SFTS-infected cats to human, it is important to diagnose SFTS-suspected animals. In this study, a reverse transcription polymerase chain reaction (RT-PCR) was newly developed to diagnose SFTS-suspected animals without non-specific reactions. Methodology/principle findings Four primer sets were newly designed from consensus sequences constructed from 108 strains of SFTSV. A RT-PCR with these four primer sets successfully and specifically detected four clades of SFTSV. Their limits of detection are 1–10 copies/reaction. Using this RT-PCR, 5 cat cases among 56 SFTS-suspected animal cases were diagnosed as SFTS. From these cats, IgM or IgG against SFTSV were detected by enzyme-linked immunosorbent assay (ELISA), but not neutralizing antibodies by plaque reduction neutralization titer (PRNT) test. This phenomenon is similar to those of fatal SFTS patients. Conclusion/significance This newly developed RT-PCR could detect SFTSV RNA of several clades and from SFTS-suspected animals. In addition to ELISA and PRNT test, the useful laboratory diagnosis systems of SFTS-suspected animals has been made in this study.
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Affiliation(s)
- Eun-sil Park
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Osamu Fujita
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masanobu Kimura
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Akitoyo Hotta
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Koichi Imaoka
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masayuki Shimojima
- Department of Virology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Masayuki Saijo
- Department of Virology I, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
| | - Ken Maeda
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
- Laboratory of Veterinary Microbiology, Yamaguchi University, Yamaguchi, Japan
| | - Shigeru Morikawa
- Department of Veterinary Science, National Institute of Infectious Diseases, Shinjuku, Tokyo, Japan
- Department of Microbiology, Faculty of Veterinary Medicine, Okayama University of Science, Imabari, Ehime, Japan
- * E-mail:
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Crump A, Tanimoto T. Severe Fever with Thrombocytopenia Syndrome: Japan under Threat from Life-threatening Emerging Tick-borne Disease. JMA J 2020; 3:295-302. [PMID: 33225100 PMCID: PMC7676996 DOI: 10.31662/jmaj.2019-0073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Accepted: 06/02/2020] [Indexed: 11/09/2022] Open
Abstract
Japan, like many other parts of the world, is under threat from newly emerging, potentially fatal diseases. Severe fever with thrombocytopenia syndrome (SFTS), first clinically identified in 2009, is an emerging tick-borne hemorrhagic viral disease, currently limited in distribution to East Asia. Relatively little is known about the disease with an initial Case Fatality Rate ranging from 5% to 40%. It primarily affects the elderly living in rural areas, which is particularly troublesome given Japan’s rapidly aging population. Control efforts are severely hampered by lack of specific knowledge of the disease and its means of transmission, coupled with the absence of both a vaccine and an effective treatment regime, although some antiviral drugs and blood transfusions are successful in treating the disease. Despite both the causative virus and vector ticks being commonly found throughout Japan, the disease shows a very specific, limited geographical distribution for as yet unknown reasons.
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Huang XY, He ZQ, Wang BH, Hu K, Li Y, Guo WS. Severe fever with thrombocytopenia syndrome virus: a systematic review and meta-analysis of transmission mode. Epidemiol Infect 2020; 148:e239. [PMID: 32993819 PMCID: PMC7584033 DOI: 10.1017/s0950268820002290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.
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Affiliation(s)
- X. Y. Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Z. Q. He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - B. H. Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - K. Hu
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Y. Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - W. S. Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
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Ijaz MK, Sattar SA, Rubino JR, Nims RW, Gerba CP. Combating SARS-CoV-2: leveraging microbicidal experiences with other emerging/re-emerging viruses. PeerJ 2020; 8:e9914. [PMID: 33194365 PMCID: PMC7485481 DOI: 10.7717/peerj.9914] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/19/2020] [Indexed: 12/17/2022] Open
Abstract
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Wuhan City, China, late in December 2019 is an example of an emerging zoonotic virus that threatens public health and international travel and commerce. When such a virus emerges, there is often insufficient specific information available on mechanisms of virus dissemination from animal-to-human or from person-to-person, on the level or route of infection transmissibility or of viral release in body secretions/excretions, and on the survival of virus in aerosols or on surfaces. The effectiveness of available virucidal agents and hygiene practices as interventions for disrupting the spread of infection and the associated diseases may not be clear for the emerging virus. In the present review, we suggest that approaches for infection prevention and control (IPAC) for SARS-CoV-2 and future emerging/re-emerging viruses can be invoked based on pre-existing data on microbicidal and hygiene effectiveness for related and unrelated enveloped viruses.
