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Saba Villarroel PM, Chaiphongpachara T, Nurtop E, Laojun S, Pangpoo-Nga T, Songhong T, Supungul D, Baronti C, Thirion L, Leaungwutiwong P, de Lamballerie X, Missé D, Wichit S. Seroprevalence study in humans and molecular detection in Rhipicephalus sanguineus ticks of severe fever with thrombocytopenia syndrome virus in Thailand. Sci Rep 2024; 14:13397. [PMID: 38862576 PMCID: PMC11167008 DOI: 10.1038/s41598-024-64242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 06/06/2024] [Indexed: 06/13/2024] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne virus with a mortality rate of up to 30%. First identified in China in 2009, it was later reported in other Asian countries, including Thailand in 2020. SFTSV has been detected in several tick species, including Rhipicephalus sanguineus, known for infesting dogs. We conducted a seroprevalence study of SFTSV in Bangkok and Nong Khai, Thailand, by analyzing 1162 human samples collected between 2019 and 2023. The testing method relied on IgG detection using ELISA and confirmed though a virus seroneutralization test. The results indicated that out of the participants, 12 (1.1%) tested positive for anti-SFTSV IgG antibodies; however, none exhibited positive results in the seroneutralization assay. Additionally, molecular detection of SFTSV, Crimean-Congo hemorrhagic fever (CCHF), Coxiella spp., Bartonella spp., and Rickettsia spp. was performed on 433 Rh. sanguineus ticks collected from 49 dogs in 2023 in Chachoengsao Province, Thailand. No evidence of these pathogens was found in ticks. These findings highlight the importance of exploring viral cross-reactivity. Furthermore, it is important to conduct additional studies to isolate SFTSV from animals and ticks in order to identify the potential transmission routes contributing to human and animal infections in Thailand.
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Affiliation(s)
- Paola Mariela Saba Villarroel
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
- Viral Vector Joint Unit and Joint Laboratory, Mahidol University, Nakhon Pathom, Thailand
| | - Tanawat Chaiphongpachara
- Department of Public Health and Health Promotion, College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkhram, Thailand
| | - Elif Nurtop
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190- Inserm 1207), Marseille, France
| | - Sedthapong Laojun
- Department of Public Health and Health Promotion, College of Allied Health Sciences, Suan Sunandha Rajabhat University, Samut Songkhram, Thailand
| | | | - Thanaphon Songhong
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
- Viral Vector Joint Unit and Joint Laboratory, Mahidol University, Nakhon Pathom, Thailand
| | - Dolruethai Supungul
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand
- Viral Vector Joint Unit and Joint Laboratory, Mahidol University, Nakhon Pathom, Thailand
| | - Cécile Baronti
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190- Inserm 1207), Marseille, France
| | - Laurence Thirion
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190- Inserm 1207), Marseille, France
| | - Pornsawan Leaungwutiwong
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Xavier de Lamballerie
- Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190- Inserm 1207), Marseille, France
| | - Dorothée Missé
- MIVEGEC, CNRS, IRD, Univ. Montpellier, Montpellier, France
| | - Sineewanlaya Wichit
- Department of Clinical Microbiology and Applied Technology, Faculty of Medical Technology, Mahidol University, Nakhon Pathom, Thailand.
- Viral Vector Joint Unit and Joint Laboratory, Mahidol University, Nakhon Pathom, Thailand.
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Chen L, Ma M, Zou M, Zhao L, Ou M, Geng Y, Li C, Shen H, Chen Y. Rapid and portable bunyavirus SFTSV RNA testing utilizing catalytic hairpin assembly coupled with lateral flow immunoassay. Microbiol Spectr 2023; 11:e0214423. [PMID: 37681992 PMCID: PMC10581038 DOI: 10.1128/spectrum.02144-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Accepted: 07/06/2023] [Indexed: 09/09/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a prevalent, life-threatening, emergent infectious disease. Currently, reverse transcription-polymerase chain reaction is the gold standard for diagnosing SFTS virus (SFTSV) infection, which requires sophisticated equipment and professional personnel that are frequently unavailable in most SFTS endemic rural areas. Here, we reported a simple, rapid nucleic acid amplification system that combined the catalytic hairpin assembly (CHA) with a lateral flow immunoassay (LFIA) strip-based detection method for SFTSV detection. The detection of SFTSV RNA could be realized by generation of H1-H2 hybrid duplexes labeled with biotin and digoxin, which subsequently added to the LFIA test strips containing streptavidin conjugated with Alexa Fluor 647 as well as anti-digoxin antibodies. Our CHA-based LFIA assay offered high amplification efficiency and specificity with a detection limit of 1 aM. Crucially, this method enabled stable detection of 500 copies/mL of SFTSV within 30 min using clinical serum samples. Therefore, our CHA-based LFIA approach provided a potential useful tool to facilitate early and precise diagnosis of SFTS patients in poorly resourced SFTS endemic areas.IMPORTANCESevere fever with thrombocytopenia syndrome (SFTS) is an emerging and potentially fatal infectious disease prevalent in China. Here we report a simple, rapid nucleic acid amplification system, the catalytic hairpin assembly (CHA) in conjunction with a lateral flow immunoassay (LFIA) strip-based detection method for SFTS virus detection, which demonstrated high amplification efficiency and specificity with limit of detection of 1 aM. Most importantly, we also validate our CHA-based LFIA assay using the clinical serum samples, which was fully compatible with reverse transcription-PCR results. Therefore, our strategy provides a potential useful tool to facilitate early and precise diagnosis of SFTS patients especially in poorly resourced SFTS endemic areas.
