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Shan D, Chen W, Liu G, Zhang H, Chai S, Zhang Y. Severe fever with thrombocytopenia syndrome with central nervous system symptom onset: a case report and literature review. BMC Neurol 2024; 24:158. [PMID: 38730325 PMCID: PMC11084135 DOI: 10.1186/s12883-024-03664-6] [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: 11/30/2023] [Accepted: 05/02/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is a natural focal disease transmitted mainly by tick bites, and the causative agent is SFTS virus (SFTSV). SFTS can rapidly progress to severe disease, with multiple-organ failure (MOF) manifestations such as shock, respiratory failure, disseminated intravascular coagulation (DIC) and death, but cases of SFTS patients with central nervous system (CNS) symptoms onset and marked persistent involuntary shaking of the perioral area and limbs have rarely been reported. CASE PRESENTATION A 69-year-old woman with fever and persistent involuntary shaking of the perioral area and limbs was diagnosed with SFTS with CNS symptom onset after metagenomic next-generation sequencing (mNGS) of cerebrospinal fluid (CSF) and peripheral blood identified SFTSV. The patient developed a cytokine storm and MOF during the course of the disease, and after aggressive antiviral, glucocorticoid, and gamma globulin treatments, her clinical symptoms improved, her laboratory indices returned to normal, and she had a good prognosis. CONCLUSION This case gives us great insight that when patients with CNS symptoms similar to those of viral encephalitis combined with thrombocytopenia and leukopenia are encountered in the clinic, it is necessary to consider the possibility of SFTS involving the CNS. Testing for SFTSV nucleic acid in CSF and blood (mNGS or polymerase chain reaction (PCR)) should be carried out, especially in critically ill patients, and treatment should be given accordingly.
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Affiliation(s)
- Dawei Shan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Weibi Chen
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Gang Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Huimin Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Shuting Chai
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Yan Zhang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Zhang Z, Tan J, Jin W, Qian H, Wang L, Zhou H, Yuan Y, Wu X. Severe fever with thrombocytopenia syndrome virus trends and hotspots in clinical research: A bibliometric analysis of global research. Front Public Health 2023; 11:1120462. [PMID: 36817929 PMCID: PMC9933999 DOI: 10.3389/fpubh.2023.1120462] [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: 12/10/2022] [Accepted: 01/18/2023] [Indexed: 02/05/2023] Open
Abstract
Background Since severe fever with thrombocytopenia syndrome virus (SFTSV) was first reported in 2009, a large number of relevant studies have been published. However, no bibliometrics analysis has been conducted on the literature focusing on SFTSV. This study aims to evaluate the research hotspots and future development trends of SFTSV research through bibliometric analysis, and to provide a new perspective and reference for future SFTSV research and the prevention of SFTSV. Methods We retrieved global publications on SFTSV from the Web of Science Core Collection (WoSCC) and Scopus databases from inception of the database until 2022 using VOSviewer software and CiteSpace was used for bibliometric analysis. Results The number of SFTSV-related publications has increased rapidly since 2011, peaking in 2021. A total of 45 countries/regions have published relevant publications, with China topping the list with 359. The Viruses-Basel has published the most papers on SFTSV. In addition, Yu et al. have made the greatest contribution to SFTSV research, with their published paper being the most frequently cited. The most popular SFTSV study topics included: (1) pathogenesis and symptoms, (2) characteristics of the virus and infected patients, and (3) transmission mechanism and risk factors for SFTSV. Conclusions In this study, we provide a detailed description of the research developments in SFTSV since its discovery and summarize the SFTSV research trends. SFTSV research is in a phase of explosive development, and a large number of publications have been published in the past decade. There is a lack of collaboration between countries and institutions, and international collaboration and exchanges should be strengthened in the future. The current research hotpots of SFTSV is antiviral therapy, immunotherapy, virus transmission mechanism and immune response.
