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Wang W, Wang Z, Chen Z, Liang M, Zhang A, Sheng H, Ni M, Yang J. Construction of an early differentiation diagnosis model for patients with severe fever with thrombocytopenia syndrome and hemorrhagic fever with renal syndrome. J Med Virol 2024; 96:e29626. [PMID: 38654664 DOI: 10.1002/jmv.29626] [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: 12/29/2023] [Revised: 04/09/2024] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with a high mortality rate. Differentiating between SFTS and hemorrhagic fever with renal syndrome (HFRS) is difficult and inefficient. Retrospective analysis of the medical records of individuals with SFTS and HFRS was performed. Clinical and laboratory data were compared, and a diagnostic model was developed based on multivariate logistic regression analyzes. Receiver operating characteristic curve analysis was used to evaluate the diagnostic model. Among the 189 patients, 113 with SFTS and 76 with HFRS were enrolled. Univariate analysis revealed that more than 20 variables were significantly associated with SFTS. Multivariate logistic regression analysis revealed that gender, especially female gender (odds ratio [OR]: 4.299; 95% confidence interval [CI]: 1.163-15.887; p = 0.029), age ≥65 years (OR: 16.386; 95% CI: 3.043-88.245; p = 0.001), neurological symptoms (OR: 12.312; 95% CI: 1.638-92.530; p = 0.015), leukopenia (<4.0 × 109/L) (OR: 17.355; 95% CI: 3.920-76.839; p < 0.001), and normal Cr (OR: 97.678; 95% CI: 15.483-616.226; p < 0.001) were significantly associated with SFTS but not with HFRS. The area under the curve of the differential diagnostic model was 0.960 (95% CI: 0.936-0.984), which was significantly better than that of each single factor. In addition, the model exhibited very excellent sensitivity and specificity (92.9% and 85.5%, respectively). In cases where HFRS and SFTS are endemic, a diagnostic model based on five parameters, such as gender, age ≥65 years, neurological symptoms, leukopenia and normal Cr, will facilitate the differential diagnosis of SFTS and HFRS in medical institutions, especially in primary care settings.
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Affiliation(s)
- Wenjie Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zijian Wang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Zumin Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Manman Liang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Aiping Zhang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Haoyu Sheng
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Mingyue Ni
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jianghua Yang
- Department of Infectious Diseases, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
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Wang J, Luo M, Li T, Liu Y, Jiang G, Wu Y, Liu Q, Gong Z, Sun J. The ecological and etiological investigation of ticks and rodents in China: results from an ongoing surveillance study in Zhejiang Province. Front Vet Sci 2023; 10:1268440. [PMID: 38089699 PMCID: PMC10715276 DOI: 10.3389/fvets.2023.1268440] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/13/2023] [Indexed: 05/07/2024] Open
Abstract
OBJECTIVES This study aimed to analyze the population density of vector ticks and reservoir hosts rodents, and to investigate the relevant pathogen infection in Zhejiang Province, China. METHODS In this surveillance study, the data of ticks density were collected with the tick picking method on animal body surface and the drag-flag method, while the rodent density with the night trapping method. The samples of ticks were examined for the severe fever with thrombocytopenia syndrome virus (SFTSV), and blood serum and organs from rodents were subjected for SFTSV, hantavirus, Leptospira, Orientia tsutsugamushi (O. tsutsugamushi) and Yersinia pestis (Y. pestis) screening in the laboratory. RESULTS From 2017 to 2022 in Zhejiang Province, 16,230 parasitic ticks were found in 1848 positive animals, with the density of parasitic ticks of 1.29 ticks per host animal, and a total of 5,201 questing ticks were captured from 1,140,910 meters of vegetation distance with the questing tick density of 0.46 ticks/flag·100 m. Haemaphysalis longicornis (H. longicornis) was the major species. A total of 2,187,739 mousetraps were distributed and 12,705 rodents were trapped, with the density of 0.58 per 100 trap-nights. Rattus norvegicus was the major species. For SFTSV screening, two groups nymphal ticks of H. longicornis were tested to be positive. For the rodents samples, the Leptospira had a positive rate of 12.28% (197/1604), the hantavirus was 1.00% (16/1604), and the O. tsutsugamushi was 0.15% (2/1332). No positive results were found with SFTSV and Y. pestis in the rodents samples. CONCLUSION Findings from this study indicated that the ticks and rodents were widely distributed in Zhejiang Province. Particularly, the positive detection of SFTSV, Leptospira, hantavirus and O. tsutsugamushi in ticks or rodents from this area suggested that more attention should be paid to the possibilities of relevant vector-borne diseases occurrence.