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Affiliation(s)
- Lin Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mengyin Ma
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mingyuan Zou
- Department of Thoracic Surgery, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Liwei Zhao
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Mingrong Ou
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu Geng
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Chuang Li
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Han Shen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yuxin Chen
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
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3
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Zhang Q, Liu W, Wang W, Zhang L, Li J, Tang R, Jin J, Chen W, Zhang L. Analysis of spatial-temporal distribution characteristics and natural infection status of SFTS cases in Hefei from 2015 to 2021. Environ Health Prev Med 2023; 28:70. [PMID: 37967947 PMCID: PMC10654213 DOI: 10.1265/ehpm.23-00149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 09/21/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND To analyze the prevalence and spatial-temporal characteristics of severe fever with thrombocytopenia syndrome (SFTS), clustering mode of transmission, and the serological dynamic detection results in multiple areas in Hefei from 2015 to 2021, and to provide the basis for SFTS prevention and control. METHOD Case data were obtained from the Chinese Disease Control and Prevention Information System. Information on the clustering outbreak was obtained from the outbreak investigation and disposal report. Population latent infection rate information was obtained from field sampling in multiple-incidence counties in 2016 and 2021 by multi-stage random sampling. Epi data3.2 and SPSS 16.0 softwares were used to perform a statistical analysis of the data on SFTS cases, and QGIS 3.26 software was used to draw the incidence map with township (street) as unit. RESULTS The an average annual reported incidence rate of SFTS in Hefei from 2015 to 2021 was 0.65/100,000, and the case fatality rate was 9.73%. The overall prevalence of SFTS epidemics in Hefei City showed a fluctuating upward trend from 2015 to 2021 (χ2trends = 103.353, P < 0.001). Chaohu City, Feixi County, Feidong County and Lujiang County ranked the top 4 in the city in terms of average annual incidence rate. The number of epidemic-involved towns (streets) kept increasing ((χ2trend = 47.640, P = 0.000)). Co-exposure to ticks accounted for the majority of clustered outbreaks and also human-to-human outbreaks. Population-based latent infection rate surveys were conducted in four SFTS multi-incidence counties, with 385 people surveyed in 2016 and 403 people surveyed in 2021, increasing the population-based latent infection rate from 6.75% to 10.91%, just as the incidence rate increased. CONCLUSIONS The incidence rate of SFTS in Hefei is obviously regional, with an expanding trend in the extent of the epidemic involved. Co-exposure to ticks accounted for the majority of clustered outbreaks and the latent infection rate cannot be ignored.
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Affiliation(s)
- Qi Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wenwen Liu
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wenjing Wang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Linlin Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Juan Li
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Renshu Tang
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Jing Jin
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Wei Chen
- Hefei Center for Disease Control and Prevention, Hefei, China
| | - Lei Zhang
- Hefei Center for Disease Control and Prevention, Hefei, China
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Wang M, Tan W, Li J, Fang L, Yue M. The Endless Wars: Severe Fever With Thrombocytopenia Syndrome Virus, Host Immune and Genetic Factors. Front Cell Infect Microbiol 2022; 12:808098. [PMID: 35782112 PMCID: PMC9240209 DOI: 10.3389/fcimb.2022.808098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 05/10/2022] [Indexed: 01/10/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging arboviral infectious disease with a high rate of lethality in susceptible humans and caused by severe fever with thrombocytopenia syndrome bunyavirus (SFTSV). Currently, neither vaccine nor specific antiviral drugs are available. In recent years, given the fact that both the number of SFTS cases and epidemic regions are increasing year by year, SFTS has become a public health problem. SFTSV can be internalized into host cells through the interaction between SFTSV glycoproteins and cell receptors and can activate the host immune system to trigger antiviral immune response. However, SFTSV has evolved multiple strategies to manipulate host factors to create an optimal environment for itself. Not to be discounted, host genetic factors may be operative also in the never-ending winning or losing wars. Therefore, the identifications of SFTSV, host immune and genetic factors, and their interactions are critical for understanding the pathogenic mechanisms of SFTSV infection. This review summarizes the updated pathogenesis of SFTS with regard to virus, host immune response, and host genetic factors to provide some novel perspectives of the prevention, treatment, as well as drug and vaccine developments.