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Affiliation(s)
- Zhengyu Zhang
- Medical Records Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Juntao Tan
- Operation Management Office, Affiliated Banan Hospital of Chongqing Medical University, Chongqing, China
| | - Wen Jin
- Medical Records Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hong Qian
- Medical Records Department, The First Hospital of Lanzhou University, Lanzhou, China
| | - Loulei Wang
- Medical Records Department, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Hu Zhou
- General Committee Office, The People's Hospital of Yubei District of Chongqing City, Chongqing, China
| | - Yuan Yuan
- Medical Department, Women and Children's Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Yuan Yuan ✉
| | - Xiaoxin Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Centre for Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China,Xiaoxin Wu ✉
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Kim SY, Seo CW, Lee HI. Severe fever with thrombocytopenia syndrome virus from ticks: a molecular epidemiological study of a patient in the Republic of Korea. EXPERIMENTAL & APPLIED ACAROLOGY 2023; 89:305-315. [PMID: 36928542 PMCID: PMC10097770 DOI: 10.1007/s10493-023-00783-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne infectious disease caused by Dabie bandavirus, commonly called SFTS virus (SFTSV). In the Republic of Korea (ROK), 1,504 cases of SFTS have been reported since the first human case was identified in 2013 until 2021. However, no case exists to provide molecular evidence between questing tick and patients with confirmed SFTS in the same living environment. In this study, we investigated the presence of ticks near the area of a patient infected with SFTSV. Ticks were collected by flagging and dry ice-baited traps at three spots in the vegetation around the patients' residence in Chuncheon City, Gangwon Province (ROK). Among the tick samples collected, the presence of SFTSV was genetically determined using reverse transcription PCR, followed by the phylogenetic analysis of the tick virus sequences and SFTSV found in the patient. In total 1,212 Haemaphysalis longicornis ticks were collected, and SFTSV was detected at a minimum infection rate of 5.3% (33 pools/618 tested ticks). The sequences of SFTSV in ticks were 99.6-100% identical with the patient's SFTSV in the M segment. To the best of our knowledge, this study is the first case to provide a molecular correlation between SFTSV in questing ticks collected from residence and patient with SFTS in the ROK. The present results provide useful information for the epidemiological investigation of patients with SFTS using ticks as vectors of SFTSV.
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Affiliation(s)
- Seong Yoon Kim
- Division of Vectors and Parasitic Diseases, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, 187 Osongsaengmyeong 2-ro, Cheongwon-gun, Cheongju-si, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Choong Won Seo
- Department of Medical Laboratory Science, Dong-Eui Institute of Technology, 54 Yangji-ro, Busanjin-gu, Busan, 47230, Korea
| | - Hee Il Lee
- Division of Vectors and Parasitic Diseases, Bureau of Infectious Disease Diagnosis Control, Korea Disease Control and Prevention Agency, 187 Osongsaengmyeong 2-ro, Cheongwon-gun, Cheongju-si, Chungcheongbuk-do, 363-951, Republic of Korea.
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Chen R, Li Q, Chen H, Yang H, Wei X, Chen M, Wen H. Severe fever with thrombocytopenia syndrome virus replicates in brain tissues and damages neurons in newborn mice. BMC Microbiol 2022; 22:204. [PMID: 35987890 PMCID: PMC9392058 DOI: 10.1186/s12866-022-02609-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 07/27/2022] [Indexed: 11/14/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) is an emerging tick-borne phlebovirus with a high fatality rate of 12–30%, which has an expanding endemic and caused thousands of infections every year. Central nervous system (CNS) manifestations are an important risk factor of SFTS outcome death. Further understanding of the process of how SFTSV invades the brain is critical for developing effective anti-SFTS encephalitis therapeutics. We obeserved changes of viral load in the brain at different time points after intraperitoneal infection of SFTSV in newborn C57/BL6 mice. The virus invaded the brain at 3 h post-infection (hpi). Notably, the viral load increased exponentially after 24 hpi. In addition, it was found that in addition to macrophages, SFTSV infected neurons and replicated in the brain. These findings provide insights into the CNS manifestations of severe SFTS, which may lead to drug development and encephalitis therapeutics.
