Search

Objective To investigate the differences in epidemiological and clinical characteristics of patients with spotted fever (SF) and severe fever with thrombocytopenia syndrome (SFTS). Methods A total of 86 patients with SF and 113 patients with SFTS who were laboratory-confirmed in the second-level and above hospitals in Lu'an City from January 2017 to January 2022 were selected. The basic data, epidemiological history, clinical data and laboratory test results of the two diseases were retrospectively analyzed for comparison. Results The proportion of male in SF group was 32.56% (28/86), and the proportion of male in SFTS group was 53.98% (61/113), the difference was statistically significant (χ2=9.067, P<0.01). The proportions of abdominal pain and diarrhea in the SF group were (3.49%, 3/83) and (21.24%, 24/113), which were significantly lower than corresponding (6.98%, 6/86) and (46.90%, 53/113) in the SFTS group (χ2=13.121, 37.322, P<0.01). The incidences of rash and eschar in SF group were 95.35% (82/86) and 20.93% (18/86), which were significantly higher than corresponding 1.77% (2/113) and 0.88% (1/113) in SFTS group (χ2=175.311, 22.721, P<0.01). The levels of leukocytes, platelets and Creactive protein in the SF group were significantly higher than those in the SFTS group, and the levels of transaminase, lactate dehydrogenase and D-dimer were significantly lower than those in the SFTS group, and the differences were statistically significant (all P<0.05). Conclusions The rash and inflammatory reaction are more obvious in SF patients, while the liver function, myocardial function and coagulation function are significantly impaired in SFTS patients. [ABSTRACT FROM AUTHOR]

This article aims to present a rare case of severe fever with thrombocytopenia syndrome (SFTS) complicated by with bacteraemia caused by Campylobacter jejuni, and to discuss the pathogenic characteristics, culture methods, clinical features and treatment points of Campylobacter jejuni and the patient's outcome, with a view to raising clinical awareness of blood culture and providing experience for the treatment of this disease. Methods The clinical data of a case with SFTS complicated by bacteremia caused by Campylobacter jejuni admitted to Weihai Municipal Hospital were collected and the diagnostic process of the pathogenic bacteria as well as the treatment plan were retrospectively analysed. Results The patient was a female who had been bitten by a tick bite half a month ago and presented to the hospital on 30th August with a fever, vague pain in the peribulbar abdomen and diarrhea for 5 days. Laboratory tests showed leukopenia and thrombocytopenia, and nucleic acid detection for SFTS was positive, resulting in a diagnosis of SFTS. After a week of antiviral treatment with ribavirin and symptomatic treatment, the patient suddenly experienced high fever at night, with a temperature reaching 39.5 °C. Blood cultures were immediately taken from both sides of the double bottle. Bilateral anaerobic bottles were tested for positive after 53.06 hours, and Gram-negative Campylobacter was cultured anaerobically in a transfer blood plate and further identified as Campylobacter jejuni using mass spectrometry MALDI-TOF MS. Vancomycin was stopped clinically on the basis of bacterial pathogenesis and meropenem was used for anti-infection and symptomatic treatment. During the treatment, blood culture and nucleic acid detection for SFTS turned negative, and the patient's symptoms improved. After normal results were achieved in the follow-up testing, the patient was discharged. Conclusions This case serves as a reminder that Campylobacter jejuni not only causes intestinal infections, but can also lead to extra-intestinal infections in immunocompromised individuals. Clinical and laboratory personnel should increase their recognition of Campylobacter jejuni, prioritize blood culture methods, and utilize a multidisciplinary approach in diagnosis and treatment. [ABSTRACT FROM AUTHOR]