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Affiliation(s)
- Min Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Weilong Tan
- Department of Infection Disease, Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
| | - Jun Li
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Liqun Fang
- State Key Lab Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
- *Correspondence: Liqun Fang, ; Ming Yue,
| | - Ming Yue
- Department of Infectious Diseases, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- *Correspondence: Liqun Fang, ; Ming Yue,
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Tao M, Liu Y, Ling F, Chen Y, Zhang R, Ren J, Shi X, Guo S, Lu Y, Sun J, Jiang J. Severe Fever With Thrombocytopenia Syndrome in Southeastern China, 2011-2019. Front Public Health 2022; 9:803660. [PMID: 35223761 PMCID: PMC8864090 DOI: 10.3389/fpubh.2021.803660] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/31/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease, and the number of cases has increased in recent years in Zhejiang Province, China. However, whether the seasonal distribution, geographic distribution, and demographic characteristics of SFTS have changed with the increase of incidence was unclear. Materials and Methods Data on SFTS cases in Zhejiang Province and tick density in Daishan County from 2011 to 2019 were collected. The changing epidemiological characteristics of SFTS including seasonal distribution, geographical distribution, and demographic features were analyzed using descriptive statistical methods, Global Moran's I, local Getis-Ord Gi* statistic, and spatial scan statistic. Results A total of 463 SFTS cases including 53 (11.45%) deaths were reported from 2011 to 2019 in Zhejiang Province, and the annual number of cases showed increasing tendency. SFTS cases were reported in almost half of the counties (40/89) of Zhejiang Province. Elderly farmers accounted for most cases and the proportion of farmers has increased. Most cases (81.21%) occurred during April and August. The interval from illness onset to confirmation was significantly shortened (Z = 5.194, p < 0.001). The majority of cases were reported in Zhoushan City from 2011 to 2016, but most cases were reported in Taizhou City since 2017. Discussion We observed dynamic changes in the seasonal distribution, geographical distribution, and demographic features of SFTS, and comprehensive intervention measures, such as clearance of breeding sites, killing of tick adults, and health education should be strengthened in farmers of the key areas according to the changed epidemiological characteristics.
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Affiliation(s)
- Mingyong Tao
- Medical School, Ningbo University, Ningbo, China
| | - Ying Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Feng Ling
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Yijuan Chen
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Rong Zhang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiangping Ren
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuguang Shi
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Song Guo
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ye Lu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jianmin Jiang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Jiang X, Wang Y, Zhang X, Pang B, Yao M, Tian X, Sang S. Factors Associated With Severe Fever With Thrombocytopenia Syndrome in Endemic Areas of China. Front Public Health 2022; 10:844220. [PMID: 35284401 PMCID: PMC8907623 DOI: 10.3389/fpubh.2022.844220] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Objective To explore the influence of climatic, environmental and socioeconomic factors on SFTS occurrence in Shandong Province, China. Methods We used generalized additive model to estimate the association between SFTS cases and climatic factors, environmental factors and socioeconomic factors, including annual average temperature, precipitation, land cover, normalized difference vegetation index, altitude, population density, meat production, milk production, and gross domestic product (GDP). Results There were a total of 4,830 cases reported in 100 (70.9%) counties and districts in Shandong Province from 2010 to 2020. The results showed that the annual average temperature, precipitation, forest and grassland coverage rate, altitude and meat production (square root transform) had a reversed “V” relationship with SFTS occurrence, with the inflection points around 12.5–13.0°C in temperature, around 650 mm in precipitation, around 0.3 in forest and grassland coverage rate, around 300 m in altitude, and around 200–300 tons in meat production (square root transform), respectively. SFTS occurrence had a “V” relationship with milk production (square root transform) and GDP (square root transform), with the inflection points around 100–200 tons in milk production (square root transform), and around 150,000–200,000 yuan in GDP (square root transform), respectively. Conclusions Climatic, environmental, and socioeconomic factors contributed to the heterogeneous distribution of SFTS in Shandong Province, and the influence of these factors on SFTS occurrence was nonlinear.