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Affiliation(s)
- Jinna Wang
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Mingyu Luo
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Tianqi Li
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Guoqin Jiang
- Shaoxing Center for Disease Control and Prevention, Shaoxing, China
| | - Yuyan Wu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Qinmei Liu
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhenyu Gong
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
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Qi Y, Ai L, Jiao J, Wang J, Wu D, Wang P, Zhang G, Qin Y, Hu C, Lv R, Lu N, Zhu C, Mao Y, Qi R, Li Y, Tan W. High prevalence of Rickettsia spp. in ticks from wild hedgehogs rather than domestic bovine in Jiangsu province, Eastern China. Front Cell Infect Microbiol 2022; 12:954785. [PMID: 35959365 PMCID: PMC9360493 DOI: 10.3389/fcimb.2022.954785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundSpotted fever group Rickettsia (SFGR), containing various pathogenic Rickettsia spp., poses remarkable negative influences to public health by causing various severe or mild diseases. Information regarding prevalence of SFGR in ticks in Jiangsu province, Eastern China, is still limited and needs urgent investigations.MethodsHedgehog- and bovine-attached ticks were collected from Jiangsu province, Eastern China. DNA of individual ticks was extracted for nested polymerase chain reaction amplifications targeting gltA, 16S ribosomal RNA (rrs), ompA, ompB, and sca4 genes following with sequencing. SFGR-specific IgG antibodies in sera of local donators were evaluated using ELISA.ResultsOverall, 144 (83.2%) of the 173 ticks from hedgehogs and 2 (1.2%) of the 168 ticks from bovine were positive for one of the three identified Rickettsia spp., with significant difference between the two groups (P = 3.6e-52). Candidatus Rickettsia principis (9; 5.2%) and R. heilongjiangensis (135; 78.0%) were detected in Haemaphysalis flava rather than in H. longicornis ticks from hedgehogs. R. heilongjiangensis (1; 0.6%) and Candidatus R. jingxinensis (or Candidatus R. longicornii) (1; 0.6%) were identified in H. longicornis and Rhipicephalus microplus ticks from bovine, respectively. Phylogenetic analysis indicated Candidatus R. jingxinensis belonged to R. japonica subgroup, whereas Candidatus R. principis belonged to a novel subgroup. Higher serological prevalence of spotted fever and SFGR-specific IgG antibody level in humans were observed around the investigated area than in urban areas, without significant difference.ConclusionCandidatus R. principis and Candidatus R. jingxinensis were identified in Jiangsu province, Eastern China, and fully genetically characterized for the first time. The higher prevalence of SFGR in hedgehog-attached ticks as well as the higher SFGR-specific IgG antibody level and seropositive rate in humans around the investigated area suggested that more attention should be paid to SFGR. This pathogen is usually transmitted or harbored by wild animals and ticks. This study provides important epidemiological data for both physicians and public health officers in developing early prevention and control strategies against potential Rickettsia infections and in the preparation of suitable testing and treatment needs for rickettsiosis in the endemic areas.