ObjectiveTo understand the epidemiological characteristics of severe fever with thrombocytopenia syndrome （SFTS）， and the association with seasonal fluctuation in tick density， so as to provide scientific evidence for better control and prevention measures.MethodsDescriptive epidemiological methods were used to analyze the SFTS epidemic situation in Chongyang County from 2013 to 2021. The cloth flag method was used to investigate the seasonal fluctuation in tick density and determine the association with the SFTS.ResultsA total of 71 SFTS cases were reported in Chongyang County from 2013 to 2021 including 8 deaths， with the annual morbidity rate of 1.88/10-5. The majority were mainly from June to August， accounting for 61.97% of the total reported cases. The cases were geographically distributed in 41 administrative villages and 4 urban areas in 11 towns. The highest incidence was in Lukou town （n=26） and Baini town （n=12）， which accounted for 53.52% of the total reported cases. Furthermore， the cases were mainly 50‒69 years old， accounting for 57.75% of the total reported cases. The ratio of male to female was 1.84∶1， and most were farmers. Blood samples during acute phase in 41 cases were collected for examination of SFTS virus， of which 25 cases tested positive （60.98%）. There was a positive association between tick density and the number of reported SFTS cases （r=0.78， P=0.003）.ConclusionSeasonal density of free adult ticks and nymphs is associated with the number of reported SFTS cases in Chongyang County.

Objective: To understand the epidemiological characteristics and incidence trend of severe fever with thrombocytopenia syndrome (SFTS) in China. Methods: The incidence data of SFTS in China from 2018 to 2021 were collected from Chinese Disease Prevention and Control Information System for a statistical and descriptive epidemiological analysis by using software such as Excel 2016, Joinpoint 5.0.2, SPSS 26.0, and GraphPad Prism 8.0, especially, the SFTS cases reported monthly by key provinces were analyzed. Results: From 2018 to 2021, a total of 8 835 SFTS cases were reported in 25 provinces and the annual incidence showed an upward trend. The distribution of SFTS cases showed clustering, but the cases were mainly sporadic ones. The cases began to increase in March, mainly occurred during April to October (96.79%,8 551/8 835), and peaked during May to July. The cases were mainly distributed in middle-aged and old farmers, and slight more cases were women. The average case fatality rate was 5.38%, which varied greatly with areas. The case fatality rate tended to increase with age. Conclusion: From 2018 to 2021, the epidemiological characteristics of SFTS in China remained stable, but the number of reported cases gradually increased and the distribution showed an expanding trend, to which close attention should be paid.

Objective: To understand the epidemiological characteristics of tick-borne infectious diseases (TBID) and the risk factors of severe illness and death in Hubei Province from 2016 to 2021. Methods: Based on the incidence data of fever with thrombocytopenia syndrome (SFTS), tsutsugamushi disease, typhus and other TBID reported during 2016-2021, the epidemiological analysis was conducted. Field investigation results of TBID in areas with high incidence in 2021, logistic regression analysis of population characteristics, epidemiological history and other factors were used to explore the risk factors of severe and fatal cases. In the field vector investigation, free ticks and surface ticks of the host animals in the cases' home and surrounding grassland were monitored and detected. Results: A total of 3 826 TBID cases were reported in Hubei from 2016 to 2021, of which 71.30% (2 728/3 826) were SFTS, 13.04% (499/3 826) were tsutsugamushi disease and 15.66% (599/3 826) were typhus. A total of 44 cases died in 6 years; the fatality rate was 1.15% (44/3 826). In the peak seasons of incidence from May to July, the cases in people engaged in agriculture related work accounted for 84.61% (3 237/3 826). The incidence rate in women was higher than that in men, and the cases aged ≥50 years accounted for 81.02% of the total (3 100/3 826), and the incidence rate increased with age ( P <0.001). The TBID cases were distributed in 86 counties and districts in 16 prefectures (municipality). The incidence rates of different areas had significant differences ( P <0.05), and there was a certain spatial-temporal clustering and expasion. Bovis microplus and Haemaphysalis longicornis were captured in the field, and the positive rates in host animals and grassland ticks were 10.94% (7/64) and 40.00% (2/5), respectively. Univariate logistic regression analysis results showed that age ≥50 years and leukocyte <2.0×10 9 /L were risk factors for severe illness and death. Conclusions: The TBID reported in Hubei were mainly SFTS, tsutsugamushi disease and typhus. In order to reduce the incidence of TBID, it is necessary to strengthen the prevention and control in women aged ≥50 years and reduce field exposure and tick bites during the epidemic period.