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Affiliation(s)
- Xiaolin Jiang
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
- Shandong Key Laboratory of Infectious Diseases, Jinan, China
| | - Yiguan Wang
- Ashworth Laboratories, Institute of Evolutionary Biology, University of Edinburgh, Edinburgh, United Kingdom
| | - Xiaomei Zhang
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
- Shandong Key Laboratory of Infectious Diseases, Jinan, China
| | - Bo Pang
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
- Shandong Key Laboratory of Infectious Diseases, Jinan, China
| | - Mingxiao Yao
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
- Shandong Key Laboratory of Infectious Diseases, Jinan, China
| | - Xueying Tian
- Shandong Provincial Center for Disease Control and Prevention, Jinan, China
- Shandong Key Laboratory of Infectious Diseases, Jinan, China
| | - Shaowei Sang
- Clinical Epidemiology Unit, Qilu Hospital of Shandong University, Jinan, China
- Clinical Research Center of Shandong University, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Shaowei Sang
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Chen S, Xu M, Wu X, Bai Y, Shi J, Zhou M, Wu Q, Tang S, Deng F, Qin B, Shen S. A new luciferase immunoprecipitation system assay provided serological evidence for missed diagnosis of severe fever with thrombocytopenia syndrome. Virol Sin 2022; 37:107-114. [PMID: 35234635 PMCID: PMC8922417 DOI: 10.1016/j.virs.2022.01.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/12/2021] [Indexed: 11/19/2022] Open
Affiliation(s)
- Shengyao Chen
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China; University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Minjun Xu
- Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, China
| | - Xiaoli Wu
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Yuan Bai
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Junming Shi
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Min Zhou
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Qiaoli Wu
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Shuang Tang
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Fei Deng
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
| | - Bo Qin
- Shaoxing Women and Children's Hospital, No. 305 East Street Road, Shaoxing, 312000, China; Shaoxing People's Hospital, Zhejiang University School of Medicine, Shaoxing, 312000, China.
| | - Shu Shen
- State Key Laboratory of Virology and National Virus Resource Center, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
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Zhao J, Lu QB, Li H, Yuan Y, Cui N, Yuan C, Zhang XA, Yang ZD, Ruan SM, Liu LZ, Du J, Fang LQ, Liu W. Sex Differences in Case Fatality Rate of Patients With Severe Fever With Thrombocytopenia Syndrome. Front Microbiol 2021; 12:738808. [PMID: 34721338 PMCID: PMC8552034 DOI: 10.3389/fmicb.2021.738808] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Accepted: 09/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne disease with high mortality. However, detailed analysis is lacking to explore the complex effect of sex with age or comorbidities. Methods: A retrospective cohort study was performed among 2,938 SFTS patients entered during 2011-2020 in Xinyang, China. The case fatality rate (CFR) was estimated for their association with sex, age, and comorbidities by an interactive way. The difference of immune response between sex was explored in an age dependent way. Results: An overall CFR of 15.3% (450/2,938) was obtained, which appeared to be higher in males than in females [17.7% vs. 13.6%, adjusted odds ratio (aOR) = 1.24; 95% CI, 1.00-1.53; P = 0.048] and increased dramatically with age (P < 0.001). The associations between sex and SFTS fatal outcome were age-dependent and varied according to the status of comorbidities. The mortality-related risk conferred by older age was more pronounced in males, with aOR (95% CI) to be 5.76 (3.75-8.84) vs. 5.30 (3.54-7.95) in female. Sex-stratified analysis disclosed significant associations between death and comorbidities among female patients (aOR = 1.87, 95% CI: 1.40-2.49; P < 0.001), while none among males. Among females, the significant associations between presence of comorbidity and fatal outcome differed among age groups, with aOR (95% CI) decreased from 2.28 (1.16-4.46) in ≤60 years, to 2.06 (1.34-3.18) in 60-70 years and further to 1.55 (0.97-2.47) in >70 years. Altogether 194 SFTS patients were randomly selected for the test of B cells, natural killer (NK) cells, CD4 cells percentages, and anti-SFTSV IgM antibody level, the results revealed that males >60 years had significantly decreased percentages of B cells, CD4 cells, lower anti-SFTSV IgM antibody titer, and increased level of NK cells than male aged ≤60 years, while none of these age specific differences was observed in the females. This finding underlies the more pronounced age specific difference in CFR among male than female. Conclusions: Males had a significantly higher mortality of SFTS than did females, and more likely to be affected by aging for SFTS mortality. This difference can be explained by the effect from comorbidities and the host immunity. It is essential to take a sex- and age-based approach to SFTS treatment and management.