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Affiliation(s)
- Yong Qi
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Lele Ai
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Jun Jiao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Junhu Wang
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Deping Wu
- Huaian Medical District of Jinling Hospital, Medical School of Nanjing University, Huaian, China
| | | | - Guoyu Zhang
- Xuyi County Hospital of Chinese Medicine, Huaian, China
| | - Yong Qin
- Xuyi County Hospital of Chinese Medicine, Huaian, China
| | - Cheng Hu
- The 907Hospital of Chinese PLA, Nanping, China
| | - Ruichen Lv
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Nianhong Lu
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Changqiang Zhu
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Yingqing Mao
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
| | - Rui Qi
- Army Medical University, Shijiazhuang, China
| | - Yuexi Li
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- *Correspondence: Yuexi Li, ; Weilong Tan,
| | - Weilong Tan
- Huadong Research Institute for Medicine and Biotechniques, Nanjing, China
- Nanjing Bioengineering (Gene) Technology Center for Medicines, Nanjing, China
- *Correspondence: Yuexi Li, ; Weilong Tan,
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Zhan L, Huang K, Xia W, Chen J, Wang L, Lu J, Wang J, Lin J, Wu W. The Diagnosis of Severe Fever with Thrombocytopenia Syndrome Using Metagenomic Next-Generation Sequencing: Case Report and Literature Review. Infect Drug Resist 2022; 15:83-89. [PMID: 35046673 PMCID: PMC8760998 DOI: 10.2147/idr.s345991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an infectious disease caused by a bunyaviridae virus. Its main clinical manifestation is fever with thrombocytopenia, which may be accompanied by other clinical symptoms. Here, we report a patient diagnosed with SFTS using metagenomic next‑generation sequencing (mNGS). Case Presentation A 56-year-old female patient was hospitalized with intermittent diarrhea and fever. She visited a local clinic for treatment, but instead of improving, the symptoms progressed to unconsciousness. Diagnosis Using mNGS, we isolated the bunyaviridae virus and several other pathogens from the patient’s blood samples to confirm the diagnosis. Interventions The patient was treated with symptomatic and supportive therapy, including intravenous human γ-globulin (20 g/d), platelet transfusion, platelet elevation (subcutaneous injection of recombinant human thrombopoietin, 15,000 IU), white blood cell elevation (subcutaneous injection of recombinant human granulocyte colony-stimulating factor, 200 ug, qd); and antibiotic (cefoperazone sodium and tazobactam sodium, 2 g, q8h), antiviral (ganciclovir, 250 mg, q12h), and antifungal therapy (voriconazole for injection, 0.2 g, q12h). After ten days of treatment, the patient’s condition gradually improved. Conclusion Compared to traditional detection methods, mNGS has many advantages. It can quickly identify the pathogen when the patient’s clinical manifestations are complex and difficult to diagnose, resulting in the formulation of an effective treatment.
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Affiliation(s)
- Liying Zhan
- Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Kai Huang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Wenfang Xia
- Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Jingdi Chen
- Department of Orthopedics, The Airborne Military Hospital, Wuhan, Hubei, People’s Republic of China
| | - Lu Wang
- Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Jiaming Lu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Jing Wang
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Jun Lin
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
| | - Wei Wu
- Department of Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan, Hubei, People’s Republic of China
- Correspondence: Wei Wu; Jun Lin Email ;
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Vectors, Hosts, and the Possible Risk Factors Associated with Severe Fever with Thrombocytopenia Syndrome. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2021; 2021:8518189. [PMID: 34777671 PMCID: PMC8580678 DOI: 10.1155/2021/8518189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/26/2021] [Accepted: 10/20/2021] [Indexed: 11/17/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease caused by infection with the SFTS virus (SFTSV). SFTS has become a crucial public health concern because of the heavy burden, lack of vaccines, effective therapies, and high-fatality rate. Evidence suggests that SFTSV circulates between ticks and animals in nature and is transmitted to humans by tick bites. In particular, ticks have been implicated as vectors of SFTSV, where domestic or wild animals may play as the amplifying hosts. Many studies have identified antigens and antibodies against SFTSV in various animals such as sheep, goats, cattle, and rodents. Besides, person-to-person transmission through contact with blood or mucous of an infected person has also been reported. In this study, we reviewed the literature and summarized the vectors and hosts associated with SFTS and the possible risk factors.
