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Gong L, Zhang Y, Wang J, Xiong Y, Wang J, Wu J, Chen F, Zhu M, Cheng D, Jiang X. Evaluation of a community intervention program on knowledge, attitudes, and practices regarding severe fever with thrombocytopenia syndrome in Anhui Province, China. Front Public Health 2022; 10:891700. [PMID: 36388366 PMCID: PMC9659599 DOI: 10.3389/fpubh.2022.891700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Accepted: 10/13/2022] [Indexed: 01/21/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is a novel infectious disease with no specific therapeutics and vaccines. We hypothesize that health education in vulnerable people would ameliorate their knowledge, attitudes and practices (KAP) regarding SFTS and reduce its prevalence. Methods A four-stage cluster cross-section study in sixteen community units was performed. Sixteen groups were allocated to the intervention or control groups. A 6 months education program was administrated. The primary outcome was KAP scores 6 months after intervention. Predictors of KAP score changes were also analyzed. Results Eight hundred and fifteen valid questionnaires pre-intervention and 767 ones post-intervention were retreated. No significant differences were found in demographic characteristics and KAP scores before intervention. A significant improvement in KAP score (16.8 ± 4.7 vs. 22.0 ± 4.2, p < 0.001) in the intervention group was observed compare with the controls. Educational level and intervention program were the common predictors of KAP score changes. Conclusions Education improved KAP scores in SFTS vulnerable people which may contribute to the control of the disease.
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Affiliation(s)
- Lei Gong
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Yong Zhang
- Department of Acute Infectious Disease Prevention and Control, Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Jinsheng Wang
- Department of Acute Infectious Disease Prevention and Control, Anqing Municipal Center for Disease Control and Prevention, Anqing, China
| | - Yingying Xiong
- Department of Pediatrics, Affiliated First Hospital, University of Science and Technology of China (USTC), Hefei, China
| | - Jiling Wang
- Department of Respiratory and Critical Medicine, The Second People's Hospital of Hefei, Hefei, China
| | - Jiabing Wu
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Fang Chen
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Meng Zhu
- Department of Acute Infectious Disease Prevention and Control, Anhui Provincial Center for Disease Control and Prevention, Hefei, China
| | - Donglin Cheng
- Department of Acute Infectious Disease Prevention and Control, Chuzhou Municipal Center for Disease Control and Prevention, Chuzhou, China
| | - Xuqin Jiang
- Department of Respiratory and Critical Medicine, Affiliated First Hospital, USTC, Hefei, China,*Correspondence: Xuqin Jiang
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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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He Z, Wang B, Li Y, Hu K, Yi Z, Ma H, Li X, Guo W, Xu B, Huang X. Changes in peripheral blood cytokines in patients with severe fever with thrombocytopenia syndrome. J Med Virol 2021; 93:4704-4713. [PMID: 33590892 PMCID: PMC8360139 DOI: 10.1002/jmv.26877] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 02/03/2021] [Accepted: 02/12/2021] [Indexed: 12/11/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is recognized as an emerging infectious disease. This study aimed to investigate the pathogenic mechanism of SFTS. A total of 100 subjects were randomly included in the study. Cytokine levels were detected by enzyme‐linked immunosorbent assay and the viral load was detected by micro drop digital PCR. The results showed that levels of interleukin‐6 (IL‐6), IL‐8, IL‐10, IFN‐inducible protein‐10 (IP‐10), monocyte chemoattractant protein‐1 (MCP‐1), macrophage inflammatory protein‐1α (MIP‐1α), transforming growth factor‐β1 (TGF‐β1), and regulated upon activation normal T cell expressed and secreted factor (RANTES) differed significantly among the SFTS patient group, healthy people group, and asymptomatic infection group (p < .05). Compared to the healthy people group, the patient group had increased cytokine levels (IL‐6, IL‐10, IP‐10, MCP‐1, and IFN‐γ) but reduced levels of IL‐8, TGF‐β1, and RANTES (p < .0167). IL‐6, IL‐8, IL‐10, IP‐10, MCP‐1, MIP‐1α, TGF‐β1, and the RANTES levels had different trends after the onset of the disease. IL‐6, IL‐10, IP‐10, and MCP‐1 levels in severe patients were higher than those in mild patients (p < .05). There was a positive correlation between viral load and IL‐6 and IP‐10 but a negative correlation between viral load and RANTES. SFTSV could cause a cytokine change: the cytokine levels of patients had different degrees of fluctuation after the onset of the disease. The levels of IL‐6 and IL‐8 in the asymptomatic infection group were found between the SFTS patients group and the healthy people group. The levels of IL‐6, IL‐10, IP‐10, and MCP‐1 in the serum could reflect the severity of the disease, and the levels of IL‐6, IP‐10, and RANTES were correlated with the viral load.