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Affiliation(s)
- M. Khalid Ijaz
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
- Department of Biology, Medgar Evers College of the City University of New York (CUNY), Brooklyn, NY, USA
| | - Syed A. Sattar
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Joseph R. Rubino
- Global Research & Development for Lysol and Dettol, Reckitt Benckiser LLC, Montvale, NJ, USA
| | | | - Charles P. Gerba
- Water & Energy Sustainable Technology Center, University of Arizona, Tucson, AZ, United States
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Perez-Sautu U, Gu SH, Caviness K, Song DH, Kim YJ, Paola ND, Lee D, Klein TA, Chitty JA, Nagle E, Kim HC, Chong ST, Beitzel B, Reyes DS, Finch C, Byrum R, Cooper K, Liang J, Kuhn JH, Zeng X, Kuehl KA, Coffin KM, Liu J, Oh HS, Seog W, Choi BS, Sanchez-Lockhart M, Palacios G, Jeong ST. A Model for the Production of Regulatory Grade Viral Hemorrhagic Fever Exposure Stocks: From Field Surveillance to Advanced Characterization of SFTSV. Viruses 2020; 12:v12090958. [PMID: 32872451 PMCID: PMC7552075 DOI: 10.3390/v12090958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 02/05/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging human pathogen, endemic in areas of China, Japan, and the Korea (KOR). It is primarily transmitted through infected ticks and can cause a severe hemorrhagic fever disease with case fatality rates as high as 30%. Despite its high virulence and increasing prevalence, molecular and functional studies in situ are scarce due to the limited availability of high-titer SFTSV exposure stocks. During the course of field virologic surveillance in 2017, we detected SFTSV in ticks and in a symptomatic soldier in a KOR Army training area. SFTSV was isolated from the ticks producing a high-titer viral exposure stock. Through the use of advanced genomic tools, we present here a complete, in-depth characterization of this viral stock, including a comparison with both the virus in its arthropod source and in the human case, and an in vivo study of its pathogenicity. Thanks to this detailed characterization, this SFTSV viral exposure stock constitutes a quality biological tool for the study of this viral agent and for the development of medical countermeasures, fulfilling the requirements of the main regulatory agencies.
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Affiliation(s)
- Unai Perez-Sautu
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Se Hun Gu
- The 4th Research & Development Institute, Agency for Defense Development (ADD), Daejeon 34186, Korea; (S.H.G.); (D.H.S.); (D.L.)
| | - Katie Caviness
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Dong Hyun Song
- The 4th Research & Development Institute, Agency for Defense Development (ADD), Daejeon 34186, Korea; (S.H.G.); (D.H.S.); (D.L.)
| | - Yu-Jin Kim
- Army Headquarters, Gyeryong-si 32800, Korea; (Y.-J.K.); (B.-S.C.)
| | - Nicholas Di Paola
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Daesang Lee
- The 4th Research & Development Institute, Agency for Defense Development (ADD), Daejeon 34186, Korea; (S.H.G.); (D.H.S.); (D.L.)
| | - Terry A. Klein
- Force Health Protection and Preventive Medicine, Medical Department Activity-Korea/65th Medical Brigade, Unit 15281, APO AP 96271, USA; (T.A.K.); (H.-C.K.); (S.-T.C.)
| | - Joseph A. Chitty
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Elyse Nagle
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Heung-Chul Kim
- Force Health Protection and Preventive Medicine, Medical Department Activity-Korea/65th Medical Brigade, Unit 15281, APO AP 96271, USA; (T.A.K.); (H.-C.K.); (S.-T.C.)
| | - Sung-Tae Chong
- Force Health Protection and Preventive Medicine, Medical Department Activity-Korea/65th Medical Brigade, Unit 15281, APO AP 96271, USA; (T.A.K.); (H.-C.K.); (S.-T.C.)
| | - Brett Beitzel
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Daniel S. Reyes
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
| | - Courtney Finch
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA; (C.F.); (R.B.); (K.C.); (J.L.); (J.H.K.)
| | - Russ Byrum
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA; (C.F.); (R.B.); (K.C.); (J.L.); (J.H.K.)
| | - Kurt Cooper
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA; (C.F.); (R.B.); (K.C.); (J.L.); (J.H.K.)
| | - Janie Liang
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA; (C.F.); (R.B.); (K.C.); (J.L.); (J.H.K.)
| | - Jens H. Kuhn
- Integrated Research Facility at Fort Detrick (IRF-Frederick), Division of Clinical Research (DCR), National Institute of Allergy and Infectious Diseases (NIAID), National Institutes of Health (NIH), Fort Detrick, Frederick, MD 21702, USA; (C.F.); (R.B.); (K.C.); (J.L.); (J.H.K.)
| | - Xiankun Zeng
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (X.Z.); (K.A.K.); (K.M.C.); (J.L.)