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Saijo M. Severe fever with thrombocytopenia syndrome, a viral hemorrhagic fever, endemic to Japan: achievements and directions to the future in the scientific and medical research. Jpn J Infect Dis 2022; 75:217-227. [PMID: 35354707 DOI: 10.7883/yoken.jjid.2021.851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A novel infectious disease, severe fever with thrombocytopenia syndrome (SFTS) caused by a novel bunyavirus, with high case fatality rate (CFR) was reported by Chinese scientists in 2011. The causative virus, Dabie bandavirus [former SFTS virus (SFTSV)] belonged to the Bandavirus genus (former Phlebovirus genus) of Phenuiviridae family (former Bunyaviridae family). SFTS was also reported to be endemic to South Korea and Japan in 2013. Humans are infected with SFTSV through bites by ticks such as Haemophysalis longicornis and Amblyomma testidinarium. However, it was reported that domesticated animals such as cats and dogs were also infected with SFTSV probably through tick bites in living environment and show the SFTS-like symptoms with high CFR. Furthermore, there have been the cases of SFTS patients, who were infected with SFTSV through close contacts with sick cats or dogs. The high CFR in patients with SFTS is approximately 30% in Japan. SFTSV is circulating in nature between some species of ticks and animals. There are always the risks of SFTSV infection for human populations living in the endemic areas. Therefore, development of specific therapies and vaccines is an urgent need to reduce the number of fatal SFTS patients.
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Affiliation(s)
- Masayuki Saijo
- Department of Virology 1, National Institute of Infectious Diseases, Japan
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Xu Y, Shao M, Liu N, Dong D, Tang J, Gu Q. Clinical feature of severe fever with thrombocytopenia syndrome (SFTS)-associated encephalitis/encephalopathy: a retrospective study. BMC Infect Dis 2021; 21:904. [PMID: 34479504 PMCID: PMC8418043 DOI: 10.1186/s12879-021-06627-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND/OBJECTIVE Severe fever with thrombocytopenia syndrome (SFTS) cause encephalitis/encephalopathy, but few reports were available. We aimed to investigate the incidence of encephalitis/encephalopathy in SFTS patients and to summarize clinical characteristics, laboratory findings and imaging features. METHODS We conducted a retrospective review of all patients with confirmed SFTS admitted to Nanjing Drum Tower Hospital, a tertiary hospital in Nanjing City, China, between January 2016 and July 2020. The patients were divided into two groups according to whether they had encephalitis/encephalopathy: encephalitis/encephalopathy group and non- encephalitis/encephalopathy group. Clinical data, laboratory findings, imaging characteristics, treatments and outcomes of these patients were collected and analyzed. RESULTS A total of 109 SFTS patients with were included, of whom 30 (27.5 %) developed encephalitis/encephalopathy. In-hospital mortality (43.3 %) was higher in encephalitis/encephalopathy group than non-encephalitis/encephalopathy group (12.7 %). Univariate logistic regression showed that cough, wheezing, dyspnoea, respiratory failure, vasopressors use, bacteremia, invasive pulmonary aspergillosis (IPA) diagnoses, PCT > 0.5 ug/L, CRP > 8 mg/L, AST > 200 U/L and serum amylase level > 80 U/L were the risk factors for the development of encephalitis/encephalopathy for SFTS patients. Multivariate logistic regression analysis identified bacteremia, PCT > 0.5 mg/L and serum amylase level > 80 U/L as independent predictors of encephalitis/ encephalopathy development for SFTS patients. CONCLUSIONS SFTS-associated encephalitis/encephalopathy has high morbidity and mortality. it was necessary to strengthen the screening of CSF testing and brain imaging after admission for SFTS patients who had symptoms of encephalitis/encephalopathy. SFTS patients with bacteremia, PCT > 0.5 ug/L or serum amylase level > 80 U/L should be warned to progress to encephalopathy.
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Affiliation(s)
- Ying Xu
- Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China
| | - Mingran Shao
- Department of Radiology, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China
| | - Ning Liu
- Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China
| | - Danjiang Dong
- Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China
| | - Jian Tang
- Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China
| | - Qin Gu
- Department of Intensive Care Unit, The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, 210008, Nanjing, China.