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Affiliation(s)
- Zhiquan He
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bohao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Kai Hu
- Health Policy Research Center, Henan Academy of Medical Sciences, Zhengzhou, China
| | - Zhijie Yi
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongxia Ma
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xingle Li
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Wanshen Guo
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bianli Xu
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xueyong Huang
- Department of Infectious Disease Control and Prevention, Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Henan Province Center for Disease Control and Prevention, Zhengzhou, China
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4
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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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Huang XY, Du YH, Wang HF, You AG, Li Y, Su J, Nie YF, Ma HX, Xu BL. Prevalence of severe fever with thrombocytopenia syndrome virus in animals in Henan Province, China. Infect Dis Poverty 2019; 8:56. [PMID: 31230595 PMCID: PMC6589873 DOI: 10.1186/s40249-019-0569-x] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/10/2019] [Indexed: 01/28/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by severe fever with thrombocytopenia syndrome virus (SFTSV). SFTSV has been found in humans, ticks and animals, and SFTS has high mortality and increasing prevalence in East Asia. In the study, the samples (heart, liver, lung, kidney, spleen, brain tissue and serum) were collected from 374 domestic animals and 241 wild animals in Pingqiao District and Xinxian County of Xinyang in Henan Province, China. 275 (44.72%, 275/615) animals were positive for anti-SFTSV antibodies, the anti-SFTSV antibodies positive ratios of domestic and wild animals were 43.58% (163/374) and 46.47% (112/241), respectively. There was no significant difference in domestic and wild animals, but significant differences were detected among different species of animals (χ2 = 112.59, P < 0.0001). Among 615 animals, 105 (17.07%, 105/615) animals were positive for SFTSV RNA, and only one SFTSV strain was isolated from heart tissue of a yellow weasel. The phylogenetic analysis shows that the sequence from animals belonged to the same group with viral sequences obtained from humans. The animals maybe play a reservoir host in maintaining the life cycle of SFTSV in nature.
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Affiliation(s)
- Xue-Yong Huang
- Henan Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Yan-Hua Du
- Henan Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Hai-Feng Wang
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Ai-Guo You
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Yi Li
- Henan Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Jia Su
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Yi-Fei Nie
- Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Hong-Xia Ma
- Henan Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Bian-Li Xu
- Henan Center for Disease Control and Prevention, Zhengzhou, China. .,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China.
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Yang L, Zhao Z, Hou G, Zhang C, Liu J, Xu L, Li W, Tan Z, Tu C, He B. Genomes and seroprevalence of severe fever with thrombocytopenia syndrome virus and Nairobi sheep disease virus in Haemaphysalis longicornis ticks and goats in Hubei, China. Virology 2019; 529:234-245. [PMID: 30738361 PMCID: PMC7127444 DOI: 10.1016/j.virol.2019.01.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 01/20/2019] [Accepted: 01/29/2019] [Indexed: 11/18/2022]
Abstract
Ticks are medically-important arthropods that maintain and transmit numerous emerging viruses. China suffers severely from tick-borne viral diseases such as tick-borne encephalitis and severe fever with thrombocytopenia syndrome (SFTS), but the background of tick-borne viruses is very limited. Here we report the virome profiling of ticks and goat sera from SFTS-epidemic areas, and serological investigation of SFTS virus (SFTSV) and Nairobi sheep disease virus (NSDV). Results revealed divergent viruses in ticks and goat sera, including SFTSV and NSDV. Sequence and phylogenetic analyses showed that the SFTSV identified here was most closely related to human SFTSV in sampling and surrounding areas, and the NSDV to the previously identified NSDV from northeast China. Serological investigation of SFTSV infection in goats revealed intensive activity in those areas. Surprisingly, two different methods of NSDV serological investigation showed no sera positive for this virus.
