scholarly journals Clinical Update of Severe Fever with Thrombocytopenia Syndrome

Viruses ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1213
Author(s):  
Jun-Won Seo ◽  
Dayoung Kim ◽  
Nara Yun ◽  
Dong-Min Kim
Keyword(s):  
Antiviral Agents ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
Multiple Organ ◽  
Haemaphysalis Longicornis ◽  
Number Of Patients ◽  
Amblyomma Testudinarium ◽  
Severe Fever

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.

scholarly journals Nationwide Temporal and Geographical Distribution of Tick Populations and Phylogenetic Analysis of Severe Fever with Thrombocytopenia Syndrome Virus in Ticks in Korea, 2020

2021 ◽  
Vol 9 (8) ◽  
pp. 1630
Author(s):  
Min-Goo Seo ◽  
Byung-Eon Noh ◽  
Hak Seon Lee ◽  
Tae-Kyu Kim ◽  
Bong-Goo Song ◽  
...  
Keyword(s):  
Tick Species ◽  
Temporal Distribution ◽  
Epidemiological Studies ◽  
Haemaphysalis Longicornis ◽  
Geographical Regions ◽  
Control And Prevention ◽  
Amblyomma Testudinarium ◽  
High Degree ◽  
Severe Fever ◽  
Minimum Infection Rate

Since 2010, the Korea Disease Control and Prevention Agency has established centers at 16 locations to monitor disease vectors and pathogens. Here, we examined tick populations to understand the geographical and temporal distribution of severe fever with thrombocytopenia syndrome virus (SFTSV) vectors in 2020. From April to November, 63,376 ticks were collected from traps to monitor tick populations, with a trap index of 41.3. Tick incidence varied from April to October, with population peaks observed for nymphs in May, adults in July, and larvae in September. The predominant tick species were Haemaphysalis longicornis, Haemaphysalis spp., H. flava, Ixodes spp., Amblyomma testudinarium, and Ixodes nipponensis. Approximately 50% of the collected ticks were pooled into 2973 groups to detect the rate of SFTSV infection in ticks. The minimum infection rate (MIR) of SFTSV was 0.2%, and Andong had the highest MIR for SFTSV (4.0%). The B3 genotype was the most prevalent (52.2%) followed by B2 (28.6%), B5 (15.9%), B4 (1.6%), and B6 (1.6%). We identified widely distributed tick species and a high degree of diversity in SFTSV strains in ticks from different geographical regions. The results may provide a basis for future epidemiological studies and risk assessments for tick-borne diseases.

scholarly journals IL-6 and IL-10 Levels, Rather Than Viral Load and Neutralizing Antibody Titers, Determine the Fate of Patients With Severe Fever With Thrombocytopenia Syndrome Virus Infection in South Korea

2021 ◽  
Vol 12 ◽  
Author(s):  
Jeong Rae Yoo ◽  
Tae-Jin Kim ◽  
Sang Taek Heo ◽  
Kyung-Ah Hwang ◽  
Hyunjoo Oh ◽  
...  
Keyword(s):  
Viral Load ◽  
Close Contact ◽  
Multiorgan Failure ◽  
Severe Disease ◽  
Elevated Serum ◽  
Gastrointestinal Symptoms ◽  
Neutralizing Antibody ◽  
Haemaphysalis Longicornis ◽  
Antibody Titers ◽  
Severe Fever

Severe fever with thrombocytopenia syndrome (SFTS) is a new tick-borne viral disease, and most SFTS virus (SFTSV) infections occur via bites from the tick Haemaphysalis longicornis; however, SFTSV transmission can also occur through close contact with an infected patient. SFTS is characterized by acute high fever, thrombocytopenia, leukopenia, elevated serum hepatic enzyme levels, gastrointestinal symptoms, and multiorgan failure and has a 16.2 to 30% mortality rate. In this study, we found that age, dyspnea rates, aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase, multiorgan dysfunction score (MODS), viral load, IL-6 levels, and IL-10 levels were higher in patients with fatal disease than in patients with nonfatal disease during the initial clinical course of SFTS. In addition, we found that IL-6 and IL-10 levels, rather than viral load and neutralizing antibody titers, in patients with an SFTSV infection strongly correlated with outcomes (for severe disease with an ultimate outcome of recovery or death).

