We identified a period of 7-13 days after the onset of illness as the critical stage in SFTS progression. A sustained serum viral load may indicate that disease conditions will worsen and lead to death.

The study demonstrates that SFTSV infection induces a cytokine storm with abnormally expressed cytokine profiles, which are associated with the disease severity.

Hantaviruses have the potential to cause two different types of diseases in human: hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome (HPS). HFRS, initially described clinically at the turn of the 20 th century, occurs endemically in the Asian and European continents, while HPS, recognized as a clinical entity since 1993, represents the prototype of emerging diseases occurring in the Western hemisphere. Approximately 150,000 to 200,000 cases of HFRS are hospitalized each year world wide, with most of the cases occurring in the developing countries. The case fatality rate of HFRS varies from <1% to 12% depending on the viruses. Although HPS is much smaller in number than HFRS, with approximately 200 HPS cases per year in the Americas, the average case fatality rate is 40%. The reported cases of hantaviral infection is increasing in many countries and new hantavirus strains have been increasingly identified worldwide, which constitutes a public health problem of increasing global concern. Hantaviral infection might be underestimated due to its asymptomatic and nonspecific mild infection, and the lack of simple standardized laboratory diagnostics in hospitals, especially in the developing countries. This review summarizes the current knowledge on virology, epidemiology, clinical manifestation, laboratory diagnostics, treatment and prevention of hantaviruses and hantaviral infections.

To investigate the infections of severe fever with thrombocytopenia syndrome virus (SFTSV) in domesticated animals, we sampled a total of 3,039 animals in 2 counties in Shandong Province, People’s Republic of China, from April to November 2011. SFTSV-specific antibodies were detected in 328 (69.5%) of 472 sheep, 509 (60.5%) of 842 cattle, 136 (37.9%) of 359 dogs, 26 (3.1%) of 839 pigs, and 250 (47.4%) of 527 chickens. SFTSV RNA was detected in all sampled animal species, but the prevalence was low, ranging from 1.7% to 5.3%. A cohort study in 38 sheep was conducted to determine when seroconversion to SFTSV occured. SFTSVs were isolated from sheep, cattle, and dogs and shared >95% sequence homology with human isolates from the same disease-endemic regions. These findings demonstrate that natural infections of SFTSV occur in several domesticated animal hosts in disease-endemic areas and that the virus has a wide host range.

Severe fever with thrombocytopenia syndrome bunyavirus is a newly discovered bunyavirus with high pathogenicity to human. The transmission model has been largely uncharacterized. Investigation on a cluster of severe fever with thrombocytopenia syndrome cases provided evidence of person-to-person transmission through blood contact to the index patient with high serum virus load.