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Affiliation(s)
- Ling'En Yang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China
| | - Zihan Zhao
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China
| | - Guobin Hou
- Animal Husbandry and Veterinary Service Center of Xiaolin Town, Suizhou, Hubei Province, China
| | - Chang Zhang
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China
| | - Jun Liu
- Centers for Animal Disease Control and Prevention of Suixian County, Suizhou, Hubei Province, China
| | - Lin Xu
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China
| | - Wei Li
- Animal Health Inspection Institute of Xiangyang, Xiangyang, Hubei Province, China
| | - Zhizhou Tan
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China
| | - Changchun Tu
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, Jiangsu Province, China
| | - Biao He
- Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Institute of Military Veterinary Medicine, Academy of Military Medical Sciences, Changchun, Jilin Province, China; Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou University, Yangzhou, Jiangsu Province, China
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Wang T, Li XL, Liu M, Song XJ, Zhang H, Wang YB, Tian BP, Xing XS, Li SY. Epidemiological Characteristics and Environmental Risk Factors of Severe Fever with Thrombocytopenia Syndrome in Hubei Province, China, from 2011 to 2016. Front Microbiol 2017; 8:387. [PMID: 28337190 PMCID: PMC5340758 DOI: 10.3389/fmicb.2017.00387] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 02/24/2017] [Indexed: 11/13/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease affecting hundreds of people in China each year. To better understand the epidemiological characteristics and environmental risk factors associated with the incidence of SFTS in Hubei Province, China, we conducted a retrospective epidemiological study and risk assessment of SFTS from 2011 to 2016. Although, the incidence and epidemic areas of SFTS are increasing, the fatality rate has decreased. Elderly farmers are the population most commonly infected with SFTS virus between May and July in the northeast Hubei Province, which seems to be consistent with local agricultural activities and the seasonal abundance of ticks. Spatial scanning showed that regions bordering with Xinyang City, Henan Province accounted for most of the SFTS cases in Hubei Province, and there was a significant association of SFTS incidence with temporal changes in the climate within these clusters. Multivariate modeling analysis identified density of cattle, rain-fed cropland, built-up land, temperature, and relative humidity as independent risk factors for the distribution of SFTS. Future epidemiological and serological studies are warranted to elucidate the dynamics and immunity patterns of local SFTS disease and to optimize interventions.
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Affiliation(s)
- Tang Wang
- School of Health Sciences, Wuhan University Wuhan, China
| | - Xin-Lou Li
- Center for Disease Control and Prevention of Aerospace System Beijing, China
| | - Man Liu
- Hubei Provincial Center for Disease Control and Prevention Wuhan, China
| | - Xiao-Jia Song
- Shiyan Center for Disease Control and Prevention Shiyan, China
| | - Hao Zhang
- Yichang Center for Disease Control and Prevention Yichang, China
| | - Yu-Bin Wang
- Center for Disease Control and Prevention of Aerospace System Beijing, China
| | - Bao-Pin Tian
- Center for Disease Control and Prevention of Aerospace System Beijing, China
| | - Xue-Sen Xing
- Hubei Provincial Center for Disease Control and Prevention Wuhan, China
| | - Shi-Yue Li
- School of Health Sciences, Wuhan University Wuhan, China
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8
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Wang L, Zou Z, Hou C, Liu X, Jiang F, Yu H. Score risk model for predicting severe fever with thrombocytopenia syndrome mortality. BMC Infect Dis 2017; 17:42. [PMID: 28061758 PMCID: PMC5219703 DOI: 10.1186/s12879-016-2111-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/10/2016] [Indexed: 02/02/2023] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease with high mortality in East Aisa, especially in China. To predict the prognosis of SFTS precisely is important in clinical practice. Methods From May 2013 to November 2015, 233 suspected SFTS patients were tested for SFTS virus using RT-PCR. Cox regression model was utilized to comfirm independent risk factors for mortality. A risk score model for mortality was constructed based on regression coefficient of risk factors. Log-rank test was used to evaluate the significance of this model. Results One hundred seventy-four patients were confirmed with SFTS, of which 40 patients died (23%). Baseline age, serum aspartate aminotransferase (AST) and serum creatinine (sCr) level were independent risk factors of mortality. The area under ROC curve (AUCs) of these parameters for predicting death were 0.771, 0.797 and 0.764, respectively. And hazard ratio (HR) were 1.128, 1.002 and 1.013, respectively. The cutoff value of the risk model was 10. AUC of the model for predicting mortality was 0.892, with sensitivity and specificity of 82.5 and 86.6%, respectively. Log-rank test indicated strong statistical significance (×2 = 88.35, p < 0.001). Conclusions This risk score model may be helpful to predicting the prognosis of SFTS patients.