| | - Kathleen A. Kuehl
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (X.Z.); (K.A.K.); (K.M.C.); (J.L.)
| | - Kayla M. Coffin
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (X.Z.); (K.A.K.); (K.M.C.); (J.L.)
| | - Jun Liu
- Pathology Division, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (X.Z.); (K.A.K.); (K.M.C.); (J.L.)
| | - Hong Sang Oh
- Armed Forces Medical Command, Seongnam-si 13590, Korea; (H.S.O.); (W.S.)
| | - Woong Seog
- Armed Forces Medical Command, Seongnam-si 13590, Korea; (H.S.O.); (W.S.)
| | - Byung-Sub Choi
- Army Headquarters, Gyeryong-si 32800, Korea; (Y.-J.K.); (B.-S.C.)
| | - Mariano Sanchez-Lockhart
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
- Department of Pathology & Microbiology, University of Nebraska Medical Centre, Omaha, NE 68198, USA
- Correspondence: (M.S.-L.); (G.P.); (S.T.J.)
| | - Gustavo Palacios
- Center for Genome Sciences, United States Army Medical Research Institute of Infectious Diseases (USAMRIID), Fort Detrick, Frederick, MD 21702, USA; (U.P.-S.); (K.C.); (N.D.P.); (J.A.C.); (E.N.); (B.B.); (D.S.R.)
- Correspondence: (M.S.-L.); (G.P.); (S.T.J.)
| | - Seong Tae Jeong
- The 4th Research & Development Institute, Agency for Defense Development (ADD), Daejeon 34186, Korea; (S.H.G.); (D.H.S.); (D.L.)
- Correspondence: (M.S.-L.); (G.P.); (S.T.J.)
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11
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Lee HS, Kim J, Son K, Kim Y, Hwang J, Jeong H, Ahn TY, Jheong WH. Phylogenetic analysis of severe fever with thrombocytopenia syndrome virus in Korean water deer (Hydropotes inermis argyropus) in the Republic of Korea. Ticks Tick Borne Dis 2019; 11:101331. [PMID: 31787559 DOI: 10.1016/j.ttbdis.2019.101331] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 10/25/2019] [Accepted: 11/07/2019] [Indexed: 10/25/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging zoonotic tick-borne disease caused by SFTS virus, which circulates among ticks and their host animals, including wildlife. However, few studies have examined SFTS virus infection in wildlife present in the Republic of Korea (ROK). We evaluated SFTS virus infection in tissue samples from Korean water deer (Hydropotes inermis argyropus), one of the most common wild ungulates in ROK. In this study, we evaluated tissue samples of 129 water deer carcasses collected in 2017 and detected SFTS viral RNA by conventional PCR. SFTS viral RNA was found in 3 of the 129 carcasses, showing a prevalence of 2.3 %; 2 of which were collected in Gyeongsangnam-do and 1 of which was in the Gangwon-do region. Among the 6 internal organs studied, only the spleen samples were positive. Phylogenetic analysis revealed close relationships between deer- and human-derived strains. The medium segments of the three positive cases clustered with genotype B, which is the predominant genotype in ROK. In the small segment, two cases clustered with genotype B, samples 17WD044 and 17WD065. The third sample, 17WD068 from Gangwon-do province, showed genotype A, which circulates mainly in China. The disagreement in the genotypes of the two tested segments suggests a potential reassortment between genotype A and B, resulting in genetic recombination as observed in sample 17WD068, which may be co-circulating in China and Korea. Further studies in wildlife and humans are necessary to understand the genetic characteristics of SFTS viruses circulating in ROK.
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Affiliation(s)
- Hyun Seo Lee
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea; Department of Microbiology, College of Natural Sciences, Dankook University, Cheonan, 31116, Republic of Korea.
| | - Jisoo Kim
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
| | - Kidong Son
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
| | - Yongkwan Kim
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
| | - Jusun Hwang
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
| | - Hyesung Jeong
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
| | - Tae-Young Ahn
- Department of Microbiology, College of Natural Sciences, Dankook University, Cheonan, 31116, Republic of Korea.
| | - Weon-Hwa Jheong
- Environmental Health Research Department, National Institution of Environmental Research, Hwangyeong-ro 42, Seo-gu, Incheon, Republic of Korea.