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Clinical Update of Severe Fever with Thrombocytopenia Syndrome. Viruses 2021; 13:v13071213. [PMID: 34201811 PMCID: PMC8310018 DOI: 10.3390/v13071213] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/18/2021] [Accepted: 06/18/2021] [Indexed: 12/17/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness characterized by fever, leukopenia, thrombocytopenia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting resulting from infection with the SFTS virus (SFTSV). The SFTSV is transmitted to humans by tick bites, primarily from Haemaphysalis longicornis, Amblyomma testudinarium, Ixodes nipponensis, and Rhipicephalus microplus. Human-to-human transmission has also been reported. Since the first report of an SFTS patient in China, the number of patients has also been increasing. The mortality rate of patients with SFTS remains high because the disease can quickly lead to death through multiple organ failure. In particular, an average fatality rate of approximately 20% has been reported for SFTS patients, and no treatment strategy has been established. Therefore, effective antiviral agents and vaccines are required. Here, we aim to review the epidemiology, clinical manifestations, laboratory diagnosis, and various specific treatments (i.e., antiviral agents, steroids, intravenous immunoglobulin, and plasma exchange) that have been tested to help to cope with the disease.
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Casel MA, Park SJ, Choi YK. Severe fever with thrombocytopenia syndrome virus: emerging novel phlebovirus and their control strategy. Exp Mol Med 2021; 53:713-722. [PMID: 33953322 PMCID: PMC8178303 DOI: 10.1038/s12276-021-00610-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/23/2020] [Accepted: 01/11/2021] [Indexed: 02/03/2023] Open
Abstract
An emerging infectious disease first identified in central China in 2009, severe fever with thrombocytopenia syndrome (SFTS) was found to be caused by a novel phlebovirus. Since SFTSV was first identified, epidemics have occurred in several East Asian countries. With the escalating incidence of SFTS and the rapid, worldwide spread of SFTSV vector, it is clear this virus has pandemic potential and presents an impending global public health threat. In this review, we concisely summarize the latest findings regarding SFTSV, including vector and virus transmission, genotype diversity and epidemiology, probable pathogenic mechanism, and clinical presentation of human SFTS. Ticks most likely transmit SFTSV to animals including humans; however, human-to-human transmission has been reported. The majority of arbovirus transmission cycle includes vertebrate hosts, and potential reservoirs include a variety of both domestic and wild animals. Reports of the seroprevalence of SFTSV in both wild and domestic animals raises the probability that domestic animals act as amplifying hosts for the virus. Major clinical manifestation of human SFTS infection is high fever, thrombocytopenia, leukocytopenia, gastrointestinal symptoms, and a high case-fatality rate. Several animal models were developed to further understand the pathogenesis of the virus and aid in the discovery of therapeutics and preventive measures.
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Affiliation(s)
- Mark Anthony Casel
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea
| | - Su Jin Park
- Research Institute of Life Science, Gyeongsang National University, Jinju, Republic of Korea
| | - Young Ki Choi
- College of Medicine and Medical Research Institute, Chungbuk National University, Cheongju, Republic of Korea.
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Mizoe A, Sakaue J, Takahara N. Why does activated partial thromboplastin time prolongation occur in severe fever with thrombocytopenia syndrome? BMJ Case Rep 2020; 13:13/10/e235447. [PMID: 33033003 DOI: 10.1136/bcr-2020-235447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is caused by infection with SFTS virus and this mortality rate is 16.2% to 30%. An 85-year-old male patient presented to the emergency department of the hospital with primary complaints of fever and consciousness disturbance. Haemophagocytic syndrome and prolonged activated partial thromboplastin time (APTT) without associated prolonged prothrombin time were observed, suggesting SFTS, which was eventually diagnosed. APTT-only prolongation has been reported previously with SFTS, but the mechanism is unknown. The absence of coagulation factors was determined by a cross-mixing study. In addition, examination of intrinsic coagulation factors showed reduced factor XI activity. These results suggest that factor XI is causally related to APTT-only prolongation in SFTS.
