两起发热伴血小板减少综合征聚集性疫情流行病学及病原学分析

doi:10.16288/j.yczz.23-176

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Hereditas(Beijing) ›› 2023, Vol. 45 ›› Issue (11): 1062-1073.doi: 10.16288/j.yczz.23-176

• Research Article • Previous Articles Next Articles

Epidemiololgical and etiological analysis of two clusters of severe fever with thrombocytopenia syndrome

Xin Yang¹(), Yongxiang Wu¹, Yu Leng¹, Jiachen Li², Chaojie Wang¹, Yimei Yuan³, Zhen Wang³, Lan Zhang³, Hao Li¹(), Wei Liu¹()

1. Institute of Microbiology and Epidemiology,Academy of Military Medical Sciences; state Key Laboratory of Pathogen and Biosecurity; Beijing Key Laboratory of Vector Borne and Natural Focus Infectious Diseases, Beijing 100071, China
2. Center for Disease Control and Prevention in Northern Theater Command，Shenyang 110034, China
3. Xinyang 154th Hospital, Xinyang 464000, China

Received:2023-06-29 Revised:2023-09-15 Online:2023-11-20 Published:2023-09-29
Contact: Hao Li,Wei Liu E-mail:499163792@qq.com;lwbime@163.com;lihao_1986@126.com
Supported by:
National Natural Science Foundation of China(82172270)

Abstract

Abstract:

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease, caused by severe fever with thrombocytopenia syndrome virus (SFTSV), which is primarily transmitted via tick bites. Clusters of SFTS caused by human-to-human transmission have been reported both at home and abroad, mainly focused on the transmission or exposure modes. However, the correlation between SFTS clusters and viral genotypes has not been investigated. This study mainly reported two clusters of SFTS in Xinyang City, Henan Province, from 2022 to 2023, discussed the possible route of person-to-person transmission of SFTSV infection and analyzed the association between SFTS clusters and virus genotypes. We found that two groups of SFTSV in two clusters were clustered separately into different genotypes through viral sequence analysis of 4 confirmed patients. We also performed phylogenetic analysis, after including SFTSV sequences obtained from SFTS clusters deposited in the GenBank. Three SFTSV genotypes have been reported among cases of human-to-human transmission, suggesting that the occurrence of SFTS clusters may not be related to SFTSV genotypes. This study provided genetic evidence for revealing the chain of human-to-human transmission of SFTS clusters, indicating that contact with patients’ blood is an important transmission route of SFTSV. The findings laid the foundation for preventing and controlling human-to-human transmission of SFTS.

Key words: severe fever with thrombocytopenia syndrome, tick-borne diseases, human-to-human transmission

Xin Yang, Yongxiang Wu, Yu Leng, Jiachen Li, Chaojie Wang, Yimei Yuan, Zhen Wang, Lan Zhang, Hao Li, Wei Liu. Epidemiololgical and etiological analysis of two clusters of severe fever with thrombocytopenia syndrome[J]. Hereditas(Beijing), 2023, 45(11): 1062-1073.