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Baseline mapping of severe fever with thrombocytopenia syndrome virology, epidemiology and vaccine research and development. NPJ Vaccines 2020; 5:111. [PMID: 33335100 PMCID: PMC7746727 DOI: 10.1038/s41541-020-00257-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 10/13/2020] [Indexed: 12/13/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emergent tick-borne bunyavirus first discovered in 2009 in China. SFTSV is a growing public health problem that may become more prominent owing to multiple competent tick-vectors and the expansion of human populations in areas where the vectors are found. Although tick-vectors of SFTSV are found in a wide geographic area, SFTS cases have only been reported from China, South Korea, Vietnam, and Japan. Patients with SFTS often present with high fever, leukopenia, and thrombocytopenia, and in some cases, symptoms can progress to severe outcomes, including hemorrhagic disease. Reported SFTSV case fatality rates range from ~5 to >30% depending on the region surveyed, with more severe disease reported in older individuals. Currently, treatment options for this viral infection remain mostly supportive as there are no licensed vaccines available and research is in the discovery stage. Animal models for SFTSV appear to recapitulate many facets of human disease, although none of the models mirror all clinical manifestations. There are insufficient data available on basic immunologic responses, the immune correlate(s) of protection, and the determinants of severe disease by SFTSV and related viruses. Many aspects of SFTSV virology and epidemiology are not fully understood, including a detailed understanding of the annual numbers of cases and the vertebrate host of the virus, so additional research on this disease is essential towards the development of vaccines and therapeutics.
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Huang XY, He ZQ, Wang BH, Hu K, Li Y, Guo WS. Severe fever with thrombocytopenia syndrome virus: a systematic review and meta-analysis of transmission mode. Epidemiol Infect 2020; 148:e239. [PMID: 32993819 PMCID: PMC7584033 DOI: 10.1017/s0950268820002290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 09/21/2020] [Accepted: 09/23/2020] [Indexed: 11/29/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a disease with a high case-fatality rate that is caused by infection with the SFTS virus (SFTSV). Five electronic databases were systematically searched to identify relevant articles published from 1 January 2011 to 1 December 2019. The pooled rates with 95% confidence interval (CI) were calculated by a fixed-effect or random-effect model analysis. The results showed that 92 articles were included in this meta-analysis. For the confirmed SFTS cases, the case-fatality rate was 0.15 (95% CI 0.11, 0.18). Two hundred and ninety-six of 1384 SFTS patients indicated that they had been bitten by ticks and the biting rate was 0.21 (95% CI 0.16, 0.26). The overall pooled seroprevalence of SFTSV antibodies among the healthy population was 0.04 (95% CI 0.03, 0.05). For the overall seroprevalence of SFTSV in animals, the seroprevalence of SFTSV was 0.25 (95% CI 0.20, 0.29). The infection rate of SFTSV in ticks was 0.08 (95% CI 0.05, 0.11). In conclusion, ticks can serve as transmitting vectors of SFTSVs and reservoir hosts. Animals can be infected by tick bites, and as a reservoir host, SFTSV circulates continuously between animals and ticks in nature. Humans are infected by tick bites and direct contact with patient secretions.
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Affiliation(s)
- X. Y. Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Z. Q. He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - B. H. Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - K. Hu
- Henan Academy of Medical Sciences, Zhengzhou, China
| | - Y. Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
- Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - W. S. Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
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He Z, Wang B, Li Y, Du Y, Ma H, Li X, Guo W, Xu B, Huang X. Severe fever with thrombocytopenia syndrome: a systematic review and meta-analysis of epidemiology, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. BMC Infect Dis 2020; 20:575. [PMID: 32758175 PMCID: PMC7409422 DOI: 10.1186/s12879-020-05303-0] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 07/27/2020] [Indexed: 12/29/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease with the high case-fatality rate, and lack of vaccines. We aimed to systematically analysed the epidemiological characteristics, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. Methods Documents on SFTS were collected by searching the Chinese National Knowledge Infrastructure, Wan Fang Data, PubMed, Embase, and Web of Science databases from 2011 to 2018. Meta-analysis was performed by using Review Manager and Stata software. Results Twenty-five articles involving 4143 cases were included. Diarrhea (odds ratio (OR) =1.60, 95% confidence interval (CI): 1.06 to 2.42, P = 0.02), and vomiting (OR = 1.56, 95% CI: 1.01 to 2.39, P = 0.04) on admission were associated with the fatal outcomes of SFTS. Compared