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12
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Severe Fever with Thrombocytopenia Syndrome Phlebovirus causes lethal viral hemorrhagic fever in cats. Sci Rep 2019; 9:11990. [PMID: 31427690 PMCID: PMC6700174 DOI: 10.1038/s41598-019-48317-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 08/02/2019] [Indexed: 11/28/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging hemorrhagic fever caused by the SFTS phlebovirus (SFTSV). SFTS patients were first reported in China, followed by Japan and South Korea. In 2017, cats were diagnosed with SFTS for the first time, suggesting that these animals are susceptible to SFTSV. To confirm whether or not cats were indeed susceptible to SFTSV, animal subjects were experimentally infected with SFTSV. Four of the six cats infected with the SPL010 strain of SFTSV died, all showing similar or more severe symptoms than human SFTS patients, such as a fever, leukocytopenia, thrombocytopenia, weight loss, anorexia, jaundice and depression. High levels of SFTSV RNA loads were detected in the serum, eye swab, saliva, rectal swab and urine, indicating a risk of direct human infection from SFTS-infected animals. Histopathologically, acute necrotizing lymphadenitis and hemophagocytosis were prominent in the lymph nodes and spleen. Severe hemorrhaging was observed throughout the gastrointestinal tract. B cell lineage cells with MUM-1 and CD20, but not Pax-5 in the lesions were predominantly infected with SFTSV. The present study demonstrated that cats were highly susceptible to SFTSV. The risk of direct infection from SFTS-infected cats to humans should therefore be considered.
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13
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Yasuo K, Nishiura H. Spatial epidemiological determinants of severe fever with thrombocytopenia syndrome in Miyazaki, Japan: a GWLR modeling study. BMC Infect Dis 2019; 19:498. [PMID: 31174484 PMCID: PMC6556057 DOI: 10.1186/s12879-019-4111-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/20/2019] [Indexed: 01/01/2023] Open
Abstract
Background Cases of severe fever with thrombocytopenia syndrome (SFTS) have increasingly been observed in Miyazaki, southwest Japan. It is critical to identify and elucidate the risk factors of infection at community level. In the present study, we aimed to identify areas with a high risk of SFTS virus infection using a geospatial dataset of SFTS cases in Miyazaki. Methods Using 10 × 10-km mesh data and a geographically weighted logistic regression (GWLR) model, we examined the statistical associations between environmental variables and spatial variation in the risk of SFTS. We collected geospatial and population census data as well as forest and agriculture mesh information. Altitude and farmland were selected as two specific variables for predicting the presence of SFTS cases in a given mesh area. Results Using GWLR, the area under the receiver operating characteristic curve (AUC) was estimated at 73.9%, outperforming the classical logistic regression model (72.4%). The sensitivity and specificity of the GWLR model were estimated at 90.9 and 58.7%, respectively. We identified altitude (odds ratio (OR) = 0.996, 95% confidence interval (CI): 0.994–0.999 per one-meter elevation) and farmland (OR = 0.999, 95% CI: 0.998–1.000 per % increase) as useful negative predictors of SFTS cases in Miyazaki. Conclusions Our study findings revealed that the risk of SFTS is high in geographic areas where farmland area begins to diminish and at mid-level altitudes. Our findings can help to improve the efficiency of ecological and animal surveillance in high-risk areas. Using finer geographic resolution, such surveillance can help raise awareness among local residents in areas with a high risk of SFTS. Electronic supplementary material The online version of this article (10.1186/s12879-019-4111-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kazuhiro Yasuo
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Sapporo, Japan.,Sapporo Higashi Tokushukai Hospital, 3-1 Kita 33 Jo, Higashi 14 Chome, Sapporo, Japan
| | - Hiroshi Nishiura
- Graduate School of Medicine, Hokkaido University, Kita 15 Jo Nishi 7 Chome, Sapporo, Japan.
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14
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Chen C, Li P, Li KF, Wang HL, Dai YX, Cheng X, Yan JB. Animals as amplification hosts in the spread of severe fever with thrombocytopenia syndrome virus: A systematic review and meta-analysis. Int J Infect Dis 2019; 79:77-84. [DOI: 10.1016/j.ijid.2018.11.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 11/21/2018] [Accepted: 11/21/2018] [Indexed: 10/27/2022] Open
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15
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Hu B, Cai K, Liu M, Li W, Xu J, Qiu F, Zhan J. Laboratory detection and molecular phylogenetic analysis of severe fever with thrombocytopenia syndrome virus in Hubei Province, central China. Arch Virol 2018; 163:3243-3254. [PMID: 30136250 DOI: 10.1007/s00705-018-3993-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/14/2018] [Indexed: 11/26/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by the SFTS virus (SFTSV). Hubei Province is a major epidemic area for SFTS in China. In this study, quantitative reverse-transcription polymerase chain reaction (qRT-PCR) and serological testing (IgM) were used simultaneously for laboratory detection of SFTS; however, testing results showed poor consistency between these two methods. Further analysis revealed that time post-onset was the main factor leading to inconsistent results. Thus, qRT-PCR is unable to detect all SFTS cases, and serological testing is essential. Here, 15 strains of SFTSV were successfully isolated from serum samples of acute SFTSV infection and their complete genomes were sequenced and submitted to GenBank. Phylogenetic analysis showed that the 15 SFTS virus strains clustered into four independent genotypes (A, B, D, and E), demonstrating that at least four genotypes of SFTSV have been co-circulating in Hubei Province. Furthermore, four strains of our isolates (HB2014-31, HB2014-35, HB2014-36, and HB2014-37) clustered in genotype E, which was the predominant genotype in Japan and South Korea. In this study, we identified multiple co-prevalent genotypes and confirmed the existence of genotype E viruses circulating in the Dabie Mountains of Hubei, central China. We concluded that SFTSV strains from Hubei exhibit most of the genetic diversity found in China.
