Infection Control and Prevention in Hospitals and Household

  • Yasuyuki KatoEmail author


Human-to-human transmission of severe fever thrombocytopenia syndrome virus (SFTSV) is a rare modes of transmission, but it cannot be ignored for family members and healthcare workers who provide direct patient care. There have been eleven human clusters reported, which included 60 secondary cases in China and Korea. The index patients were always fatal and usually had high viral loads and hemorrhagic symptoms, which suggests that biological factors are important for human-to-human transmission. However, social, cultural, and behavioral factors also seem associated with the transmission. Transmission from human remains was also documented as was seen in outbreaks of other viral hemorrhagic fevers.

In most of the clusters poor compliance of basic infection prevention and control measures were observed. Standard precautions and appropriate use of personal protective equipment are keys to prevent human-to-human transmission of SFTSV. When performing aerosol-generating procedure, higher standards including airborne precaution might be required. Occupational infection in veterinary practice and post-exposure chemoprophylaxis following high-risk exposure are emerging issues that deserve further investigation.


Severe fever thrombocytopenia syndrome SFTSV Human-to-human transmission Viral hemorrhagic fever Infection control and prevention Personal protective equipment 


  1. Bao CJ, Guo XL, Qi X, Hu JL, Zhou MH, Varma JK, Cui LB, Yang HT, Jiao YJ, Klena JD, Li LX, Tao WY, Li X, Chen Y, Zhu Z, Xu K, Shen AH, Wu T, Peng HY, Li ZF, Shan J, Shi ZY, Wang H (2011) A family cluster of infections by a newly recognized bunyavirus in Eastern China, 2007: further evidence of person-to-person transmission. Clin Infect Dis 53:1208–1214CrossRefGoogle Scholar
  2. Bausch DG, Hadi CM, Khan SH, Lertora JJ (2010) Review of the literature and proposed guidelines for the use of oral ribavirin as postexposure prophylaxis for Lassa fever. Clin Infect Dis 51:1435–1441CrossRefGoogle Scholar
  3. Chen H, Hu K, Zou J, Xiao J (2013) A cluster of cases of human-to-human transmission caused by severe fever with thrombocytopenia syndrome bunyavirus. Int J Infect Dis 17:e206–e208CrossRefGoogle Scholar
  4. Ehlkes L, George M, Samosny G, Burckhardt F, Vogt M, Bent S, Jahn K, Zanger P (2017) Management of a Lassa fever outbreak, Rhineland-Palatinate, Germany, 2016. Euro Surveill 22:pii=16-00728Google Scholar
  5. Fischer WA 2nd, Vetter P, Bausch DG, Burgess T, Davey RT Jr, Fowler R, Hayden FG, Jahrling PB, Kalil AC, Mayers DL, Mehta AK, Uyeki TM, Jacobs M (2018) Ebola virus disease: an update on post-exposure prophylaxis. Lancet Infect Dis 18:e183–e192CrossRefGoogle Scholar
  6. Fletcher TE, Gulzhan A, Ahmeti S, Al-Abri SS, Asik Z, Atilla A, Beeching NJ, Bilek H, Bozkurt I, Christova I, Duygu F, Esen S, Khanna A, Kader Ç, Mardani M, Mahmood F, Mamuchishvili N, Pshenichnaya N, Sunbul M, Yalcin TY, Leblebicioglu H (2017) Infection prevention and control practice for Crimean-Congo hemorrhagic fever – a multi-center cross-sectional survey in Eurasia. PLoS One 12:e0182315CrossRefGoogle Scholar