to patients with mild symptoms, patients with severe symptoms had significantly elevated levels of lactic acid dehydrogenase (standard mean difference (SMD) =1.27, 95% CI: 0.59 to 1.94), alanine aminotransferase (SMD = 0.55, 95% CI: 0.24 to 0.85), aspirate aminotransferase (SMD = 1.01, 95% CI: 0.69 to 1.32), and creatine kinase (SMD = 1.04, 95% CI: 0.74 to 1.33) but had reduced platelet counts (SMD = -0.87, 95% CI: − 1.16 to − 0.58) and albumin levels (SMD = -1.00, 95% CI: − 1.32 to − 0.68). The risk factors for poor prognosis included age (mean difference (MD) =6.88, 95% CI: 5.41 to 8.35) and farming (OR = 2.01, 95% CI: 1.06 to 3.80). For the risk factors of contracting SFTS, the incidence of SFTS related to tick bites was 24% [95% CI: 0.18 to 0.31]. The pooled case-fatality rate of SFTS patients was 18% [95% CI: 0.16 to 0.21]. Conclusions China is the country with the highest incidence of SFTS. May to July was the peak of the epidemic, and farmers were a high-risk group. The risk factor for SFTS included age (poor prognosis) and tick bites (contracting SFTS). Patients with severe diarrhea and vomiting symptoms on admission should be noted. Clinicians could use routine laboratory parameters and clinical symptoms as references for clinically suspected cases, classification of SFTS, and timely treatment, especially in basic hospitals.
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Affiliation(s)
- Zhiquan He
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bohao Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yi Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Yanhua Du
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Hongxia Ma
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Xingle Li
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China.,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China
| | - Wanshen Guo
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Bianli Xu
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China
| | - Xueyong Huang
- Henan Province Center for Disease Control and Prevention, Zhengzhou, China. .,Henan Key Laboratory of Pathogenic Microorganisms, Zhengzhou, China.
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Duan Y, Wu W, Zhao Q, Liu S, Liu H, Huang M, Wang T, Liang M, Wang Z. Enzyme-Antibody-Modified Gold Nanoparticle Probes for the Ultrasensitive Detection of Nucleocapsid Protein in SFTSV. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124427. [PMID: 32575570 PMCID: PMC7344430 DOI: 10.3390/ijerph17124427] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 06/11/2020] [Accepted: 06/16/2020] [Indexed: 12/22/2022]
Abstract
As humans and climate change continue to alter the landscape, novel disease risk scenarios have emerged. Sever fever with thrombocytopenia syndrome (SFTS), an emerging tick-borne infectious disease first discovered in rural areas of central China in 2009, is caused by a novel bunyavirus (SFTSV). The potential for SFTS to spread to other countries in combination with its high fatality rate, possible human-to-human transmission, and extensive prevalence among residents and domesticated animals in endemic regions make the disease a severe threat to public health. Because of the lack of preventive vaccines or useful antiviral drugs, diagnosis of SFTS is the key to prevention and control of the SFTSV infection. The development of serological detection methods will greatly improve our understanding of SFTSV ecology and host tropism. We describe a highly sensitive protein detection method based on gold nanoparticles (AuNPs) and enzyme-linked immunosorbent assay (ELISA)—AuNP-based ELISA. The optical sensitivity enhancement of this method is due to the high loading efficiency of AuNPs to McAb. This enhances the concentration of the HRP enzyme in each immune sandwich structure. The detection limit of this method to the nucleocapsid protein (NP) of SFTSV was 0.9 pg mL−1 with good specificity and reproducibility. The sensitivity of AuNP-based ELISA was higher than that of traditional ELISA and was comparable to real-time quantitative polymerase chain reaction (qRT-PCR). The probes are stable for 120 days at 4 °C. This can be applied to diagnosis and hopefully can be developed into a commercial ELISA kit. The ultrasensitive detection of SFTSV will increase our understanding of the distribution and spread of SFTSV, thus helping to monitor the changes in tick-borne pathogen SFTSV risk in the environment.
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Affiliation(s)
- Yuqin Duan
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Wei Wu
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100000, China;
| | - Qiuzi Zhao
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Sihua Liu
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Hongyun Liu
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Mengqian Huang
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Tao Wang
- School of Life Sciences, Tianjin University, Tianjin 300072, China; (Y.D.); (Q.Z.); (S.L.); (H.L.); (M.H.); (T.W.)
| | - Mifang Liang
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100000, China;
- Correspondence: (M.L.); (Z.W.)
| | - Zhiyun Wang
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China
- Correspondence: (M.L.); (Z.W.)
