Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne disease caused by the SFTS virus (SFTSV) of family Phenuiviridae. Since the virus was first identified in 2009, it has been rapidly spread in many Asian countries including Myanmar, Korea, Japan, and central China. In this study, we investigated the epidemiological characteristics of SFTS patients in Hefei from 2011 to 2018. In addition, we conducted a serological survey of SFTSV-specific antibody among healthy residents of five counties. We performed a retrospective observational study of SFTS cases reported to Hefei Center for Disease Control and Prevention (CDC) during Jan 2011 to Dec 2018. Almost every patient completed a structure questionnaire including clinical examination, course of disease, and history of epidemiology. A total of 754 serum specimens were collected and tested for IgG antibody with double-antigen sandwich ELISA method. Of 257 cases reported during that period, 33 died, with a case fatality rate of 13.0%. We found no significant difference between 30 non-survivors and 198 survivors except for age. The overall rate of seropositivity for SFTSV antibodies among healthy residents were 20.16%. We demonstrated that living in hilly areas, direct contact with domestic livestock and knowledge of tick-borne disease were significantly associated with positive serology result. SFTSV infection was prevalent among farming-related populations. Our study identified a relatively high seroprevalence of SFTSV-specific antibody in healthy residents, which provided the basis for asymptomatic SFTSV infections. More attention should be given to susceptible population and prevent SFTSV outbreak in high-endemic areas.
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The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.
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Acknowledgments
The authors thank the staff members at the hospitals, county-, districts-, and cities-level CDC for their valuable assistance in coordinating data collection. We sincerely thank the healthy participants whose consent and contributions made this study possible.
Funding
The study was sponsored though the Hefei health emergency project administered by the Hefei center for Disease Control and Prevention.
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EY designed the study and coordinated investigation process. LW analyzed the data and drafted the manuscript together with EY. LZ, JW, and KZ all contributed to collect the data. FH revised the manuscript. EY and LW contributed equally. All authors approved the final version and agreed to be accountable for all aspects of the work.
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This study was approved by the Ethics Committee of Hefei Center for Diseases Control and Prevention.
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Appendix
Appendix
The geographical location of Anhui Province in China and distribution of each districts(counties) in Hefei
Geographic distribution of 257 SFTS cases in Hefei (annal cumulative numbers) from 2011 to 2018
The reported number of SFTS cases per month in Hefei from 2011 to 2018
Timeline of events occurred in two family clusters of SFTS patients in Hefei
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You, E., Wang, L., Zhang, L. et al. Epidemiological characteristics of severe fever with thrombocytopenia syndrome in Hefei of Anhui Province: a population-based surveillance study from 2011 to 2018. Eur J Clin Microbiol Infect Dis 40, 929–939 (2021). https://doi.org/10.1007/s10096-020-04098-x
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DOI: https://doi.org/10.1007/s10096-020-04098-x