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Affiliation(s)
- Atsushi Mizoe
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
| | - Junya Sakaue
- Integrated Clinical Education Center, Kyoto University Hospital, Kyoto, Japan
| | - Noriko Takahara
- Department of Internal Medicine, Ako City Hospital, Ako, Hyogo, Japan
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Tong Y, Wang Q, Fu Y, Li S, Zhang Z, Zhang Z, Yu X. Molecular identification of severe fever with thrombocytopenia syndrome viruses from tick and bitten patient in Southeast China. Virol J 2020; 17:122. [PMID: 32758245 PMCID: PMC7409506 DOI: 10.1186/s12985-020-01391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 07/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Severe fever and thrombocytopenia bunyavirus (SFTSV) infection causes severe fever and thrombocytopenia syndrome with high mortality. It is extremely rare that a transmitting tick can be directly captured in bite wounds, and that SFTSV can be isolated from both the captured tick and patient's serum to establish a solid pathogen diagnosis. CASE PRESENTATION We report a case infected with severe fever and thrombocytopenia bunyavirus. The 69-year-old male patient presented with fever and tenderness on two lymph nodes in the right groin. A visible tick bite mark appeared on right upper quadrant of the patient's abdomen, and a live tick was captured in the bite wound upon physical examination. The virus was detected in both the blood of the patient and in the tick that stayed in the bite wound for 7 days. The phylogenetic analysis indicated that the SFTSV isolated from the tick and the patient's serum sample belonged to type B, in which the L/S segment of these two isolates shared 100% homology, while the M segment had 99.9% homology. The bitten patient was given various supportive care, but eventually died of multiple organ failure. CONCLUSION The present case provides strong evidence of SFTSV transmission from H. longicornis to humans, and suggests that direct cross-species transmission can occur without additional intermediate hosts.
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Affiliation(s)
- Yongxi Tong
- Department of Infectious Disease, Zhejiang Province People's Hospital, Hangzhou, China
| | - Qiujing Wang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China.
| | - Yongfeng Fu
- Institute of Biomedical Sciences, Department of Medical Microbiology and Parasitology, School of Basic Medical Sciences, Fudan University, Shanghai, China
| | - Shibo Li
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Zhao Zhang
- McGoven Medical School, 6431 Fannin St., Houston, TX, USA
| | - Zheen Zhang
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
| | - Xuewen Yu
- Department of Infectious Disease, Zhoushan Hospital, Wenzhou Medical University, Zhoushan, 316021, China
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Hu YY, Zhuang L, Liu K, Sun Y, Dai K, Zhang XA, Zhang PH, Feng ZC, Li H, Liu W. Role of three tick species in the maintenance and transmission of Severe Fever with Thrombocytopenia Syndrome Virus. PLoS Negl Trop Dis 2020; 14:e0008368. [PMID: 32520966 PMCID: PMC7307786 DOI: 10.1371/journal.pntd.0008368] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/22/2020] [Accepted: 05/06/2020] [Indexed: 12/12/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome virus (SFTSV) is a novel phlebovirus in the Bunyaviridae family, causing SFTS with high mortality rate. Haemaphysalis longicornis ticks has been demonstrated as a competent vector of SFTSV by experimental transmission study and field study. However, there has been query whether other tick species that infest human beings in the SFTS endemic regions are capable of transmitting the pathogen. Here by performing experimental transmission study, we compared the capable of transmitting SFTSV among Ixodes sinensis, Ixodes persulcatus and Dermacentor silvarum ticks. The transovarial transmission was seen in the I. sinensis ticks with a rate of 40%, but neither in I. persulcatus nor in D. silvarum ticks. I. sinensis ticks also have the ability to transmit SFTSV horizontally to uninfected mice at 7 days after feeding, but not for I. persalcatus or D. silvarum ticks. In the transstadial transmission of I. persulcatus and D. silvarum ticks, I. persulcatus ticks were tested negative from larvae to adults. But the D. silvarum ticks were tested positive from larvae to nymphs, with the positive rate of 100% (10/10) for engorged larval ticks and 81.25% (13/16) for molted nymphs. However, the mice bitten by SFTSV-infected D. silvarum nymphs were negative for SFTSV detection. Therefore, there is not enough evidence to prove the transstadial transmission of SFTSV in I. persalcatus and D. silvarum ticks. Due to its wide distribution and high fatality rate (16%-30%), severe fever with thrombocytopenia syndrome (SFTS) has been listed in the top 10 priority diseases blueprint by the world health organization (WHO) in 2017. SFTSV is a novel phlebovirus in the Bunyaviridae family, and Haemaphysalis longicornis tick has been demonstrated as a competent vector of SFTSV by experimental transmission study and field study. However, there are many other tick species that infest human beings in the SFTS endemic regions. Therefore, it’s neccessary to query whether these tick species are capable of transmitting SFTSV. The authors found that in addition to H. longicornis ticks, Ixodes sinensis ticks also served as an efficient vector capable of transovarial transmitting SFTSV, therefore posing as a potential threat in causing the circulation of SFTSV. In contrast, Dermacentor silvarum and Ixodes persulcatus ticks might not serve as an efficient vector of transmitting SFTSV. This research will provide important reference for the surveillance of SFTSV and the disease prevention and control.