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Affiliation(s)
- Jing Zhao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Qing-Bin Lu
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Yang Yuan
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Ning Cui
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, China
| | - Chun Yuan
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Zhen-Dong Yang
- The 990th Hospital of Joint Logistic Support Force of Chinese People's Liberation Army, Xinyang, China
| | - Shi-Man Ruan
- Jinan Center for Disease Control and Prevention, Jinan, China
| | - Lan-Zheng Liu
- Jinan Center for Disease Control and Prevention, Jinan, China
| | - Juan Du
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Li-Qun Fang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China.,Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing, China
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Wang B, He Z, Yi Z, Yuan C, Suo W, Pei S, Li Y, Ma H, Wang H, Xu B, Guo W, Huang X. Application of a decision tree model in the early identification of severe patients with severe fever with thrombocytopenia syndrome. PLoS One 2021; 16:e0255033. [PMID: 34329338 PMCID: PMC8324211 DOI: 10.1371/journal.pone.0255033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 07/08/2021] [Indexed: 12/04/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a serious infectious disease with a fatality of up to 30%. To identify the severity of SFTS precisely and quickly is important in clinical practice. Methods From June to July 2020, 71 patients admitted to the Infectious Department of Joint Logistics Support Force No. 990 Hospital were enrolled in this study. The most frequently observed symptoms and laboratory parameters on admission were collected by investigating patients’ electronic records. Decision trees were built to identify the severity of SFTS. Accuracy and Youden’s index were calculated to evaluate the identification capacity of the models. Results Clinical characteristics, including body temperature (p = 0.011), the size of the lymphadenectasis (p = 0.021), and cough (p = 0.017), and neurologic symptoms, including lassitude (p<0.001), limb tremor (p<0.001), hypersomnia (p = 0.009), coma (p = 0.018) and dysphoria (p = 0.008), were significantly different between the mild and severe groups. As for laboratory parameters, PLT (p = 0.006), AST (p<0.001), LDH (p<0.001), and CK (p = 0.003) were significantly different between the mild and severe groups of SFTS patients. A decision tree based on laboratory parameters and one based on demographic and clinical characteristics were built. Comparing with the decision tree based on demographic and clinical characteristics, the decision tree based on laboratory parameters had a stronger prediction capacity because of its higher accuracy and Youden’s index. Conclusion Decision trees can be applied to predict the severity of SFTS.
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Affiliation(s)
- Bohao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhiquan He
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Zhijie Yi
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Chun Yuan
- Joint Logistics Support Force NO.990 Hospital, Xinyang, China
| | - Wenshuai Suo
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shujun Pei
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Hongxia Ma
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Haifeng Wang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bianli Xu
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Wanshen Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xueyong Huang
- College of Public Health, Zhengzhou University, Zhengzhou, China
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
- * E-mail:
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10
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Epidemiological Characteristics of Severe Fever with Thrombocytopenia Syndrome from 2010 to 2019 in Mainland China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063092. [PMID: 33802869 PMCID: PMC8002760 DOI: 10.3390/ijerph18063092] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 11/20/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease and that is a severe threat to public health considering its high fatality and person-to-person transmission. In order to obtain an updated and deep understanding of the epidemiological characteristics of SFTS in mainland China, we used Pearson’s chi-squared test to compare the fatality rate and demographic characteristics in different groups. Data were analyzed in R3.6.1 (R Development Core Team 2018), while the visualization was performed in ArcGIS 10 (ESRI, Redlands, CA, USA), and the statistical significance was set at p < 0.05. A total of 13,824 SFTS cases involving 8899 lab-confirmed cases and 4925 probable cases were reported and included in the epidemiological analysis. Our study found that the number of SFTS cases showed an increasing trend with a small decrease in the past three years. The laboratory-confirmed rate was about 64.4%, which varied between different years and areas. Although most cases (99.3%) were distributed in 7 provinces (Henan, Shandong, Anhui, Hubei, Liaoning, Zhejiang, and Jiangsu), the regional distribution of SFTS gradually expanded from 5 provinces in 2010 to 25 provinces by 2019, especially at the town level. The SFTS cases were mainly sporadic. A total of 96.5% occurred from April to October, and 93.3% of cases were concentrated in middle-aged and elderly people (40–84 years old). Farmers were the main high-risk population. Female cases were slightly more than male cases; however, there were differences between different provinces. The mortality rate showed an increasing trend with age. Overall, the SFTS cases were mainly middle-aged and elderly farmers that sporadically distributed throughout seven provinces with a spatially expanding trend. The laboratory-confirmed rate varied in different years and provinces, which implied that the diagnosis and report criteria for SFTS should be further updated and unified in order to get a better understanding of its epidemiological characteristics and provide scientific data for SFTS control.