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Kim MC, Chong YP, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH. Differentiation of Severe Fever With Thrombocytopenia Syndrome From Scrub Typhus. Clin Infect Dis 2019; 66:1621-1624. [PMID: 29293899 DOI: 10.1093/cid/cix1119] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/22/2017] [Indexed: 11/13/2022] Open
Abstract
We developed a scoring system to differentiate severe fever with thrombocytopenia syndrome (SFTS) in 21 patients with SFTS and 91 with scrub typhus; it provided 100% sensitivity and 97% specificity (score > 1). Criteria included altered mental status, leukopenia, prolonged activated partial thromboplastin time, and normal C-reactive protein (1-point each).
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Affiliation(s)
- Min-Chul Kim
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan.,Division of Infectious Diseases, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Republic of Korea
| | - Yong Pil Chong
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
| | - Sang-Oh Lee
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
| | - Sang-Ho Choi
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
| | - Yang Soo Kim
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
| | - Jun Hee Woo
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
| | - Sung-Han Kim
- Department of Infectious Diseases, Asan Medical Center, College of Medicine, University of Ulsan
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Qi R, Qin XR, Wang L, Han HJ, Cui F, Yu H, Liu JW, Yu XJ. Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome. PLoS Negl Trop Dis 2019; 13:e0007308. [PMID: 30925154 PMCID: PMC6457554 DOI: 10.1371/journal.pntd.0007308] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 04/10/2019] [Accepted: 03/15/2019] [Indexed: 12/23/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever with a high fatality rate and high frequency of person-to-person transmission and is caused by SFTSV, a tick-borne Phlebovirus. Because SFTS has similar clinical manifestations and epidemic characters (such as spatial and temporal distributions) with hemorrhagic fever with renal syndrome (HFRS) in China, we reason that SFTS patients might be misdiagnosed as HFRS. Methodology/principal findings Acute-phase sera of 128 clinically diagnosed HFRS patients were retrospectively analyzed for Hantavirus IgM antibodies with ELISA. Hantavirus-negative patients’ sera were further analyzed for SFTSV IgM antibodies with ELISA. ELISA showed that 73 of 128 (57.0%) of clinically diagnosed HFRS patients were IgM antibody positive to Hantaviruses. Among the 55 Hantavirus-IgM negative patients, four (7.3%) were IgM antibody positive to SFTSV. The results indicated that the four SFTS patients were misdiagnosed as HFRS. The misdiagnosed SFTS patients had clinical manifestations common to HFRS and were unable to be differentiated from HFRS clinically. Conclusions Our study showed that SFTS patients could be clinically misdiagnosed as HFRS. The misdiagnosis of SFTS as HFRS causes particular concern because it may increase the risk of death of SFTS patients and person-to-person transmission of SFTSV without proper care for and isolation of SFTS patients. SFTS were clinically misdiagnosed as HFRS. It could cause particular concern in China. Physicians could not rely heavily on the exposure history. Both SFTS and HFRS patients are treated based on the clinical diagnosis in China. Laboratory confirmation of both diseases is not performed in clinical hospitals and the patients’ blood was usually submitted to a local or provincial center for disease control and prevention. In most cases the confirmation diagnosis is to provide retrospective information rather than to guide clinical therapy. Therefore, physicians need to carefully differentiate SFTS and HFRS patients because the fatality of SFTS is much higher than HFRS and SFTS is easily spread from person to person by contacting infected blood or even through aerosol.
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Affiliation(s)
- Rui Qi
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xiang-rong Qin
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Ling Wang
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hui-ju Han
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Feng Cui
- Zibo Center for Disease Control and Prevention, Zibo City, China
| | - Hao Yu
- Fudan University School of Medicine, Shanghai, China
| | - Jian-wei Liu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
| | - Xue-jie Yu
- Wuhan University School of Health Sciences, Wuhan, China
- State Key Laboratory of Virology, Wuhan University, Wuhan, China
- * E-mail: ,
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