A Family Cluster of Infections by a Newly Recognized Bunyavirus in Eastern China, 2007: Further Evidence of Person-to-Person Transmission
A Family Cluster of Infections by a Newly Recognized Bunyavirus in Eastern China, 2007: Further Evidence of Person-to-Person Transmission
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DOI：
10.1093/cid/cir732
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发表时间：
2011-12-15
影响因子：
11.8
通讯作者：
Wang, Hua
中科院分区：
文献类型：
--
作者：
Bao, Chang-jun;Guo, Xi-ling;Wang, Hua
背景2007年5月，居住在中国东部的一个家庭中有7人出现发热和血小板减少，但初步调查未能确定感染性病因。2009年12月，一种新型布尼亚病毒（指定为重度发热伴血小板减少综合征布尼亚病毒[SFTSV]）被确定为中国具有相似临床表现的患者的病因。我们重新检查了这个家庭群SFTSV感染。我们分析了索引患者和6个继发患者的流行病学和临床数据。采用真实的时间反转录聚合酶链反应（RT-PCR）、病毒培养、基因测序、微量中和试验（MNA）和间接免疫荧光试验（IFA）对6例继发性患者的储存血液标本进行检测。1例80岁女性患者因发热、白细胞减少症和血小板减少症于2007年4月27日死亡。2007年5月3日至7日，她的家人中又有6名病人因发烧和其他类似症状被当地一家县医院收治。2007年从这6例患者中采集的血清标本经RT-PCR检测SFTS病毒RNA阳性，经MNA和IFA检测SFTSV抗体阳性。从1份保存的血清标本中分离到SFTSV。二级患者之间唯一的共同特征是与指示患者有个人接触;没有人报告接触过疑似动物或病媒。结论。2007年华东地区一个家庭聚集性发热和血小板减少症患者的临床和实验室证据证实是由一种新发现的布尼亚病毒引起的。流行病学调查强烈提示继发患者的感染通过个人接触传播给家庭成员。
Background. Seven persons in one family living in eastern China developed fever and thrombocytopenia during May 2007, but the initial investigation failed to identify an infectious etiology. In December 2009, a novel bunyavirus (designated severe fever with thrombocytopenia syndrome bunyavirus [SFTSV]) was identified as the cause of illness in patients with similar clinical manifestations in China. We reexamined this family cluster for SFTSV infection.Methods. We analyzed epidemiological and clinical data for the index patient and 6 secondary patients. We tested stored blood specimens from the 6 secondary patients using real time reverse transcription polymerase chain reaction (RT-PCR), viral culture, genetic sequencing, micro-neutralization assay (MNA), and indirect immunofluorescence assay (IFA).Results. An 80-year-old woman with fever, leucopenia, and thrombocytopenia died on 27 April 2007. Between 3 and 7 May 2007, another 6 patients from her family were admitted to a local county hospital with fever and other similar symptoms. Serum specimens collected in 2007 from these 6 patients were positive for SFTS viral RNA through RT-PCR and for antibody to SFTSV through MNA and IFA. SFTSV was isolated from 1 preserved serum specimen. The only shared characteristic between secondary patients was personal contact with the index patient; none reported exposure to suspected animals or vectors.Conclusions. Clinical and laboratory evidence confirmed that the patients of fever and thrombocytopenia occurring in a family cluster in eastern China in 2007 were caused by a newly recognized bunyavirus, SFTSV. Epidemiological investigation strongly suggests that infection of secondary patients was transmitted to family members by personal contact.