Seroprevalence and risk factors of severe fever with thrombocytopenia syndrome virus infection in endemic areas

Lyu, Yong; Ding, Fan; Sun, Jie; Xu, Pengpeng; Hu, Jingyu; Xie, Shaoyu; Li, Kaichun; Chang, Hong-Wei; Qin, Wei; Yu, Liang; Xie, Hua; Li, Guang-Jiang; Yang, Chengwu; Huang, Xiaoxia; Wang, Qin; Zhang, Xiujun

doi:10.3109/23744235.2016.1165351

Cited by 16 publications

(10 citation statements)

References 7 publications

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“…Although cases identified as SFTSV infection had previously been reported in nearby areas, no cases of SFTS have been reported there since the first case of SFTS was reported in China. Our study showed that the seropositivity rate of SFTSV-IgG antibodies among participants in Yixian country was 6.3%, which was higher than the reported rate of 4.66% in endemic areas of Anhui Province (21). This discrepancy may be related to the number involved, age, sex, geographic location, and types of antibodies tested (total antibodies or IgG antibodies against SFTSV) (22).…”

Section: Discussioncontrasting

confidence: 70%

Presence of Antibodies against Severe Fever with Thrombocytopenia Syndrome Virus in Non-Endemic Areas of China

et al. 2017

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Section: Discussioncontrasting

confidence: 70%

Presence of Antibodies against Severe Fever with Thrombocytopenia Syndrome Virus in Non-Endemic Areas of China

et al. 2017

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“…6 studies were of high quality, other studies were of moderate quality ( Table 1 ). Generally, the most prevalence studies were conducted in the center and east of China (Shaanxi [22], Henan [23], Hubei [24, 25], Zhejiang [26–28], Jiangsu [29–32], Jiangsu&Anhui [33], Anhui [34–36], and Shandong provinces [37–42]), the location of referred provinces in China was shown in Fig 2 .…”

Section: Resultsmentioning

confidence: 99%

Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis

Li¹,

Tong²,

Li³

et al. 2017

PLoS ONE

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ObjectiveSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus-SFTSV. The seroprevalence of anti-SFTSV antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTSV in the general population has been investigated in various epidemiological studies with inconsistent results. Here, we clarify this discrepancy and reach a more comprehensive result by mean of a meta-analysis.MethodsAll relevant articles were searched in the electronic databases (PubMed, Web of science, Embase, Chinese National Knowledge Infrastructure database, Chinese Wanfang database) up to November 2016. The pooled seroprevalence and 95% confidence intervals (95% CIs) were calculated by random- or fixed- model on the basis of heterogeneity.ResultsIn total, 21 studies containing 23,848 blood samples from 7 provinces were included in this meta-analysis. The minimum and maximum reported seroprevalences of SFTSV among humans in China were 0.23% and 9.17%, respectively. The overall pooled seroprevalence of SFTSV antibodies was 4.3% (95%CI: 3.2%-5.5%). The pooled prevalence was 5.9% (95%CI: 4.7%-7.0%) in Zhejiang province, 4.9% (95%CI: 4.1–5.8%) in Anhui province, 3.9% (95%CI: 1.3%-6.4%) in Shandong province, and 0.7% (95%CI: 0.2%-1.1%) in Jiangsu province. Stratified by occupation, the pooled prevalence of farmer was 6.1% (95%CI: 3.4%-8.9%) and others (mainly are students) was 3.3% (95%CI: 2.4%-4.2%). Additionally, seroprevalence of SFTSV in people who lived in the same village with the patient were higher than that of people who lived in a different village. Seropositive rates in sampling years after 2012 were higher than that before 2012. The prevalence of SFTSV did not differ by age or gender. Sensitive analysis by omitting one study at a time indicated the results of the pooled seroprevalence were robust.ConclusionsSeroprevalence of SFTSV among healthy population in central and eastern China is high. Surveillance efforts on mild or asymptomatic infections among endemic persons are needed.

