Investigation of Heartland Virus Disease Throughout the United States, 2013-2017
Investigation of Heartland Virus Disease Throughout the United States, 2013-2017
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DOI：
10.1093/ofid/ofaa125
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发表时间：
2020-05-01
影响因子：
4.2
通讯作者：
Fischer, Marc
中科院分区：
文献类型：
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作者：
Staples, J. Erin;Pastula, Daniel M.;Fischer, Marc
背景。心脏地带病毒（HRTV）于2012年首次被描述为人类病原体。2013年至2017年，美国疾病控制与预防中心（CDC）实施了一项国家方案，以评估HRTV疾病患者，更好地确定其地理分布、流行病学和临床特征，并开发这种新型病毒的诊断方法。临床医生联系州卫生部门或疾病控制与预防中心进行HRTV感染检测的年龄在bb0 = 12岁的个体进行了筛查，以确定最近出现的发热伴白细胞减少和血小板减少。进行问卷调查，收集人口统计、危险因素、体征和症状方面的数据；血液样本检测HRTV RNA和中和抗体的存在。在85名受试者中，16人（19%）有急性HRTV感染的证据，1人（1%）有感染史，68人（80%）没有感染。急性HRTV疾病患者来自美国7个州，12例（75%）为男性，中位年龄（范围）为71岁（43-80岁）。发病时间为4月至9月。大多数患者报告疲劳、厌食、恶心、头痛、精神错乱、关节痛或肌痛。14例（88%）住院；2例（13%）死亡。14名（88%）参与者报告在发病前2周发现自己身上有蜱虫。hrtv感染者年龄明显增大(P
Background. Heartland virus (HRTV) was first described as a human pathogen in 2012. From 2013 to 2017, the Centers for Disease Control and Prevention (CDC) implemented a national protocol to evaluate patients for HRTV disease, better define its geographic distribution, epidemiology, and clinical characteristics, and develop diagnostic assays for this novel virus.Methods. Individuals aged >= 12 years whose clinicians contacted state health departments or the CDC about testing for HRTV infections were screened for recent onset of fever with leukopenia and thrombocytopenia. A questionnaire was administered to collect data on demographics, risk factors, and signs and symptoms; blood samples were tested for the presence of HRTV RNA and neutralizing antibodies.Results. Of 85 individuals enrolled and tested, 16 (19%) had evidence of acute HRTV infection, 1 (1%) had past infection, and 68 (80%) had no infection. Patients with acute HRTV disease were residents of 7 states, 12 (75%) were male, and the median age (range) was 71 (43-80) years. Illness onset occurred from April to September. The majority reported fatigue, anorexia, nausea, headache, confusion, arthralgia, or myalgia. Fourteen (88%) cases were hospitalized; 2 (13%) died. Fourteen (88%) participants reported finding a tick on themselves in the 2 weeks before illness onset. HRTV-infected individuals were significantly older (P