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Affiliation(s)
- Yuan-Yuan Hu
- Graduate School of Anhui Medical University, Hefei, P. R. China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Lu Zhuang
- Affiliated Bayi Children’s Hospital, The 7th Medical Center of People’s Liberation Amy General Hospital, Beijing, P. R. China
| | - Kun Liu
- School of Public Health, Air Force Medical University, Xi’an, Shaanxi, P. R. China
| | - Yi Sun
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Ke Dai
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Xiao-Ai Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Pan-He Zhang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
| | - Zhi-Chun Feng
- Affiliated Bayi Children’s Hospital, The 7th Medical Center of People’s Liberation Amy General Hospital, Beijing, P. R. China
| | - Hao Li
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
- * E-mail: (HL); (WL)
| | - Wei Liu
- Graduate School of Anhui Medical University, Hefei, P. R. China
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, P. R. China
- * E-mail: (HL); (WL)
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Lee SH, Goo YK, Geraldino PJL, Kwon OD, Kwak D. Molecular Detection and Characterization of Borrelia garinii (Spirochaetales: Borreliaceae) in Ixodes nipponensis (Ixodida: Ixodidae) Parasitizing a Dog in Korea. Pathogens 2019; 8:E289. [PMID: 31817729 PMCID: PMC6963618 DOI: 10.3390/pathogens8040289] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 12/01/2019] [Accepted: 12/04/2019] [Indexed: 11/16/2022] Open
Abstract
The present study aimed to detect and characterize Borrelia spp. in ticks attached to dogs in Korea. Overall, 562 ticks (276 pools) attached to dogs were collected and tested for Borrelia infection by PCR targeting the 5S-23S rRNA intergenic spacer region (rrf-rrl). One tick larva (pool level, 0.4%; individual level, 0.2%) was confirmed by sequencing Borrelia garinii, a zoonotic pathogen. For molecular characterization, the outer surface protein A (ospA) and flagellin genes were analyzed. Phylogenetic ospA analysis distinguished B. garinii from B. bavariensis, which has been recently identified as a novel Borrelia species. On the other hand, phylogenetic analysis showed that single gene analysis involving rrf-rrl or flagellin was not sufficient to differentiate B. garinii from B. bavariensis. In addition, the B. garinii-infected tick was identified as Ixodes nipponensis by sequencing according to mitochondrial 16S rRNA and the second transcribed spacer region. To our knowledge, this is the first study to report the molecular detection of B. garinii in I. nipponensis parasitizing a dog in Korea. Continuous monitoring of tick-borne pathogens in ticks attached to animals is required to avoid disease distribution and possible transmission to humans.
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Affiliation(s)
- Seung-Hun Lee
- College of Veterinary Medicine, Chungbuk National University, Cheongju 28644, Korea;
| | - Youn-Kyoung Goo
- Department of Parasitology and Tropical Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea;
| | - Paul John L. Geraldino
- Department of Biology, School of Arts and Sciences, University of San Carlos, Talamban Campus, Cebu 6000, Philippines;
| | - Oh-Deog Kwon
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea;
| | - Dongmi Kwak
- College of Veterinary Medicine, Kyungpook National University, Daegu 41566, Korea;
- Cardiovascular Research Institute, Kyungpook National University, Daegu 41566, Korea
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13
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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: 14] [Impact Index Per Article: 2.8] [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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