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Affiliation(s)
- Bing Hu
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China
| | - Kun Cai
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China
| | - Man Liu
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China
| | - Wenjing Li
- Hubei Normal University, Huangshi, 435002, Hubei, China
| | - Junqiang Xu
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China
| | - Feng Qiu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
| | - Jianbo Zhan
- Institute of Health Inspection and Testing, Hubei Provincial Center for Disease Control and Prevention, Wuhan, 430079, Hubei, China.
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16
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Lundu T, Tsuda Y, Ito R, Shimizu K, Kobayashi S, Yoshii K, Yoshimatsu K, Arikawa J, Kariwa H. Targeting of severe fever with thrombocytopenia syndrome virus structural proteins to the ERGIC (endoplasmic reticulum Golgi intermediate compartment) and Golgi complex. Biomed Res 2018; 39:27-38. [PMID: 29467349 DOI: 10.2220/biomedres.39.27] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Severe fever with thrombocytopenia syndrome phlebovirus (SFTSV) is a newly emerged phlebovirus identified in China, Japan, and South Korea. Phlebovirus glycoproteins (GP) play a key role in targeting viral structural components to the budding compartments in the ER-Golgi intermediate compartment (ERGIC) and Golgi complex. However, the role of SFTSV GP in targeting structural proteins to the ERGIC and Golgi complex remains unresolved. In this study, we show that SFTSV GP plays a significant role in targeting RNA-dependent RNA polymerase (L) and nucleocapsid protein (NP) to the budding sites. Confocal microscopy was used to investigate the subcellular localization of SFTSV structural proteins. In SFTSV-infected cells, GP and L localized to the ER, ERGIC and Golgi complex, whereas NP localized to the ERGIC and Golgi complex. In addition, GP colocalized with L and NP in infected cells. In cells singly transfected with GP, L or NP, GP localized to the same subcellular compartments as in infected cells. However, L or NP alone did not localize to the ER, ERGIC, or Golgi complex. Cotransfection experiments showed that GP altered the localization of L to the ERGIC and Golgi complex but not that of NP. Interestingly, plasmid-expressed NP fused with a hemagglutinin tag localized to the ERGIC and Golgi complex when expressed in SFTSV-infected cells and colocalised with GP, suggesting that GP plays a role in the subcellular localization of L and NP in infected cells. Thus, the SFTSV structural components start to assemble at the ERGIC to Golgi complex. GP is required for transporting L and NP to the ERGIC and Golgi complex. In addition, targeting of NP requires interaction with other factors besides GP.
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Affiliation(s)
- Tapiwa Lundu
- Laboratory of Public Health, Department of Preventive Veterinary Science, Division of Veterinary Medicine, Graduate School of Veterinary Medicine, Hokkaido University.,Department of Biomedical Sciences, School of Veterinary Medicine, University of Zambia
| | - Yoshimi Tsuda
- Laboratory of Microbiology and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University
| | - Ryo Ito
- Laboratory of Microbiology and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University
| | - Kenta Shimizu
- Laboratory of Microbiology and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University
| | - Shintaro Kobayashi
- Laboratory of Public Health, Department of Preventive Veterinary Science, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido University
| | - Kentaro Yoshii
- Laboratory of Public Health, Department of Preventive Veterinary Science, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido University
| | - Kumiko Yoshimatsu
- Laboratory of Microbiology and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University
| | - Jiro Arikawa
- Laboratory of Microbiology and Infectious Diseases, Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University
| | - Hiroaki Kariwa
- Laboratory of Public Health, Department of Preventive Veterinary Science, Division of Veterinary Medicine, Faculty of Veterinary Medicine, Hokkaido University
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17