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11
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Sun JM, Wu HX, Lu L, Liu Y, Mao ZY, Ren JP, Yao WW, Qu HH, Liu QY. Factors associated with spatial distribution of severe fever with thrombocytopenia syndrome. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 750:141522. [PMID: 32846249 DOI: 10.1016/j.scitotenv.2020.141522] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 06/11/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) was firstly identified in mainland China in 2009 and the geographic distribution has expanded in recent years. In this study, we constructed ecological niche models (ENM) of SFTS with meteorological factors, environmental factor, and density of domestic animals using MaxEnt. We found four significant associated factors including altitude, yearly average temperature, yearly accumulated precipitation, and yearly average relative humidity which accounted for 94.1% percent contribution. SFTS occurrence probability was high when altitude was between -100 m and 100 m, and the probability was nearly 0 when altitude was beyond 3000 m. Response curves of SFTS to the yearly average temperature, yearly accumulated precipitation, and yearly average relative humidity were all reversed V-shape. SFTS occurrence probability was high where the yearly average temperature, yearly accumulated precipitation, and yearly relative humidity were 12.5-17.5 °C, 700-2250 mm and 63-82%, respectively. ENMs predicted that the potential high-risk areas were mainly distributed in eastern areas and central areas of China. But there were some predicted potential high-risk areas where no SFTS case was reported up to date. More researches should be done to make clear whether SFTS case had occurred in these areas.
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Affiliation(s)
- Ji-Min Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Hai-Xia Wu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China
| | - Ying Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | | | - Jiang-Ping Ren
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Wen-Wu Yao
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, China
| | - Hong-Hua Qu
- Qilu Hospital of Shandong University, China.
| | - Qi-Yong Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, China.
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12
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Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Hefei of Anhui Province: a population-based surveillance study from 2011 to 2018. Eur J Clin Microbiol Infect Dis 2020; 40:929-939. [DOI: 10.1007/s10096-020-04098-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 11/02/2020] [Indexed: 11/25/2022]
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13
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Du Y, Cheng N, Li Y, Wang H, You A, Su J, Nie Y, Ma H, Xu B, Huang X. Seroprevalance of antibodies specific for severe fever with thrombocytopenia syndrome virus and the discovery of asymptomatic infections in Henan Province, China. PLoS Negl Trop Dis 2019; 13:e0007242. [PMID: 31765376 PMCID: PMC6901261 DOI: 10.1371/journal.pntd.0007242] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2019] [Revised: 12/09/2019] [Accepted: 10/04/2019] [Indexed: 12/03/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a severe emerging disease caused by SFTS virus (SFTSV), and the geographical distribution of SFTS has been increasing throughout China in recent years. To assess SFTSV-specific antibody seroprevalence, a cross-sectional study was conducted for healthy people in high SFTS endemic areas of Henan province in 2016. Methods This study used a stratified random sampling method to select 14 natural villages as the investigation sites. From April to May 2016, participants completed a questionnaire survey and serum samples were collected. All serum samples were subjected to ELISA to detect SFTSV-specific IgM and IgG. All IgM-positive samples were further tested by real-time RT-PCR, and isolation of virus from serum was attempted. Any participant who was IgM-positive was followed up with a month later to confirm health status. Results In total, 1463 healthy people participated in this study. The average seropositive rates for SFTSV-specific IgG and IgM were 10.46% (153/1463) and 0.82% (12/1463), respectively. IgM was detected in 12 individuals, and SFTSV RNA was detected in six of them. Virus was isolated from five of the six SFTSV RNA-positive individuals, and phylogenetic analyses revealed that all five isolates belonged to SFTSV group A. No IgM-positive participants exhibited any symptoms or other signs of illness at the one-month follow up. Conclusions This study identified a relatively high incidence of SFTSV-specific antibody seropositivity in healthy people in Xinyang city. Moreover, our data provide the first evidence for asymptomatic SFTSV infections, which may have significant implications for SFTS outbreak control. Severe fever with thrombocytopenia syndrome (SFTS) is a severe emerging infectious disease caused by SFTS virus (SFTSV) that was first discovered in rural areas of China. Henan province has had the largest number of SFTS cases in China every year since the disease was discovered, however, seropositivity for SFTSV-specific antibodies in healthy people in this region is still not clear. To address this issue, a cross-sectional survey was performed in high endemic areas from April to May 2016. The results showed that SFTSV seroprevalence was relatively high and possibly increasing. Notably, SFTSV RNA, as well as virus itself, was isolated from specimens obtained from healthy people. This study confirmed there are asymptomatic SFTSV infections in humans, and it is the first to report SFTSV isolation from healthy people.