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Affiliation(s)
- Li Wang
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China.
| | - Zhiqiang Zou
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Chunguo Hou
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Xiangzhong Liu
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Fen Jiang
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
| | - Hong Yu
- Infectious Disease Hospital of Yantai, 62 Huanshan Road, Zhifu district, Yantai, Shandong, 264001, China
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9
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Lv Q, Zhang H, Tian L, Zhang R, Zhang Z, Li J, Tong Y, Fan H, Carr MJ, Shi W. Novel sub-lineages, recombinants and reassortants of severe fever with thrombocytopenia syndrome virus. Ticks Tick Borne Dis 2017; 8:385-390. [PMID: 28117273 DOI: 10.1016/j.ttbdis.2016.12.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/29/2016] [Accepted: 12/29/2016] [Indexed: 11/30/2022]
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) has been continuously circulating in Eastern Asia in recent years, without the availability of effective vaccines or antiviral drugs, posing a serious threat to public health, particularly in the central-eastern provinces of China. In this study, we isolated and sequenced four new SFTSV strains from Shandong Province identified in 2015. Phylogenetic analysis, with all publicly available L, M and S gene segments, revealed that the four newly described SFTSV strains belonged to genotype C3. In addition, our phylogenetic analyses also identified two potentially novel sub-lineages of SFTSV, tentatively named C6 and J4. Our comprehensive analysis revealed twenty recombination events in fourteen SFTSV genomes and recombination events were found in the S gene segment for the first time. A total of twenty-six strains were probable SFTSV reassortants, including sixteen which were previously unidentified. We further characterised the genetic constellation of these putative reassortants and classified them into twelve different reassortment forms. Our study revealed multiple evolutionary forces acting on SFTSV, responsible for the increasing genetic diversity of this agent, which could potentially alter the antigenicity and pathogenicity of the virus. This calls for an urgent need for intensified surveillance and the development of vaccines and antiviral drugs against this high-consequence pathogen.
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Affiliation(s)
- Qiang Lv
- Institute of Pathogen Biology, Taishan Medical College, Taian, Shandong 271000, China
| | - Hong Zhang
- The Affiliated Hospital of Taishan Medical University, Taian, Shandong 271000, China
| | - Lei Tian
- The 88 Hospital of The Chinese People's Liberation Army, Taian, Shandong 271000, China
| | - Ruiling Zhang
- Institute of Pathogen Biology, Taishan Medical College, Taian, Shandong 271000, China
| | - Zhenjie Zhang
- Institute of Pathogen Biology, Taishan Medical College, Taian, Shandong 271000, China
| | - Juan Li
- Institute of Pathogen Biology, Taishan Medical College, Taian, Shandong 271000, China
| | - Yigang Tong
- Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Hang Fan
- Beijing Institute of Microbiology and Epidemiology, Beijing 100071, China
| | - Michael J Carr
- Global Station for Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo 001-0020, Japan; National Virus Reference Laboratory, University College Dublin, Belfield, Dublin 4, Ireland
| | - Weifeng Shi
- Institute of Pathogen Biology, Taishan Medical College, Taian, Shandong 271000, China.
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10
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Liu K, Zhou H, Sun RX, Yao HW, Li Y, Wang LP, Di Mu, Li XL, Yang Y, Gray GC, Cui N, Yin WW, Fang LQ, Yu HJ, Cao WC. A national assessment of the epidemiology of severe fever with thrombocytopenia syndrome, China. Sci Rep 2015; 5:9679. [PMID: 25902910 PMCID: PMC4407178 DOI: 10.1038/srep09679] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 03/12/2015] [Indexed: 01/18/2023] Open
Abstract
First discovered in rural areas of middle-eastern China in 2009, severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis affecting hundreds of cases reported in China each year. Using the national surveillance data from 2010 to 2013, we conducted this retrospective epidemiological study and risk assessment of SFTS in China. We found that the incidence of SFTS and its epidemic areas are continuing to grow, but the case fatality rate (CFR) has steadily decreased. SFTS most commonly affected elderly farmers who acquired infection between May and July in middle-eastern China. However, other epidemiological characteristics such as incidence, sex ratio, CFR, and seasonality differ substantially across the affected provinces, which seem to be consistent with local agricultural activities and the seasonal abundance of ticks. Spatial scan statistics detected three hot spots of SFTS that accounted for 69.1% of SFTS cases in China. There was a strong association of SFTS incidence with temporal changes in the climate within the clusters. Multivariate modeling identified climate conditions, elevation, forest coverage, cattle density, and the presence of Haemaphysalis longicornis ticks as independent risk factors in the distribution of SFTS, based on which a predicted risk map of the disease was derived.