scholarly journals Severe fever with thrombocytopenia syndrome: the disease, caused by the novel phlebovirus

2017 ◽  
Vol 62 (2) ◽  
pp. 60-65
Author(s):  
T. E. Sizikova ◽  
V. N. Lebedev ◽  
V. B. Pantukhov ◽  
S. V. Borisevich
Keyword(s):  
Clinical Symptoms ◽  
Gastrointestinal Symptoms ◽  
Epidemiological Studies ◽  
Domestic Animals ◽  
Human Infection ◽  
Haemaphysalis Longicornis ◽  
Bleeding Tendency ◽  
The Novel ◽  
Bunyaviridae Family ◽  
Severe Fever

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a new virus (SFTS virus) reported to be endemic to central and northeastern parts of China. SFTS virus, which is classified into the genus Phlebovirus (the Bunyaviridae family), is suspected to be a tick-borne virus owing to evidence in two species of ticks: Haemaphysalis longicornis and Rhipicephalus microplus. SFTS virus is detected among many species of domestic animals in China. The clinical symptoms of SFTS include fever, thrombocytopenia, leucocytopenia, gastrointestinal symptoms, neural symptoms, bleeding tendency. The fatality rate of SFTS is 6-30%. Person-to-person transmission of SFTS virus is possible through blood contact. Clinical and epidemiological studies of SFTS, the cases of SFTS outside China, person-to-person transmission of SFTS virus, evolutionary and molecular analysis of the emergent SFTS virus, and risk assessment of human infection with a novel phlebovirus are considered in this review.

scholarly journals Severe Fever with Thrombocytopenic Syndrome: Current Epidemiological Situation

2021 ◽  
Vol 20 (4) ◽  
pp. 114-122
Author(s):  
E. I. Andaev ◽  
R. V. Adelshin ◽  
S. V. Balakhonov
Keyword(s):  
Rural Areas ◽  
Pacific Islands ◽  
Far East ◽  
Clinical Manifestations ◽  
Central China ◽  
Haemaphysalis Longicornis ◽  
Emerging Infections ◽  
North East ◽  
Severe Fever ◽  
Epidemiological Situation

Relevance. Severe fever with thrombocytopenia syndrome is a viral disease characterized by acute fever, accompanied by progressive thrombocytopenia, leucopenia. The mortality is up to 30%. The disease was first identified in 2009 in rural areas of central China, Hubei and Henan. The causative agent of the disease is a new Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV). The SFTSV is mainly transmitted through tick bites, especially Haemaphysalis longicornis which is the dominant tick species in East Asia.The aim of the review is to analyze relevant information about Severe Fever with Thrombocytopenia Syndrome, including the molecular genetics features of the pathogen, clinical manifestations, geographical distribution, epidemiological features, as well as the possibility of drift and spread of infection in the Russian Federation.Conclusions. SFTS is a serious health threat as it relates to new and re-emerging infections. The further spread of SFTS in China may complicate the epidemiological situation in the country. SFTSV may have a much wider global distribution in Southeast Asia than is currently known. The risk of H. longicornis ticks spreading is predicted in the north-east United States, New Zealand, parts of Australia and several Pacific islands. The presence of the H. longicornis in the Primorsky Territory on the Far East indicates a possible risk of the natural focus formation in the event of the introduction of the pathogen.

scholarly journals Clinical and genetic spectrum of mitochondrial neurogastrointestinal encephalomyopathy