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Huang X, Wang S, Wang X, Lyu Y, Jiang M, Chen D, Li K, Liu J, Xie S, Lyu T, Sun J, Xu P, Cao M, Liang M, Li D. Estimation of the incidence of severe fever with thrombocytopenia syndrome in high endemic areas in China: an inpatient-based retrospective study. BMC Infect Dis 2018; 18:66. [PMID: 29402229 PMCID: PMC5800001 DOI: 10.1186/s12879-018-2970-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 01/18/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is a severe viral disease caused by SFTSV. It is important to estimate the rate of missed SFTS diagnosis and to further understand the actual incidence in high endemic areas in China. METHODS This study was conducted in two high SFTS endemic provinces in 2015. Patients hospitalized in 2014 or within 1 year before investigation were selected after considering their clinical manifestations, specifically, fever, platelet, and white blood cell. During retrospective investigation, sera were collected to detect SFTSV antibodies to assess SFTSV infection. To further understand SFTSV infection, acute phase sera were detected; SFTSV infection rate among a healthy population was also investigated to determine the basic infection level. RESULTS In total, 246 hospitalized cases were included, including 83 cases (33.7%) with fever, thrombocytopenia and leukopenia, 38 cases (15.4%) with fever and thrombocytopenia but without leukopenia, and 125 cases (50.8%) without fever but with thrombocytopenia and leukopenia. In total, 13 patients (5.3%) were SFTSV IgM antibody-positive, 48 (19.5%) were IgG-positive. Of the 13 IgM-positive cases, 11 (84.6%) were IgG-positive (9 with titres ≥1:400). Seropositive rates of antibodies were high (8.4% for IgM and 30.1% for IgG) in patients with fever, thrombocytopenia and leukopenia. Furthermore, among IgG-positive cases in this group, 76% (19/25) of patients' IgG antibody titres were ≥1:400. Additionally, 28 of 246 cases were initially diagnosed with suspected SFTS and were then excluded, and 218 patients were never diagnosed with SFTS; the seropositive rates of IgM and IgG in these two groups were 25% and 67.9% and 2.8% and 13.3%, respectively. These rates were 64.3% and 21.4% in 14 sera collected during acute phase of the 28 cases mentioned above. Seropositive rate of SFTSV IgG was only 1.3% in the patient-matched healthy group, and no IgM antibody was detected. A preliminary estimate of 8.3% of SFTS cases were missed in SFTS high endemic provinces. CONCLUSIONS The actual SFTS incidence was underestimated. Effective measures such as adding a new SFTS case category - "SFTS clinical diagnosis cases" or using serological detection methods during acute phase should be considered to avoid missed diagnoses.
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Affiliation(s)
- Xiaoxia Huang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 People’s Republic of China
| | - Shiwen Wang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 People’s Republic of China
| | - Xianjun Wang
- Shandong Center for Disease Control and Prevention, Jinan, Shandong Province People’s Republic of China
| | - Yong Lyu
- Lu’an Center for Disease Control and Prevention, Lu’an, Anhui Province People’s Republic of China
| | - Mei Jiang
- Yantai Center for Disease Control and Prevention, Yantai, Shandong Province People’s Republic of China
| | - Deying Chen
- Weihai Center for Disease Control and Prevention, Weihai, Shandong Province People’s Republic of China
| | - Kaichun Li
- Lu’an Center for Disease Control and Prevention, Lu’an, Anhui Province People’s Republic of China
| | - Jingyu Liu
- Yantai Center for Disease Control and Prevention, Yantai, Shandong Province People’s Republic of China
| | - Shaoyu Xie
- Lu’an Center for Disease Control and Prevention, Lu’an, Anhui Province People’s Republic of China
| | - Tao Lyu
- Weihai Center for Disease Control and Prevention, Weihai, Shandong Province People’s Republic of China
| | - Jie Sun
- Lu’an Center for Disease Control and Prevention, Lu’an, Anhui Province People’s Republic of China
| | - Pengpeng Xu
- Lu’an Center for Disease Control and Prevention, Lu’an, Anhui Province People’s Republic of China
| | - Minghua Cao
- Anhui Center for Disease Control and Prevention, Hefei, Anhui Province People’s Republic of China
| | - Mifang Liang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 People’s Republic of China
| | - Dexin Li
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 155 Changbai Road, Changping District, Beijing, 102206 People’s Republic of China
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18
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Silvas JA, Aguilar PV. The Emergence of Severe Fever with Thrombocytopenia Syndrome Virus. Am J Trop Med Hyg 2017; 97:992-996. [PMID: 28820686 DOI: 10.4269/ajtmh.16-0967] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a newly recognized hemorrhagic fever disease found throughout Asia with a case fatality rate between 12% and 30%. Since 2009, SFTS has been reported in China throughout 14 Chinese Provinces. In addition, SFTS has been recognized in South Korea and Japan with the first confirmed cases reported in 2012. A similar disease, caused by the closely related Heartland virus, was also reported in the United States in 2009. SFTS is caused by SFTS virus, a novel tick-borne virus in the family Bunyaviridae, genus Phlebovirus. Unlike other mosquito- and sandfly-borne bunyaviruses, SFTS virus has not been extensively studied due to its recent emergence and many unknowns regarding its pathogenesis, life cycle, transmission, and options for therapeutics remains. In this review, we report the most current findings in SFTS virus research.
