Fever with Thrombocytopenia associated with a novel Bunyavirus in ChinaArchived

ECDC comment

Heightened surveillance of acute febrile illness in China since 2009 has led to the identification of a severe fever with thrombocytopenia syndrome (SFTS).

Xue-Jie Yu, Mi-Fang Liang, Shou-Yin Zhang, et al. N Engl J Med 2011;364:1523-32

After intensive research on subjects with a compatible clinical picture, a novel virus has been isolated designated SFTS bunyavirus (SFTSV). This pathogen is a member of genus Phlebovirus in the Bunyaviridae family. The clinical symptoms of SFTS were nonspecific, being fever (100%) and gastrointestinal complaints (50%) the most common. Regional lymphadenopathy was also frequently observed. The most common abnormalities on laboratory testing were thrombocytopenia (95%) and leukocytopenia (86%). Mortality reached 12%. SFTSV RNA was detected in some ticks in the Ixodidae family of the species Haemaphysalis longicornis that were obtained from animals, and these ticks may be a candidate vector of SFTSV. 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.

ECDC comment: A new emerging virus has appeared in China as a cause of severe acute disease mainly in rural areas. Tick bites could be the mode of transmission. However, although the authors include epidemiologic data, clinical, and laboratory findings and several lines of evidence that include virus isolation, viral RNA detection, and molecular and serologic analyses, understanding the cycle of virus transmission and risk for spread will require further field investigations. This syndrome has to be kept in mind by those giving travel advice to travellers to rural areas of China, as well as by those attending febrile patients returning from China and perhaps other countries of the Asia-Pacific region where the potential vector is widely distributed.