Brain ◽  
2011 ◽  
Vol 134 (11) ◽  
pp. 3326-3332 ◽  
Author(s):  
Caterina Garone ◽  
Saba Tadesse ◽  
Michio Hirano
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Progressive External Ophthalmoplegia ◽  
Metabolic Complications ◽  
Mitochondrial Neurogastrointestinal Encephalomyopathy ◽  
Number Of Patients

Abstract Mitochondrial neurogastrointestinal encephalomyopathy is a rare multisystemic autosomic recessive disorder characterized by: onset typically before the age of 30 years; ptosis; progressive external ophthalmoplegia; gastrointestinal dysmotility; cachexia; peripheral neuropathy; and leucoencephalopathy. The disease is caused by mutations in the TYMP gene encoding thymidine phosphorylasethymine phosphorylase. Anecdotal reports suggest that allogeneic haematopoetic stem cell transplantation may be beneficial for mitochondrial neurogastrointestinal encephalomyopathy, but is associated with a high mortality. After selecting patients who fulfilled the clinical criteria for mitochondrial neurogastrointestinal encephalomyopathy and had severe thymidine phosphorylase deficiency in the buffy coat (<10% of normal activity), we reviewed their medical records and laboratory studies. We identified 102 patients (50 females) with mitochondrial neurogastrointestinal encephalomyopathy and an average age of 32.4 years (range 11–59 years). We found 20 novel TYMP mutations. The average age-at-onset was 17.9 years (range 5 months to 35 years); however, the majority of patients reported the first symptoms before the age of 12 years. The patient distribution suggests a relatively high prevalence in Europeans, while the mutation distribution suggests founder effects for a few mutations, such as c.866A>G in Europe and c.518T>G in the Dominican Republic, that could guide genetic screening in each location. Although the sequence of clinical manifestations in the disease varied, half of the patients initially had gastrointestinal symptoms. We confirmed anecdotal reports of intra- and inter-familial clinical variability and absence of genotype–phenotype correlation in the disease, suggesting genetic modifiers, environmental factors or both contribute to disease manifestations. Acute medical events such as infections often provoked worsening of symptoms, suggesting that careful monitoring and early treatment of intercurrent illnesses may be beneficial. We observed endocrine/exocrine pancreatic insufficiency, which had not previously been reported. Kaplan–Meier analysis revealed significant mortality between the ages of 20 and 40 years due to infectious or metabolic complications. Despite increasing awareness of this illness, a high proportion of patients had been misdiagnosed. Early and accurate diagnosis of mitochondrial neurogastrointestinal encephalomyopathy, together with timely treatment of acute intercurrent illnesses, may retard disease progression and increase the number of patients eligible for allogeneic haematopoetic stem cell transplantation.

scholarly journals Clinical manifestations of pandemic (H1N1) 2009 in the ambulatory setting

2011 ◽  
Vol 5 (09) ◽  
pp. 658-663 ◽  
Author(s):  
Vítor Duque ◽  
João Vaz ◽  
Vanda Mota ◽  
Célia Morais ◽  
Saraiva Da Cunha ◽  
...  
Keyword(s):  
Pandemic Influenza ◽  
Influenza Pandemic ◽  
Clinical Manifestations ◽  
Febrile Illness ◽  
Laboratory Diagnosis ◽  
World Health ◽  
Ambulatory Setting ◽  
Pandemic H1n1 ◽  
Pandemic H1n1 2009 ◽  
Health Organization

Introduction: In June 2009, the World Health Organization declared an influenza pandemic associated with the pandemic (H1N1) 2009 strain. It was summer in the northern hemisphere, and therefore travelling and vacation time, which also provided an increased opportunity for the dissemination of respiratory diseases. Methodology: We reviewed the paper case report forms from all the patients with influenza-like illnesses with nasopharyngeal samples submitted for laboratory diagnosis of pandemic (H1N1) 2009 infection during the first wave of pandemic influenza that occurred between June and August 2009, in the central region of Portugal. Results: From all the patients with influenza-like illnesses, one third was found positive for pandemic (H1N1) 2009. Individuals under the age of 29 (75%) were the most affected. Most of the patients (91%) presented with fever. A group of symptoms were positively correlated with the probability of pandemic (H1N1) 2009 infection: cough, epistaxis, lack of dyspnea or vomiting, fever, headache and myalgia. Conclusions: During the first wave of the pandemic influenza, young individuals were the most affected, and in the ambulatory setting, presentation was of a mild febrile illness without complications.