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Affiliation(s)
- Jesus A Silvas
- Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas.,Department of Pathology, University of Texas Medical Branch, Galveston, Texas
| | - Patricia V Aguilar
- Center for Tropical Diseases, University of Texas Medical Branch, Galveston, Texas.,Department of Pathology, University of Texas Medical Branch, Galveston, Texas.,Institute for Human Infection and Immunity, University of Texas Medical Branch, Galveston, Texas
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19
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Li P, Tong ZD, Li KF, Tang A, Dai YX, Yan JB. Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis. PLoS One 2017; 12:e0175592. [PMID: 28399161 PMCID: PMC5388504 DOI: 10.1371/journal.pone.0175592] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/28/2017] [Indexed: 02/04/2023] Open
Abstract
Objective Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus-SFTSV. The seroprevalence of anti-SFTSV antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTSV in the general population has been investigated in various epidemiological studies with inconsistent results. Here, we clarify this discrepancy and reach a more comprehensive result by mean of a meta-analysis. Methods All relevant articles were searched in the electronic databases (PubMed, Web of science, Embase, Chinese National Knowledge Infrastructure database, Chinese Wanfang database) up to November 2016. The pooled seroprevalence and 95% confidence intervals (95% CIs) were calculated by random- or fixed- model on the basis of heterogeneity. Results In total, 21 studies containing 23,848 blood samples from 7 provinces were included in this meta-analysis. The minimum and maximum reported seroprevalences of SFTSV among humans in China were 0.23% and 9.17%, respectively. The overall pooled seroprevalence of SFTSV antibodies was 4.3% (95%CI: 3.2%-5.5%). The pooled prevalence was 5.9% (95%CI: 4.7%-7.0%) in Zhejiang province, 4.9% (95%CI: 4.1–5.8%) in Anhui province, 3.9% (95%CI: 1.3%-6.4%) in Shandong province, and 0.7% (95%CI: 0.2%-1.1%) in Jiangsu province. Stratified by occupation, the pooled prevalence of farmer was 6.1% (95%CI: 3.4%-8.9%) and others (mainly are students) was 3.3% (95%CI: 2.4%-4.2%). Additionally, seroprevalence of SFTSV in people who lived in the same village with the patient were higher than that of people who lived in a different village. Seropositive rates in sampling years after 2012 were higher than that before 2012. The prevalence of SFTSV did not differ by age or gender. Sensitive analysis by omitting one study at a time indicated the results of the pooled seroprevalence were robust. Conclusions Seroprevalence of SFTSV among healthy population in central and eastern China is high. Surveillance efforts on mild or asymptomatic infections among endemic persons are needed.
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Affiliation(s)
- Peng Li
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Zhen-Dong Tong
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- * E-mail: (ZDT); (JBY)
| | - Ke-Feng Li
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - An Tang
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Ya-Xin Dai
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
| | - Jian-Bo Yan
- Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- Zhejiang Provincial Key Laboratory of Health Risk Factors for Seafood, Zhoushan Municipal Center for Disease Control and Prevention, Zhoushan, Zhejiang, P.R. China
- * E-mail: (ZDT); (JBY)
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Isolation, characterization, and phylogenic analysis of three new severe fever with thrombocytopenia syndrome bunyavirus strains derived from Hubei Province, China. Virol Sin 2017; 32:89-96. [PMID: 28251516 DOI: 10.1007/s12250-017-3953-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 02/20/2017] [Indexed: 10/20/2022] Open
Abstract
Hubei Province is a major epidemic area of severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) in China. However, to date, a few SFTSV strains have been isolated from Hubei Province, preventing effective studies of epidemic outbreaks. Here, we report three confirmed patients (2015-2016) with typical symptoms of severe fever with thrombocytopenia syndrome disease (SFTS) who were farmers resident in different regions in Hubei Province. Three new SFTSV strains were isolated from the serum samples of each patient. Characterization of viral growth properties showed that there were no significant differences in virus production. All strains were completely sequenced, and phylogenetic analysis showed that unlike the other strains from Hubei province, which belonged to the SFTSV C3 genotype, one of the three strains belonged to the SFTSV C2 genotype. These results suggested that multiple SFTSV genotypes have been circulating in Hubei Province, providing insights into SFTSV evolution and improving our understanding of SFTSV prevalence in Hubei Province.