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“…The SFTSV IgG seropositive rate (20.5%) in all subjects, especially in patients with fever, thrombocytopenia and leukopenia (30.1%), was higher than the rate reported in high endemic areas in healthy people; for example, these rates were 7.2% in Zhejiang province [ 14 ], 6.6% in Xinyang, Henan province [ 24 ], 5% in Macheng, Hubei province [ 25 ], 4.7% in the western region of Anhui province [ 26 ], 3.3% in Laizhou, Shandong province [ 27 ], and 0.4% in seven counties of Jiangsu province [ 28 ]. We found that the IgM positive rate was also high, which was not observed in healthy people [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Estimation of the incidence of severe fever with thrombocytopenia syndrome in high endemic areas in China: an inpatient-based retrospective study

Huang

Wang

et al. 2018

BMC Infect Dis

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BackgroundSevere fever with thrombocytopenia syndrome (SFTS) is a severe viral disease caused by SFTSV. It is important to estimate the rate of missed SFTS diagnosis and to further understand the actual incidence in high endemic areas in China.MethodsThis study was conducted in two high SFTS endemic provinces in 2015. Patients hospitalized in 2014 or within 1 year before investigation were selected after considering their clinical manifestations, specifically, fever, platelet, and white blood cell. During retrospective investigation, sera were collected to detect SFTSV antibodies to assess SFTSV infection. To further understand SFTSV infection, acute phase sera were detected; SFTSV infection rate among a healthy population was also investigated to determine the basic infection level.ResultsIn total, 246 hospitalized cases were included, including 83 cases (33.7%) with fever, thrombocytopenia and leukopenia, 38 cases (15.4%) with fever and thrombocytopenia but without leukopenia, and 125 cases (50.8%) without fever but with thrombocytopenia and leukopenia. In total, 13 patients (5.3%) were SFTSV IgM antibody-positive, 48 (19.5%) were IgG-positive. Of the 13 IgM-positive cases, 11 (84.6%) were IgG-positive (9 with titres ≥1:400). Seropositive rates of antibodies were high (8.4% for IgM and 30.1% for IgG) in patients with fever, thrombocytopenia and leukopenia. Furthermore, among IgG-positive cases in this group, 76% (19/25) of patients’ IgG antibody titres were ≥1:400. Additionally, 28 of 246 cases were initially diagnosed with suspected SFTS and were then excluded, and 218 patients were never diagnosed with SFTS; the seropositive rates of IgM and IgG in these two groups were 25% and 67.9% and 2.8% and 13.3%, respectively. These rates were 64.3% and 21.4% in 14 sera collected during acute phase of the 28 cases mentioned above. Seropositive rate of SFTSV IgG was only 1.3% in the patient-matched healthy group, and no IgM antibody was detected. A preliminary estimate of 8.3% of SFTS cases were missed in SFTS high endemic provinces.ConclusionsThe actual SFTS incidence was underestimated. Effective measures such as adding a new SFTS case category - “SFTS clinical diagnosis cases” or using serological detection methods during acute phase should be considered to avoid missed diagnoses.Electronic supplementary materialThe online version of this article (10.1186/s12879-018-2970-7) contains supplementary material, which is available to authorized users.

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Seroprevalence and risk factors of severe fever with thrombocytopenia syndrome virus infection in endemic areas

Cited by 16 publications

References 7 publications

Presence of Antibodies against Severe Fever with Thrombocytopenia Syndrome Virus in Non-Endemic Areas of China

Presence of Antibodies against Severe Fever with Thrombocytopenia Syndrome Virus in Non-Endemic Areas of China

Seroprevalence of severe fever with thrombocytopenia syndrome virus in China: A systematic review and meta-analysis

Estimation of the incidence of severe fever with thrombocytopenia syndrome in high endemic areas in China: an inpatient-based retrospective study

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