To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P < 0.05). For 109 cases with acute and convalescent paired serum samples, there was no significant difference in the positive rates between ELISA-IgG (75.23%) and real-time PCR (72.48%) detections (χ2=0.18, P > 0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P < 0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased (Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA-IgM can be used as an assistant method to guide clinical diagnosis. [ABSTRACT FROM AUTHOR]

To analyze the changes of coagulation function in severe fever with thrombocytopenia syndrome (SFTS) and its relationship with thrombocytopenia, and to explore its value as an early predictor of the severity of SFTS. The clinical data of 428 SFTS patients (70 deaths and 358 survivors) admitted to the Department of Infectious Disease at Wuhan Union Hospital from January 2014 to July 2020 were retrospectively analyzed. The differences of coagulation parameters and disseminated intravascular coagulation (DIC) scores between the two groups were compared. The results showed that abnormal coagulation function was commonly presented in SFTS patients. Bleeding was more frequent in mortality group (41.4% vs. 26.5%). The D-dimer levels in mortality patients were significantly higher above normal range. Activated partial thrombin time (APTT) and thrombin time (TT) were significantly prolonged. The levels of prothrombin time (PT), TT, APTT, international standardized ratio (INR) and D-dimer between mortality group and survival group started to separate from day 5-6. The difference of fibrinogen (FIB) level developed on day 7-8, while platelet counts between the two groups were significant different from day 9-10. The mortality rate increased according to the increase of baseline DIC score. When DIC score reached 6, the mortality rate surged to 66.67%. Excessive platelet consumption is mediated by significant coagulation abnormalities during disease course, and coagulation parameters are more sensitive than platelet count as an early predictor of severe SFTS.

Objective: To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS. Methods: The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS. Results: From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% ( P =0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males ( χ ²=13 185.21, P <0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females ( χ ²=12 939.83, P <0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males ( χ ²=115.70, P <0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females ( χ ²=103.42, P <0.001). Conclusion: From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease discovered in the 21 st century. This disease has been reported in several Asian countries, including China, Japan, South Korea, Vietnam, and Myanmar. Until 2019, SFTS cases have been reported in 25 provinces in China, and most of them were rural residents from mountains and hilly regions. Most SFTS cases were sporadic but geographically concentrated, mainly in Henan, Shandong, Anhui, Hubei, Liaoning, Zhejiang, and Jiangsu provinces. SFTSV infection was transmitted predominantly by a tick bite and potentially through close contact with the patient's blood or body fluids. Fever, gastrointestinal symptoms, thrombocytopenia, and leukopenia were common initial manifestations, and multiple organ failure or even death could occur in severe cases. The reported cases of SFTS have been gradually increasing, and the case fatality rate has remained at a high level, posing a severe threat to public health in China. This paper reviewed the epidemiological features, risk factors for disease transmission, and the clinical characteristics of SFTS to gain further knowledge of the disease, guide the prevention and management, and help reduce the case fatality rate.

Objective: To explore the characteristics regarding temporal, spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province. Methods: Surveillance data related to SFTS was collected in Henan province, from year 2014 to 2016. Descriptive method was used to analyze the distribution of SFTS. 1.7.0 software related to the Public health geographic information system (PHGIS), was applied to draw the spatial distribution map of SFTS. Chi -square test was used to compare the different incidence rates. Results: A total of 2 781 SFTS cases, including 34 deaths, were reported in Henan province from 2014 to 2016, with an average annual fatality rate as 1.22 % . There were statistically significant differences for the incidence rates of SFTS between different years ( P <0.01). Cases were mainly concentrated from April to October, which accounted for 96.66 % of the total number, with the incidence peak seen in May. Incidence rates of SFTS in spring, summer, autumn were higher than that in winter. The cases were scattering around in 26 counties of 8 cities. Xinyang city reported 2 714 cases, accounting for 97.59 % of the total number of cases in the province. The average annual incidence rate in Xinyang city was 17.22 per 100 000, much higher than that for the whole Henan province (0.98 per 100 000), with statistically significant difference ( P <0.01). Six counties reported having death cases, that accounted for 23.08 % of the total number of counties, reported to have death cases. Two kinds of incidence patterns of SFTS were noticed in Henan province, with aggregation in some local regions or sporadic in individual counties. The number of counties with reporting cases increased annually. The epidemic area was expanding and gradually spreading from south to north areas of the province. Conclusions: SFTS was characterized with both temporal and spatial clusters in Henan province. Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.