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Sixteen of 45 patients with severe fever with thrombocytopenia (36%) were admitted to an intensive care unit; 9 (56%) developed invasive pulmonary aspergillosis (IPA) within a median of 8 days (range, 2–11). Mortality was higher in the IPA vs non-IPA patients and in those without vs with antifungal therapy.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging epidemic infectious disease caused by the SFTS bunyavirus (SFTSV) with an estimated high case-fatality rate of 12.7% to 32.6%. Currently, the disease has been reported in mainland China, Japan, Korea, and the United States. At present, there is no specific antiviral therapy for SFTSV infection. Considering the higher mortality rate and rapid clinical progress of SFTS, supporting the appropriate treatment in time to SFTS patients is critical. Therefore, it is very important for clinicians to predict these SFTS cases who are more likely to have a poor prognosis or even more likely to decease. In the present study, we established a simple and feasible model for assessing the severity and predicting the prognosis of SFTS patients with high sensitivity and specificity. This model may aid the physicians to immediately initiate prompt treatment to block the rapid development of the illness and reduce the fatality of SFTS patients., Author summary Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel SFTS bunyavirus (SFTSV) with an estimated high case-fatality rate. However, there is no specific antiviral therapy for SFTSV infection. Symptomatic treatment and supportive therapy are the most essential part of case management. It is very important for clinicians to identify critical patients at admission. In this study, we established a simple and feasible scoring system for assessing the severity and predicting the prognosis of SFTS patients with objective parameters. This model may help the physicians to perform intervention measures in advance, control the disease progression and improve the prognosis.

We investigated an outbreak of severe fever with thrombocytopenia syndrome (SFTS) that occurred during May and June 2010, to identify the mode of transmission. Contact with the index patient's blood was significantly associated with development of SFTS (P = .01, by the χ(2) test for linear trend); the frequency of contact with the index patient's blood increased the risk of SFTS in a dose-response manner (P = .03, by the χ(2) test for linear trend). We concluded that human-to-human transmission caused this cluster of cases.

We report here a clinical and molecular study on a case suffer from severe fever with thrombocytopenia syndrome (SFTS) due to a new type of bunyavirus, named SFTS bunyavirus (SFTSV), in Zhejiang Province China. The key clinical features of this patient include fever, lymphocytopenia and thrombocytopenia. We carried out a serological and molecular investigation in the indicated case and on relatives with close contact. The SFTSV infection was confirmed through amplification of viral genetic material using the polymerase chain reaction (PCR) from the patient's serum, but not relatives with close contact. Subsequently direct sequence of PCR product demonstrated a homology of 94-96% in the nucleotide sequence compared to a reference sequence previously reported, in which the majority of patients originated from an epidemic area of Central and Northeast China. Our results suggest that SFTSV can occur in a non-epidemic area due to a similar strain of SFTSV that apparently affect the blood system, implying the importance of dissecting the pathogenesis of SFTS as well as mode of infection.

The etiological agent of severe fever with thrombocytopenia syndrome (SFTS) is a bunyavirus that was first identified in China in 2009. We have developed and validated a one-step, single-tube, reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assay for detection of SFTS bunyavirus (SFTSV). This assay demonstrated high specificity and sensitivity, with a detection limit of 10(1) TCID(50) ml(-1). When combined with the fluorescent detection reagent (FDR) method, results could be determined by observing a color change within 30 min. As an accurate, rapid, simple and low-cost diagnostic method, this RT-LAMP assay will be helpful for detecting and preventing further SFTSV infection in China.