The First Identification and Retrospective Study of Severe Fever With Thrombocytopenia Syndrome in Japan
The First Identification and Retrospective Study of Severe Fever With Thrombocytopenia Syndrome in Japan
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DOI：
10.1093/infdis/jit603
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发表时间：
2014-03-15
影响因子：
6.4
通讯作者：
Saijo, Masayuki
中科院分区：
文献类型：
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作者：
Takahashi, Toru;Maeda, Ken;Saijo, Masayuki
背景资料。严重发热伴血小板减少综合征(SFTS)是由严重发热伴血小板减少综合征(SFTS)引起的一种新的布尼亚病毒，据报道在中国中部和东北部流行。本文描述了第一例确诊的SFTS患者，并对日本SFTS进行了回顾性研究。对患者的样本进行了病毒学和病理学检查。实验室诊断是通过分离/基因组扩增和/或检测血清中抗SFTSV免疫球蛋白G抗体来进行的。医生们被告知了最初的诊断，并询问他们以前是否曾治疗过具有类似SFTS症状的患者。2012年去世的一名女性患者被诊断为SFTS。然后，对另外10名患有SFTS的患者进行了回顾性鉴定。所有患者年龄均为50岁，居住在日本西部。6例死亡。男女之比为8：3。从8例患者中分离到SFTSV。系统进化分析表明，所有分离的日本烟草花叶病毒分离株都形成了独立于中国分离株的基因。大多数患者的症状是由于出血，可能是弥漫性血管内凝血和/或吞噬血细胞。流行性口蹄疫一直是日本的地方病，流行性口蹄疫一直在日本境内自然传播。
Background. Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV), a novel bunyavirus reported to be endemic in central and northeastern China. This article describes the first identified patient with SFTS and a retrospective study on SFTS in Japan.Methods. Virologic and pathologic examinations were performed on the patient's samples. Laboratory diagnosis of SFTS was made by isolation/genome amplification and/or the detection of anti-SFTSV immunoglobulin G antibody in sera. Physicians were alerted to the initial diagnosis and asked whether they had previously treated patients with symptoms similar to those of SFTS.Results. A female patient who died in 2012 received a diagnosis of SFTS. Ten additional patients with SFTS were then retrospectively identified. All patients were aged >= 50 years and lived in western Japan. Six cases were fatal. The ratio of males to females was 8: 3. SFTSV was isolated from 8 patients. Phylogenetic analyses indicated that all of the Japanese SFTSV isolates formed a genotype independent to those from China. Most patients showed symptoms due to hemorrhage, possibly because of disseminated intravascular coagulation and/or hemophagocytosis.Conclusions. SFTS has been endemic to Japan, and SFTSV has been circulating naturally within the country.