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

Abstract

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.

Low Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Virus Antibodies in Individuals Living in an Endemic Area in Japan

“…Furthermore, a recent study in South Korea reported that the seroprevalence of SFTS among patients visiting a tertiary hospital was 2.1%. The reasons for these discrepancies may be attributed, at least in part, to occupation, geographical location, and environmental conditions (10,21). However, it is more likely that the higher seroprevalence reported in China and South Korea might be because of the differences in the SFTSV antibody detection methods used.…”

“…However, it is more likely that the higher seroprevalence reported in China and South Korea might be because of the differences in the SFTSV antibody detection methods used. Previous studies have used a double-antigen ELISA or an indirect ELISA to detect anti-SFTSV IgG antibodies (10,21). However, we used ELISA and IFA to screen the samples, and FRNA was used to confirm if the samples tested positive or negative for SFTSV antibodies.…”

“…In China, a double-antigen ELISA or an indirect ELISA has been used to identify anti-SFTSV IgG antibodies in the general population. Li et al (10) recently conducted a systematic review of 21 studies on the seroprevalence of SFTSV in China. However, no studies have examined the seroprevalence of SFTSV in healthy individuals in Japan.…”

Socioeconomic burden of severe fever with thrombocytopenia syndrome in endemic areas of Anhui Province, eastern China

“…The prevalence of SFTSV infection has become an intractable public health issue in eastern and central China (Li et al, ). A previous study reported that the overall asymptomatic infection was 4.3%, and the hospital‐based investigation result showed that the incidence of SFTSV infection was evaluated as 8.4% in patients with a fever, thrombocytopenia and leukopenia in endemic areas of China (Huang et al, ; Li et al, ). Most SFTS cases were discovered and reported during the inpatient period after seeking treatment more than once.…”

Neutralizing antibodies to Severe Fever with Thrombocytopenia Syndrome Virus in general population, Shandong Province, China

“…This was consistent with the seasonal abundance of ticks 12 . Various epidemiological studies had investigated the prevalence of SFTSV in general populations and recognized that age was the critical risk factor or determinant for SFTSV morbidity and mortality 13 .…”