Figures/Tables 5

Table 1

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Table 2

References 23

[1]	Yu XJ, Liang MF, Zhang SY, Liu Y, Li JD, Sun YL, Zhang LH, Zhang QF, Popov VL, Li C, Qu J, Li Q, Zhang YP, Hai R, Wu W, Wang Q, Zhan FX, Wang XJ, Kan B, Wang SW, Wan KL, Jing HQ, Lu JX, Yin WW, Zhou H, Guan XH, Liu JF, Bi ZQ, Liu GH, Ren J, Wang H, Zhao Z, Song JD, He JR, Wan T, Zhang JS, Fu XP, Sun LN, Dong XP, Feng ZJ, Yang WZ, Hong T, Zhang Y, Walker DH, Wang Y, Li DX. Fever with thrombocytopenia associated with a novel bunyavirus in China. N Engl J Med, 2011, 364(16): 1523-1532. doi: 10.1056/NEJMoa1010095
[2]	Tang XY, Wu WL, Wang HF, Du YH, Liu LC, Kang K, Huang XY, Ma H, Mu F, Zhang SQ, Zhao GH, Cui N, Zhu BP, You AG, Chen HM, Liu GH, Chen WJ, Xu BL. Human-to-human transmission of severe fever with thrombocytopenia syndrome bunyavirus through contact with infectious blood. J Infect Dis, 2013, 207(5): 736-739. doi: 10.1093/infdis/jis748 pmid: 23225899
[3]	Jiang XL, Zhang S, Jiang M, Bi ZQ, Liang MF, Ding SJ, Wang SW, Liu JY, Zhou SQ, Zhang XM, Li DX, Xu AQ. A cluster of person-to-person transmission cases caused by SFTS virus in Penglai, China. Clin Microbiol Infect, 2015, 21(3): 274-279. doi: 10.1016/j.cmi.2014.10.006
[4]	Chen HB, Hu K, Zou JJ, Xiao JX. A cluster of cases of human-to-human transmission caused by severe fever with thrombocytopenia syndrome bunyavirus. Int J Infect Dis, 2013, 17(3): e206-e208. doi: 10.1016/j.ijid.2012.11.006
[5]	Zhan JB, Wang Q, Cheng J, Hu B, Li J, Zhan FX, Song Y, Guo DY. Current status of severe fever with thrombocytopenia syndrome in China. Virol Sin, 2017, 32(1): 51-62. doi: 10.1007/s12250-016-3931-1 pmid: 28251515
[6]	Gai ZT, Liang MF, Zhang Y, Zhang S, Jin C, Wang SW, Sun LF, Zhou N, Zhang QF, Sun YL, Ding SJ, Li C, Gu W, Zhang FS, Wang YS, Bian PF, Li XY, Wang ZQ, Song XG, Wang XJ, Xu AQ, Bi ZQ, Chen SJ, Li DX. Person- to-person transmission of severe fever with thrombocytopenia syndrome bunyavirus through blood contact. Clin Infect Dis, 2012, 54(2): 249-252. doi: 10.1093/cid/cir776
[7]	Huang DY, Jiang YP, Liu XP, Wang B, Shi JM, Su Z, Wang H, Wang T, Tang S, Liu HY, Hu ZH, Deng F, Shen S. A cluster of symptomatic and asymptomatic infections of severe fever with thrombocytopenia syndrome caused by person-to-person transmission. Am J Trop Med Hyg, 2017, 97(2): 396-402. doi: 10.4269/ajtmh.17-0059
[8]	Wu YX, Yang X, Leng Y, Li JC, Yuan L, Wang Z, Fan XJ, Yuan C, Liu W, Li H. Human-to-human transmission of severe fever with thrombocytopenia syndrome virus through potential ocular exposure to infectious blood. Int J Infect Dis, 2022, 123: 80-83. doi: 10.1016/j.ijid.2022.08.008
[9]	Bao CJ, Guo XL, Qi X, Hu JL, Zhou MH, Varma JK, Cui LB, Yang HT, Jiao YJ, Klena JD, Li LX, Tao WY, Li X, Chen Y, Zhu Z, Xu K, Shen AH, Wu T, Peng HY, Li ZF, Shan J, Shi ZY, Wang H. A family cluster of infections by a newly recognized bunyavirus in eastern China, 2007: further evidence of person-to-person transmission. Clin Infect Dis, 2011, 53(12): 1208-1214. doi: 10.1093/cid/cir732
[10]	Wang YL, Deng BC, Zhang J, Cui W, Yao WQ, Liu P. Person-to-person asymptomatic infection of severe fever with thrombocytopenia syndrome virus through blood contact. Intern Med, 2014, 53(8): 903-906. doi: 10.2169/internalmedicine.53.1164
[11]	Liu Y, Li Q, Hu WF, Wu JB, Wang YB, Mei L, Walker DH, Ren J, Wang Y, Yu XJ. Person-to-person transmission of severe fever with thrombocytopenia syndrome virus. Vector Borne Zoonotic Dis, 2012, 12(2): 156-160. doi: 10.1089/vbz.2011.0758 pmid: 21955213
[12]	Yoo JR, Heo ST, Park D, Kim H, Fukuma A, Fukushi S, Shimojima M, Lee KH. Family cluster analysis of severe fever with thrombocytopenia syndrome virus infection in Korea. Am J Trop Med Hyg, 2016, 95(6): 1351-1357. doi: 10.4269/ajtmh.16-0527
[13]	Tao MY, Liu Y, Ling F, Zhang R, Shi XG, Ren JP, Guo S, Sun JM, Jiang JM. Characteristics of three person-to- person transmission clusters of severe fever with thrombocytopenia syndrome in southeastern China. Am J Trop Med Hyg, 2021, 105(3): 794-800. doi: 10.4269/ajtmh.21-0366
[14]	Jung IY, Choi W, Kim J, Wang E, Park SW, Lee WJ, Choi JY, Kim HY, Uh Y, Kim YK. Nosocomial person-to-person transmission of severe fever with thrombocytopenia syndrome. Clin Microbiol Infect, 2019, 25(5): 633.e1-633.e4. doi: 10.1016/j.cmi.2019.01.006
[15]	Liu Q, He B, Huang SY, Wei F, Zhu XQ. Severe fever with thrombocytopenia syndrome, an emerging tick-borne zoonosis. Lancet Infect Dis, 2014, 14(8): 763-772. doi: S1473-3099(14)70718-2 pmid: 24837566
[16]	Jeong EJ, Song JY, Lim CS, Lee I, Park MS, Choi MJ, Jeon JH, Kang SH, Jung BK, Yoon JG, Hyun HJ, Noh JY, Cheong HJ, Kim WJ. Viral shedding from diverse body fluids in a patient with severe fever with thrombocytopenia syndrome. J Clin Virol, 2016, 80: 33-35. doi: 10.1016/j.jcv.2016.04.018 pmid: 27135388
[17]	Gong Z, Gu S, Zhang Y, Sun J, Wu X, Ling F, Shi W, Zhang P, Li D, Mao H, Zhang L, Wen D, Zhou B, Zhang H, Huang Y, Zhang R, Jiang J, Lin J, Xia S, Chen E, Chen Z. Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China. Clin Microbiol Infect, 2015, 21(12): 1115-1120. doi: 10.1016/j.cmi.2015.07.024
[18]	Kim WY, Choi W, Park SW, Wang EB, Lee WJ, Jee Y, Lim KS, Lee HJ, Kim SM, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH. Nosocomial transmission of severe fever with thrombocytopenia syndrome in Korea. Clin Infect Dis, 2015, 60(11): 1681-1683.
[19]	Zhang DW, Sun CK, Yu HY, Li JX, Liu WD, Li ZF, Bao CJ, Liu DP, Zhang N, Zhu FC, Hu JL. Environmental risk factors and geographic distribution of severe fever with thrombocytopenia syndrome in Jiangsu province, China. Vector Borne Zoonotic Dis, 2019, 19(10): 758-766. doi: 10.1089/vbz.2018.2425 pmid: 30994412
[20]	Sun JM, Lu L, Wu HX, Yang J, Ren JP, Liu QY.The changing epidemiological characteristics of severe fever with thrombocytopenia syndrome in China, 2011-2016. Sci Rep, 2017, 7(1): 9236. doi: 10.1038/s41598-017-08042-6 pmid: 28835633
[21]	Li H, Lu QB, Xing B, Zhang SF, Liu K, Du J, Li XK, Cui N, Yang ZD, Wang LY, Hu JG, Cao WC, Liu W.Epidemiological and clinical features of laboratory-diagnosed severe fever with thrombocytopenia syndrome in China, 2011-17:a prospective observational study. Lancet Infect Dis, 2018, 18(10): 1127-1137. doi: 10.1016/S1473-3099(18)30293-7
[22]	He ZQ, Wang BH, Li Y, Du YH, Ma HX, Li XL, Guo WS, Xu BL, Huang XY. Severe fever with thrombocytopenia syndrome: a systematic review and meta-analysis of epidemiology, clinical signs, routine laboratory diagnosis, risk factors, and outcomes. BMC Infect Dis, 2020, 20(1): 575. doi: 10.1186/s12879-020-05303-0 pmid: 32758175
[23]	Mao LL, Deng BC, Liang YH, Liu Y, Wang ZJ, Zhang J, Wu W, Yu L, Yao WQ. Epidemiological and genetic investigation of a cluster of cases of severe fever with thrombocytopenia syndrome bunyavirus. BMC Infect Dis, 2020, 20(1): 346. doi: 10.1186/s12879-020-05072-w pmid: 32410583