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Affiliation(s)
- Yanhua Du
- Henan Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Ningning Cheng
- Kaifeng Center for Disease Control and Prevention, Kaifeng, China
| | - Yi Li
- Henan Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Haifeng Wang
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Aiguo You
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Jia Su
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Yifei Nie
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Hongxia Ma
- Henan Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Bianli Xu
- Henan Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
- * E-mail: (BX); (XH)
| | - Xueyong Huang
- Henan Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
- Henan Collaborative Innovation Center of Molecular Diagnosis and Laboratory Medicine, Xinxiang, China
- * E-mail: (BX); (XH)
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14
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Wang L, Wan G, Shen Y, Zhao Z, Lin L, Zhang W, Song R, Tian D, Wen J, Zhao Y, Yu X, Liu L, Feng Y, Liu Y, Qiang C, Duan J, Ma Y, Liu Y, Liu Y, Chen C, Ge Z, Li X, Chen Z, Fan T, Li W. A nomogram to predict mortality in patients with severe fever with thrombocytopenia syndrome at the early stage-A multicenter study in China. PLoS Negl Trop Dis 2019; 13:e0007829. [PMID: 31765414 PMCID: PMC6934327 DOI: 10.1371/journal.pntd.0007829] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 12/27/2019] [Accepted: 10/04/2019] [Indexed: 12/26/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) caused by the SFTS virus is an emerging infectious disease that was first identified in the rural areas of China in 2011. Severe cases often result in death due to multiple organ failure. To date, there are still numerous problems remain unresolved in SFTS, including unclear pathogenesis, lack of specific treatment, and no effective vaccines available. Aim To analyze the clinical information of patients with early-stage SFTS and to establish a nomogram for the mortality risk. Methods Between April 2011 and December 2018, data on consecutive patients who were diagnosed with SFTS were prospectively collected from five medical centers distributed in central and northeastern China. Multivariable Cox analyses were used to identify the factors independently associated with mortality. A nomogram for mortality was established using those factors. Results During the study period, 429 consecutive patients were diagnosed with SFTS at the early stage of the disease (within 7 days of fever), among whom 69 (16.1%) died within 28 days. The multivariable Cox proportional hazard regression analysis showed that low lymphocyte percentage, early-stage encephalopathy, and elevated concentration of serum LDH and BUN were independent risk factors for fatal outcomes. Received-operating characteristic curves for 7-, 14-, and 28-days survival had AUCs of 0.944 (95% CI: 0.920–0.968), 0.924 (95% CI: 0.896–0.953), and 0.924 (95% CI: 0.895–0.952), respectively. Among low-risk patients, 6 patients died (2.2%). Among moderate-risk patients, 25 patients died (24.0%, hazard ratio (HR) = 11.957). Among high-risk patients, the mortality rate was 69.1% (HR = 57.768). Conclusion We established a simple and practical clinical scoring system, through which we can identify critically ill patients and provide intensive medical intervention for patients as soon as possible to reduce mortality. We established a SFTS nomogram scoring system, which is the first nomogram for this disease. According to this nomogram, patients were divided into three levels of mortality risk: low, moderate, and high. This scoring system is helpful to identify critically ill patients, allowing for early intervention and intensive care, which may contribute to reducing the mortality of SFTS.