scholarly journals Identification of a new orthonairovirus associated with human febrile illness in China

2020 ◽  
Author(s):  
Jun Ma ◽  
Xiao-Long Lv ◽  
Xu Zhang ◽  
Shu-Zheng Han ◽  
Ze-Dong Wang ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Morphological Characteristics ◽  
Febrile Illness ◽  
Hemorrhagic Fever ◽  
Structural Features ◽  
Northeastern China ◽  
Ixodes Persulcatus ◽  
Haemaphysalis Longicornis ◽  
Human Hepatoma Cells ◽  
Hemorrhagic Fever Virus

AbstractThe genus Orthonairovirus of the family Nairoviridae includes the important tick-transmitted pathogens, Crimean-Congo hemorrhagic fever virus (CCHFV) and Nairobi sheep disease virus (NSDV), as well as many other poorly characterized viruses isolated from ticks, birds, and mammals1,2. Here we identified a novel orthonairovirus, designated Sōnglǐng virus (SGLV), from patients who reported being bitten by a tick in China. The genome of SGLV shared similar structural features with orthonairoviruses, with 46.5–65.7% sequence identify. Phylogenetic analysis showed that SGLV belonged to the Tamdy orthonairovirus and formed a unique clade in the Nairoviridae family. Electron microscopy revealed typical morphological characteristics of orthonairoviruses. The isolated SGLVs from the blood samples of patients could induce cytopathic effects in human hepatoma cells. SGLV infection was confirmed in 42 patients in 2017-2018, with the main clinical manifestations of headache, fever, depression, fatigue and dizziness. Serological assays showed that 69% patients generated virus-specific antibody responses in the acute phase. In contrast, neither SGLV viral RNA nor specific antibodies against SGLV were detected in healthy individuals. SGLV was also detected in Ixodes crenulatus, Haemaphysalis longicornis, Haemaphysalis concinna, and Ixodes persulcatus in northeastern China. Collectively, a newly discovered orthonairovirus was shown to be associated with human febrile illness in northeastern China.

scholarly journals Clinical Characteristics of Inpatients with Anaphylaxis in China

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Rui Tang ◽  
Han-Yi Xu ◽  
Ju Cao ◽  
Shi Chen ◽  
Jin-Lu Sun ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Multiple Organ ◽  
Female Ratio ◽  
Multisystem Involvement ◽  
Organ Systems ◽  
Number Of Patients ◽  
Male Patients ◽  
Male To Female

Objective.To analyze the clinical characteristics of inpatients with anaphylaxis and the factors that influenced those characteristics.Methods.Using the patient records from 1990 to 2013 from three highly ranked Chinese hospitals, we retrospectively analyzed the characteristics of 108 inpatients with anaphylaxis (not anaphylaxis admitted).Results.The mean patient age was42±20years old and male-to-female ratio was 1 : 1.3. The number of patients with anaphylaxis increased gradually, and cases diagnosed after 2005 accounted for 68.5% of the 108 total cases. The most common trigger was medications. The most common clinical manifestations included cutaneous, nervous, respiratory, circulatory, and digestive signs and symptoms. Male patients were more likely to experience loss of consciousness. Multisystem involvement was more likely to develop in patients with low BP, whereas it was uncommon in those with anaphylaxis induced by antibiotics or anesthetics. Epinephrine was used as the first-line treatment for 56 cases.Conclusions.Inpatient with anaphylaxis was more common in female patients and the number increased gradually during the study period. The most common trigger was medications. Patients with low BP were prone to having multisystem involvement, whereas the cases of anaphylaxis induced by antibiotics and anesthetics were less likely to involve multiple organ systems.