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A Case-control Study of Risk Sources for Severe Fever with Thrombocytopenia Syndrome in Hubei Province, China. Int J Infect Dis 2017; 55:86-91. [PMID: 28088586 DOI: 10.1016/j.ijid.2017.01.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Revised: 01/03/2017] [Accepted: 01/05/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease caused by a novel bunyavirus, was discovered in rural areas of Central China in 2009. METHODS A case-control study based on hospital data was applied to detect the potential risk sources for SFTS in SFTS-endemic counties in Hubei Province. Cases were defined as hospitalized SFTSV confirmed patients. Controls were randomly selected from non-SFTSV patients in the same hospital ward within 2 weeks of inclusion of the cases, and they were matched by age (+/- 5 years) and gender according to 1:2 matching condition. RESULTS 68 cases and 136 controls participated in this study. In multivariate analysis, "Contact with cattle tick" was the major risk source (Conditional Logistic Regression OR-MH=8.62, 95% CI=1.79-41.51), outdoor activities and working in weeds or hillside fields could increase risk of cattle tick contact and SFTS infection (Conditional Logistic Regression OR-MH=8.82, 95% CI=1.69-46.05, P value=0.01). CONCLUSION Our results suggested cattle might be dominant hosts in SFTS-endemic regions in Hubei Province, which provided clues to transmission mechanism of "vectors, host animals, and humans", thus more effectively preventing and controlling the disease.
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Risk Factors for Bunyavirus-Associated Severe Fever with Thrombocytopenia Syndrome: A Community-Based Case-Control Study. PLoS One 2016; 11:e0166611. [PMID: 27846273 PMCID: PMC5112944 DOI: 10.1371/journal.pone.0166611] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 11/01/2016] [Indexed: 11/20/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus. Previous studies about risk factors for SFTSV infection have yielded inconsistent results, and behavior factors have not been fully clarified. Methods A community-based, 1:4 matched case-control study was carried out to investigate the risk factors for SFTS in China. Cases of SFTS were defined as laboratory-confirmed cases that tested positive for real-time PCR (RT-PCR) for severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) or positive for IgM antibodies against SFTSV. Controls of four neighborhood subjects were selected by matching for sex, age, and occupation. Standardized questionnaires were used to collect detailed information about their demographics and risk factors for SFTSV infection. Results A total of 334 subjects participated in the study including 69 cases and 265 controls. The median age of the cases was 59.5 years, 55.1% were male, and 87.0% were farmers. No differences in demographics were observed between cases and controls. In the final multivariate analysis, tick bites two weeks prior to disease onset (OR = 8.04, 95%CI 3.34–19.37) and the presence of weeds and shrubs around the house (OR = 3.46, 95%CI 0.96–12.46) were found to be risk factors for SFTSV infection; taking preventative measures during outdoor activities (OR = 0.12, 95%CI 0.01–1.01) provided greater protection from SFTSV infection. Conclusions Our results further confirm that SFTSV is transmitted by tick bites and prove that preventative measures that reduce exposure to ticks can prevent SFTSV infection. More efforts should be directed toward health education and behavior change for high-risk populations, especially outdoor workers, in SFTS endemic areas.
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Park SW, Ryou J, Choi WY, Han MG, Lee WJ. Epidemiological and Clinical Features of Severe Fever with Thrombocytopenia Syndrome During an Outbreak in South Korea, 2013-2015. Am J Trop Med Hyg 2016; 95:1358-1361. [PMID: 27928084 PMCID: PMC5154450 DOI: 10.4269/ajtmh.16-0251] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 06/13/2016] [Indexed: 11/10/2022] Open
Abstract
Since the first reported case of severe fever with thrombocytopenia syndrome (SFTS) in South Korea in 2013, between 2013 and 2015, we collected 1,697 serum samples from suspected patients who experienced symptoms of SFTS. We performed reverse transcriptase polymerase chain reaction using total RNA extracted from the patients' sera. When viral RNA was detected in the sera, SFTS was diagnosed. Among the 1,697 samples, 170 were positive for SFTS virus. We then analyzed the epidemiologic features of these 170 cases. As a result, we found that the annual number of cases increased steadily. However, the annual case fatality rate exhibited a downward trend. The majority of patients were aged ≥ 60 years, and most cases occurred during May–October in the eastern and southern parts of the country. These results may be useful for effective SFTS control by describing the clinical and epidemiologic features of the disease in South Korea.
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Affiliation(s)
- Sun-Whan Park
- Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Jungsang Ryou
- Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Woo-Young Choi
- Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Myung-Guk Han
- Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
| | - Won-Ja Lee
- Korea Centers for Disease Control and Prevention, Cheongju, Republic of Korea
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