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Affiliation(s)
- Lin Wang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Gang Wan
- Statistics Room, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yi Shen
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Zhenghua Zhao
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Ling Lin
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Wei Zhang
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Rui Song
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Di Tian
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jing Wen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yongxiang Zhao
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Xiaoli Yu
- Department of Infectious Diseases, Dandong Infectious Disease Hospital, Dandong, China
| | - Li Liu
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Yang Feng
- Department of Infectious Disease, Taian City Central Hospital, Taian, China
| | - Yuanni Liu
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Chunqian Qiang
- Department of Infectious Disease, Yantai City Hospital for Infectious Disease, Yantai, China
| | - Jianping Duan
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Yanli Ma
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Ying Liu
- Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yanan Liu
- Clinical Laboratory, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Chong Chen
- Graduate School of Capital Medical University, Beijing, China
| | - Ziruo Ge
- Graduate School of Capital Medical University, Beijing, China
| | - Xingwang Li
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhihai Chen
- Center of Infectious Disease, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Tianli Fan
- Department of Infectious Disease, Qing Dao No. 6 People's Hospital, Qingdao, China
| | - Wei Li
- Interventional Therapy Oncology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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15
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Gong L, Wang J, Zhang Y, Zhang L, Lyu Y, Ma W, Gao W, Chen W, Zhou Y, Wu J, Su B. Socioeconomic burden of severe fever with thrombocytopenia syndrome in endemic areas of Anhui Province, eastern China. Zoonoses Public Health 2019; 66:879-885. [PMID: 31334609 DOI: 10.1111/zph.12634] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 06/18/2019] [Accepted: 06/29/2019] [Indexed: 01/30/2023]
Abstract
Understanding the socioeconomic burden of severe fever with thrombocytopenia syndrome (SFTS) is important for making decisions on health resources allocation. This study aimed to assess the economic burden of patients with this syndrome in endemic areas of the Anhui Province in 2018. A total of 114 patients were recruited, and the median age was 63.5 years, 62 (54.4%) were female, 97 (85.1%) were farmers, 108 (94.7%) were survival patients, and 71 (62.3%) had a family monthly income less than $453.3. The median times of hospital visits and hospitalizations of patients were three times, and the median lost work days of these patients, caregivers and visitors were 14.5 days, 14.5 days and 7.5 days, respectively. The median direct costs of the patient were $3,761.6, and the median indirect costs were $508.3. Taking direct and indirect costs into consideration, the median total economic costs of patients were $4,323.9, and the total annual cost of 2018 was $1,396,913.6. Although 113 (99.1%) patients had medical insurance, only 25.8% of costs were covered by reimbursement, and the total cost paid for by the patients and their families was $1,041,073.6 in 2018. Our findings revealed that the patients and their families had a significant economic burden, and preventive measures should be strengthened in endemic areas. The findings also provided baseline data for assessing the cost-effectiveness of the vaccines or anti-viral drugs in the near future in China.
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Affiliation(s)
- Lei Gong
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Jinsheng Wang
- Anqing Municipal Center for Disease Control and Prevention, Anqing, China
| | - Yong Zhang
- Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Lei Zhang
- Hefei Municipal Center for Disease Control and Prevention, Hefei, China
| | - Yong Lyu
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Wanwan Ma
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Weilin Gao
- Anqing Municipal Center for Disease Control and Prevention, Anqing, China
| | - Weiguo Chen
- Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Yu Zhou
- Lu'an Municipal Center for Disease Control and Prevention, Lu'an, China
| | - Jiabing Wu
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Bin Su
- Anhui Provincial Center for Disease Control and Prevention, Hefei, China
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16
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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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Miyamoto S, Ito T, Terada S, Eguchi T, Furubeppu H, Kawamura H, Yasuda T, Kakihana Y. Fulminant myocarditis associated with severe fever with thrombocytopenia syndrome: a case report. BMC Infect Dis 2019; 19:266. [PMID: 30885147 PMCID: PMC6423866 DOI: 10.1186/s12879-019-3904-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 03/13/2019] [Indexed: 01/08/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral infectious disease with high mortality. It causes multiple organ dysfunction; however, myocarditis has never been reported as a complication with SFTS. Case presentation A 62-year-old previously healthy woman developed fever, fatigue, diarrhea, and a mild consciousness disorder. She visited a local clinic, and laboratory data showed leukocytopenia, thrombocytopenia, and elevation of the aspartate aminotransferase level. She was transferred to Kagoshima University Hospital and diagnosed as having SFTS by real-time reverse transcription polymerase chain reaction. Subsequently, her blood pressure gradually decreased despite fluid resuscitation and vasopressor administration. Based on elevated toroponin I levels in serum, a transient diffuse left ventricular hypokinesis and wall thickening in echocardiography, diffuse ST elevation in electrocardiography, and exclusion of other heart diseases, she was diagnosed as having fulminant myocarditis. After hemodynamic support with inotropic agents, she recovered near normal cardiac function. She was discharged to home on day 28. Conclusions We report the first case of fulminant myocarditis associated with SFTS.
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Affiliation(s)
- Shotaro Miyamoto
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.
| | - Takashi Ito
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Shinsaku Terada
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tomohiro Eguchi
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hiroaki Furubeppu
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Hideki Kawamura
- Department of Infection Control and Prevention, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Tomotsugu Yasuda
- Division of Intensive Care Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
| | - Yasuyuki Kakihana
- Emergency and Intensive Care Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan.,Division of Intensive Care Medicine, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima, 890-8544, Japan
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