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Affiliation(s)
- Kun Liu
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Hang Zhou
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Ruo-Xi Sun
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China.,Anhui Medical University, Hefei, 230032, P. R. China
| | - Hong-Wu Yao
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Yu Li
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Li-Ping Wang
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Di Mu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Xin-Lou Li
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Yang Yang
- Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 32311, Florida, USA
| | - Gregory C Gray
- Duke University School of Medicine, Durham, 27710, North Carolina, USA
| | - Ning Cui
- The 154 Hospital, People's Liberation Army, Xinyang, 464000, P.R. China
| | - Wen-Wu Yin
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Li-Qun Fang
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
| | - Hong-Jie Yu
- Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing 102206, P. R. China
| | - Wu-Chun Cao
- The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, P. R. China
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11
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Hu C, Guo C, Yang Z, Wang L, Hu J, Qin S, Cui N, Peng W, Liu K, Liu W, Cao W. The severe fever with thrombocytopenia syndrome bunyavirus (SFTSV) antibody in a highly endemic region from 2011 to 2013: a comparative serological study. Am J Trop Med Hyg 2015; 92:479-81. [PMID: 25624404 DOI: 10.4269/ajtmh.14-0447] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
A seropositive rate of 6.59% was determined in the highly endemic region for severe fever with thrombocytopenia syndrome. A significant correlation was observed between case incidence and seroprevalence on temporal and geographic levels. Seroprevalence was comparable in the last 3 years, indicating a stable and ongoing circulation of the infection.
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Affiliation(s)
- Chunyan Hu
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Chentao Guo
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Zhendong Yang
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Liyuan Wang
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Jiangong Hu
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Shuli Qin
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Ning Cui
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Wei Peng
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Kun Liu
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Wei Liu
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
| | - Wuchun Cao
- Graduate School of Anhui Medical University, Hefei, Anhui, China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; The 154 Hospital, Xinyang, Henan, China; The Shangcheng People's Hospital, Xinyang, Henan, China
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12
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Discrimination of novel bunyavirus infection using routine laboratory test. Clin Microbiol Infect 2014; 21:204.e1-7. [PMID: 25658566 DOI: 10.1016/j.cmi.2014.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2014] [Revised: 05/25/2014] [Accepted: 07/17/2014] [Indexed: 10/24/2022]
Abstract
The wide epidemic and high case fatality rate have made severe fever with thrombocytopenia syndrome (SFTS) a significant public health problem. The diagnosis and discrimination of SFTS virus (SFTSV) infection at an early stage of the disease is important for treatment choice. A prospective study was performed in an SFTS reference hospital during 2011-2013. Suspected SFTS patients were recruited and prospectively observed. Comparison between SFTSV-positive and -negative patients was made to identify the parameters that were related to positive detection by discriminant and classification tree analysis. A total of 538 SFTSV-positive and 396 negative patients were recruited and observed. Multiple logistic regression models demonstrated the significant parameters associated with positive detection, including decreased platelet counts and elevated aspartate aminotransferase (AST) level during the first stage (1∼4 days), decreased white blood cell and platelet counts, elevated creatine kinase (CK) and AST levels during the second stage (5∼7 days), and older age, decreased consciousness and elevated CK and AST during the third stage (8-11 days). The classification trees disclosed that the significant predictors for positive SFTSV detection were AST >50.6 U/L and AST/alanine transaminase (ALT) >1.3 at the first stage, CK >257 U/L or 57.7 U/L < CK ≤98.5 U/L with AST/ALT >1.6 at the second stage, as well as CK >630.7 U/L or 114.3 U/L < CK ≤630.7 U/L with decreased consciousness at the third stage. In making the clinically probable diagnosis of SFTS, the supplementation of AST and CK evaluations might remarkably improve the diagnostic capacity of routine laboratory tests, while the leukopenia is of limited use.
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