Fever with thrombocytopenia associated with a novel bunyavirus in China.
Fever with thrombocytopenia associated with a novel bunyavirus in China.
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中国一种新型布尼亚病毒引起的发热伴血小板减少症。
DOI：
10.1056/nejmoa1010095
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发表时间：
2011-04-21
期刊：
影响因子：
--
通讯作者：
Li DX
中科院分区：
文献类型：
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作者：
Yu XJ;Liang MF;Zhang SY;Liu Y;Li JD;Sun YL;Zhang L;Zhang QF;Popov VL;Li C;Qu J;Li Q;Zhang YP;Hai R;Wu W;Wang Q;Zhan FX;Wang XJ;Kan B;Wang SW;Wan KL;Jing HQ;Lu JX;Yin WW;Zhou H;Guan XH;Liu JF;Bi ZQ;Liu GH;Ren J;Wang H;Zhao Z;Song JD;He JR;Wan T;Zhang JS;Fu XP;Sun LN;Dong XP;Feng ZJ;Yang WZ;Hong T;Zhang Y;Walker DH;Wang Y;Li DX
自2009年以来，中国加强了对急性发热性疾病的监测，发现了一种原因不明的重度发热伴血小板减少综合征（SFTS）。嗜吞噬细胞无形体感染被认为是一个原因，但病原体尚未在大多数患者的实验室检测。我们从中国六个省的SFTS病例定义的患者中获得血液样本。通过接种细胞培养物和聚合酶链反应检测病毒RNA，使用血液样本分离致病病原体。病原体的特征在于电子显微镜和核酸测序。我们采用酶联免疫吸附试验、间接免疫荧光试验和中和试验分析患者血清标本中病毒特异性抗体水平。我们从出现发热、血小板减少、白细胞减少和多器官功能障碍的患者中分离到一种新型病毒，命名为SFTS布尼亚病毒。RNA序列分析表明，该病毒是布尼亚病毒科静脉病毒属的一个新成员。电子显微镜检查显示病毒粒子的布尼亚病毒的形态特征。来自6个省的171名SFTS患者通过检测病毒RNA、血液中的病毒特异性抗体或两者同时检测，证实了病毒的存在。血清学检测显示，在急性期和恢复期从患者身上采集的所有35对血清样本中均存在病毒特异性免疫反应。在中国一种与发热和血小板减少症相关的危及生命的疾病患者中发现了一种新型静脉病毒。（由中国传染病大型项目和其他项目资助。
Heightened surveillance of acute febrile illness in China since 2009 has led to the identification of a severe fever with thrombocytopenia syndrome (SFTS) with an unknown cause. Infection with Anaplasma phagocytophilum has been suggested as a cause, but the pathogen has not been detected in most patients on laboratory testing. We obtained blood samples from patients with the case definition of SFTS in six provinces in China. The blood samples were used to isolate the causal pathogen by inoculation of cell culture and for detection of viral RNA on polymerase-chain-reaction assay. The pathogen was characterized on electron microscopy and nucleic acid sequencing. We used enzyme-linked immunosorbent assay, indirect immunofluorescence assay, and neutralization testing to analyze the level of virus-specific antibody in patients’ serum samples. We isolated a novel virus, designated SFTS bunyavirus, from patients who presented with fever, thrombocytopenia, leukocytopenia, and multiorgan dysfunction. RNA sequence analysis revealed that the virus was a newly identified member of the genus phlebovirus in the Bunyaviridae family. Electron-microscopical examination revealed virions with the morphologic characteristics of a bunyavirus. The presence of the virus was confirmed in 171 patients with SFTS from six provinces by detection of viral RNA, specific antibodies to the virus in blood, or both. Serologic assays showed a virus-specific immune response in all 35 pairs of serum samples collected from patients during the acute and convalescent phases of the illness. A novel phlebovirus was identified in patients with a life-threatening illness associated with fever and thrombocytopenia in China. (Funded by the China Mega-Project for Infectious Diseases and others.)