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人员信息	聚集性疫情1				聚集性疫情2
人员信息	原发病例1	继发病例1	密接1	密接2	原发病例2	继发病例2	密接1	密接2	密接3	密接4
姓名	张某	高某田	高某超	沈某慧	彭某芳	易某山	李某秀	易某霞	李某英	易某军
人物关系	N/A	儿子	丈夫	儿媳	N/A	儿子1	弟媳	女儿	儿媳	儿子2
性别	女	男	男	女	女	男	女	女	女	男
年龄	68	43	67	46	75	50	70	53	51	57
入院日期	2022/5/12	2022/5/27	N/A	N/A	2023/5/27	2023/6/7	N/A	N/A	N/A	N/A
发病日期	2022/5/8	2022/5/23	N/A	N/A	2023/5/20	2023/6/3	N/A	N/A	N/A	N/A
结局	死亡	幸存	无症状	无症状	死亡	幸存	无症状	无症状	无症状	无症状
出/转院日期	2022/5/16	2022/6/6	N/A	N/A	2023/5/27	2023/6/12	N/A	N/A	N/A	N/A
发病间隔(天)	7	5	N/A	N/A	N/A	7	N/A	N/A	N/A	N/A
入院延迟(天)	4	4	N/A	N/A	7	4	N/A	N/A	N/A	N/A
死亡延迟(天)	10	N/A	N/A	N/A	8	N/A	N/A	N/A	N/A	N/A
入院病毒CT值	29.08	33.42	N/A	N/A	12.5	27.84	N/A	N/A	N/A	N/A
最低病毒CT值	17.89	30.5	N/A	N/A	12.5	22.36	N/A	N/A	N/A	N/A
感染方式	蜱虫叮咬	血液接触	N/A	N/A	野外活动	血液接触	N/A	N/A	N/A	N/A
血常规
WBC(×10⁹/L)	1.8↓	1.9↓	N/A	N/A	5.4	1.9↓	N/A	N/A	N/A	N/A
PLT(×10⁹/L)	16↓	59↓	N/A	N/A	31↓	94↓	N/A	N/A	N/A	N/A
血生化
ALT(U/L)	128↑	91↑	N/A	N/A	250↑	44↑	N/A	N/A	N/A	N/A
AST(U/L)	461↑	111↑	N/A	N/A	1183↑	43↑	N/A	N/A	N/A	N/A
LDH(U/L)	1024↑	325↑	N/A	N/A	3597↑	234	N/A	N/A	N/A	N/A
CK(U/L)	301↑	435↑	N/A	N/A	2668↑	495↑	N/A	N/A	N/A	N/A

