Two confirmed cases of severe fever with thrombocytopenia syndrome with pneumonia: implication for a family cluster in East China

Zhu, Yueyong; Wu, Huanyu; Gao, Jie; Zhou, Xueping; RenYi, Zhu; Zhang, Chunzhe; Bai, Hongling; Abdullah, Abu S.; Pān, Hào

doi:10.1186/s12879-017-2645-9

Cited by 29 publications

(23 citation statements)

References 25 publications

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“…The case fatality rate of SFTS is very high, ranging from 12 to 30% in China and 22 to 30% in South Korea and Japan [1, 5, 6]. SFTS was first recognized as a family cluster of infection in central China and family clusters SFTS has been reported in China and South Korea even after discovery of SFTSV [2, 3, 7–16]. Since discovery of SFTSV in 2010, more than 2000 confirmed SFTS patients were reported annually in China [17].…”

Section: Introductionmentioning

confidence: 99%

Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome

Qin

Han

et al. 2019

PLoS Negl Trop Dis

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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.

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Section: Introductionmentioning

confidence: 99%

Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome

Qin

Han

et al. 2019

PLoS Negl Trop Dis

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“…Although SFTSV infection in humans is believed to be predominantly mediated through bites from virus-infected ticks, the first human-to-human transmission of SFTSV through contact or exposure to patient blood was reported in 2012 [10]. Since then, possible human-to-human transmissions of SFTS have been reported in families, co-residents of villages, and even in the hospital setting [11–14]. Further, some secondarily infected patients died with high viral loads and clinical symptoms, including high fever and low platelet counts [15].…”

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confidence: 99%

Shedding and Transmission Modes of Severe Fever With Thrombocytopenia Syndrome Phlebovirus in a Ferret Model

Jeong

Park

et al. 2019

Open Forum Infectious Diseases

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Background Although human-to-human transmission of severe fever with thrombocytopenia syndrome phlebovirus (SFTSV) via direct contact with body fluids has been reported, the role of specific body fluids from SFTSV-infected hosts has not been investigated in detail. Methods To demonstrate the virus transmission kinetics in SFTSV-infected hosts, we adapted the ferret infection model, and evaluated the virus shedding periods, virus titers, and transmission modes from various specimens of infected ferrets. Results Large amounts of infectious SFTSV are shed through nasal discharge, saliva and urine from SFTSV-infected ferrets. Virus could be detected from 2 dpi and persisted until 12 dpi in these specimens compared to the relatively short virus shedding period in sera. Further, transmission studies revealed that SFTSV can be transmitted to close direct- and indirect-contact naïve animals through various mediums, especially through contact with serum and urine. Further, ferrets contacted with human urine specimens from SFTSV-positive patients were successfully infected with SFTSV suggesting urine specimens could be a source of SFTSV infection in humans. Conclusion Our results demonstrate that the SFTSV can be shed in various body fluids for more than 12 days, and that these specimens can be a source for direct or indirect transmission to close contact personals.

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“…A case in which viruses did not disappear after plasma exchange has also been reported [14]. Moreover, there were several case reports that strongly suggest droplet infection [15], including a case in which a patient with SFTS developed severe pneumonia in an early stage after disease onset, and two caregiving family members also developed SFTS [16]. In addition, there was a case report of SFTS development in two persons who did not touch the body fluid of an SFTSV-infected corpse but stayed for a long period of time in a small room where the corpse was laid, indicating a possibility of aerosol transmission of SFTSV [17].…”

Section: Discussionmentioning

confidence: 98%

Detection of viral RNA in diverse body fluids in an SFTS patient with encephalopathy, gastrointestinal bleeding and pneumonia: a case report and literature review

et al. 2020

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Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that commonly has a lethal course caused by the tick-borne Huaiyangshan banyang virus [former SFTS virus (SFTSV)]. The viral load in various body fluids in SFTS patients and the best infection control measure for SFTS patients have not been fully established. Case presentation: A 79-year-old man was bitten by a tick while working in the bamboo grove in Nagasaki Prefecture in the southwest part of Japan. Due to the occurrence of impaired consciousness, he was referred to Nagasaki University Hospital for treatment. The serum sample tested positive for SFTSV-RNA in the genome amplification assay, and he was diagnosed with SFTS. Furthermore, SFTSV-RNA was detected from the tick that had bitten the patient. He was treated with multimodal therapy, including platelet transfusion, antimicrobials, antifungals, steroids, and continuous hemodiafiltration. His respiration was assisted with mechanical ventilation. On day 5, taking the day on which he was hospitalized as day 0, serum SFTSV-RNA levels reached a peak and then decreased. However, the cerebrospinal fluid collected on day 13 was positive for SFTSV-RNA. In addition, although serum SFTSV-RNA levels decreased below the detectable level on day 16, he was diagnosed with pneumonia with computed tomography. SFTSV-RNA was detected in the bronchoalveolar lavage fluid on day 21. By day 31, he recovered consciousness completely. The pneumonia improved by day 51, but SFTSV-RNA in the sputum remained

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Two confirmed cases of severe fever with thrombocytopenia syndrome with pneumonia: implication for a family cluster in East China

Cited by 29 publications

References 25 publications

Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome

Severe fever with thrombocytopenia syndrome can masquerade as hemorrhagic fever with renal syndrome

Shedding and Transmission Modes of Severe Fever With Thrombocytopenia Syndrome Phlebovirus in a Ferret Model

Detection of viral RNA in diverse body fluids in an SFTS patient with encephalopathy, gastrointestinal bleeding and pneumonia: a case report and literature review

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