Bone marrow findings in severe fever with thrombocytopenia syndrome: prominent haemophagocytosis and its implication in haemophagocytic lymphohistiocytosis

2015 ◽  
Vol 69 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Namhee Kim ◽  
Kye-Hyung Kim ◽  
Su Jin Lee ◽  
Sang-Hyuk Park ◽  
In-Suk Kim ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Fatal Case ◽  
Gastrointestinal Symptoms ◽  
Unknown Origin ◽  
Bone Marrow Examination ◽  
Multiple Organ ◽  
Haemophagocytic Lymphohistiocytosis ◽  
University Hospitals ◽  
Aetiological Diagnosis ◽  
Severe Fever

AimsSevere fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease caused by the SFTS virus; primary manifestations are fever, thrombocytopenia, leukopenia and gastrointestinal symptoms. Before an aetiological diagnosis is made, SFTS patients can undergo bone marrow examination due to cytopenias. Although several studies have reported on bone marrow examination in SFTS patients, most do not provide adequate details. Bone marrow findings in SFTS patients were investigated in this study.MethodsAn observational study was conducted in SFTS patients who were hospitalised between 2013 and 2014 in two university hospitals in South Korea. Patients were included in the study if SFTS was confirmed by real-time PCR for the SFTS virus and a bone marrow examination was conducted. The morphologic findings of the bone marrow samples were reviewed.ResultsThree cases met the study inclusion criteria. One patient died of multiple organ failure. Haemophagocytosis was evident in the bone marrow samples of all three patients. Histiocytic hyperplasia and haemophagocytosis were more pronounced in the fatal case. One patient was diagnosed as having haemophagocytic lymphohistiocytosis.ConclusionsHaemophagocytosis in the bone marrow of SFTS patients may be common. In SFTS endemic areas, SFTS should be one of the differential diagnoses of fever of unknown origin with haemophagocytosis in the bone marrow.

scholarly journals Impact of C-Reactive Protein Levels on Differentiating of Severe Fever With Thrombocytopenia Syndrome From Japanese Spotted Fever

2020 ◽  
Vol 7 (11) ◽  
Author(s):  
Takeshi Kawaguchi ◽  
Kunihiko Umekita ◽  
Atsushi Yamanaka ◽  
Seiichiro Hara ◽  
Tetsuro Yamaguchi ◽  
...  
Keyword(s):  
Spotted Fever ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Positive Likelihood Ratio ◽  
Hemorrhagic Fever ◽  
Spotted Fever Group ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Severe Fever

Abstract Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. Japanese spotted fever (JSF), which belongs to spotted fever group rickettsioses, is also endemic to Western Japan. Patients with SFTS and those with JSF display many of the same clinical manifestations. Sudden fever, rash, tick bite, and neurological and gastrointestinal symptoms may be seen in both infections, but the frequency and severity of each disease have not been compared and studied. Because laboratory confirmation of pathogens takes time, it is important to predict diagnosis of SFTS vs JSF based on the features of the clinical characteristics at the initial presentation, particularly in primary care settings. Methods We conducted a case series review at 4 medical facilities in Miyazaki, Japan. Based on the medical records, clinical and laboratory characteristics were compared between patients with SFTS and those with JSF. Results Eighty-one patients were enrolled in this study, including 41 with SFTS and 40 with JSF. The absence of rash (P < .001), leukopenia (P < .001), and normal C-reactive protein (CRP) levels (P < .001) were the variables distinguishing SFTS from JSF. Normal CRP levels (≤1.0 mg/dL) had a 95% sensitivity (84%–99%) and 97% specificity (87%–100%) for SFTS, with a positive likelihood ratio of 37.1 (5.35–257). Conclusions Normal serum CRP levels were shown to differentiate SFTS from JSF with a very high probability.

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