聚集性事件编号	PMID	流行地区	暴露方式	SFTSV基因序列accession
聚集性事件编号	PMID	流行地区	暴露方式	L	M	S
1	28722592	山东	血液体液黏膜	KR706567	KR706566	KR706565
2	32410583	辽宁	血液	MT309099	MT309102	MT309105
				MT309100	MT309103	MT309106
				MT309101	MT309104	MT309107
3	23225899	河南	血液	HQ642766	HQ642767	HQ642768
3	23225899	河南	血液	JF682776	JF682777	JF682778
4	22028437	江苏	血液	JF837593	JF837594	JF837595
5	35987469	河南	血液	ON402247	ON402253	ON402259
				ON402248	ON402254	ON402260
				ON402249	ON402255	ON402261
				ON402250	ON402256	ON402262
				ON402251	ON402257	ON402263
				ON402252	ON402258	ON402264
6	N/A	河南	血液	22-169-L_Henan^*	22-169-M_Henan^*	22-169-S_Henan^*
				22-234-L_Henan^*	22-234-M_Henan^*	22-234-S_Henan^*
				23-368-L_Henan^*	23-368-M_Henan^*	23-368-S_Henan^*
				23-466-L_Henan^*	23-466-M_Henan^*	23-466-S_Henan^*

Epidemiololgical and etiological analysis of two clusters of severe fever with thrombocytopenia syndrome

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