  7. Gai Z, Liang M, Zhang Y, Zhang S, Jin C, Wang SW, Sun L, Zhou N, Zhang Q, Sun Y, Ding SJ, Li C, Gu W, Zhang F, Wang Y, Bian P, Li X, Wang Z, Song X, Wang X, Xu A, Bi Z, Chen S, Li D (2012) Person-to-person transmission of severe fever with thrombocytopenia syndrome bunyavirus through blood contact. Clin Infect Dis 54:249–252CrossRefGoogle Scholar
  8. Gong Z, Gu S, Zhang Y, Sun J, Wu X, Ling F, Shi W, Zhang P, Li D, Mao H, Zhang L, Wen D, Zhou B, Zhang H, Huang Y, Zhang R, Jiang J, Lin J, Xia S, Chen E, Chen Z (2015) Probable aerosol transmission of severe fever with thrombocytopenia syndrome virus in southeastern China. Clin Microbiol Infect 21:1115–1120CrossRefGoogle Scholar
  9. Hiraki T, Yoshimitsu M, Suzuki T, Goto Y, Higashi M, Yokoyama S, Tabuchi T, Futatsuki T, Nakamura K, Hasegawa H, Saijo M, Kakihana Y, Arima N, Yonezawa S (2014) Two autopsy cases of severe fevere with thrombocytopenia syndrome (SFTS) in Japan: a pathognomonic histological feature and unique complication of SFTS. Pathol Int 64:569–575CrossRefGoogle Scholar
  10. Huang D, Jiang Y, Liu X, Wang B, Shi J, Su Z, Wang H, Wang T, Tang S, Liu H, Hu Z, Deng F, Shen S (2017) A cluster of symptomatic and asymptomatic infections of severe fever with thrombocytopenia syndrome caused by person-to-person transmission. Am J Trop Med Hyg 97:396–402CrossRefGoogle Scholar
  11. Jiang XL, Zhang S, Jiang M, Bi ZQ, Liang MF, Ding SJ, Wang SW, Liu JY, Zhou SQ, Zhang XM, Li DX, Xu AQ (2015) A cluster of person-to-person transmission cases caused by SFTS virus in Penglai, China. Clin Microbiol Infect 21:274–279CrossRefGoogle Scholar
  12. Kim WY, Choi W, Park SW, Wang EB, Lee WJ, Jee Y, Lim KS, Lee HJ, Kim SM, Lee SO, Choi SH, Kim YS, Woo JH, Kim SH (2015) Nosocomial transmission of severe fever with thrombocytopenia syndrome in Korea. Clin Infect Dis 60:1681–1683CrossRefGoogle Scholar
  13. Liu Y, Li Q, Hu W, Wu J, Wang Y, Mei L, Walker DH, Ren J, Wang Y, Yu XJ (2012) Person-to-person transmission of severe fever with thrombocytopenia syndrome virus. Vector Borne Zoonotic Dis 12:156–160CrossRefGoogle Scholar
  14. Osterholm MT, Moore KA, Kelley NS, Brosseau LM, Wong G, Murphy FA, Peters CJ, LeDuc JW, Russell PK, Van Herp M, Kapetshi J, Muyembe JJ, Ilunga BK, Strong JE, Grolla A, Wolz A, Kargbo B, Kargbo DK, Sanders DA, Kobinger GP (2015) Transmission of Ebola viruses: what we know and what we do not know. MBio 6:e00137Google Scholar
  15. Park SY, Kim SH, Park SW, Wang EB, Lee WJ, Jee Y, Choi W (2016) Needle-stick injury caused by a patient with severe fever with thrombocytopenia syndrome in Korea. Infect Control Hosp Epidemiol 37:368Google Scholar
  16. Pshenichnaya NY, Nenadskaya SA (2015) Probable Crimean-Congo hemorrhagic fever virus transmission occurred after aerosol-generating medical procedures in Russia: nosocomial cluster. Int J Infect Dis 33:120–122CrossRefGoogle Scholar
  17. Tang X, Wu W, Wang H, Du Y, Liu L, Kang K, Huang X, Ma H, Mu F, Zhang S, Zhao G, Cui N, Zhu BP, You A, Chen H, Liu G, Chen W, Xu B (2013) Human-to-human transmission of severe fever with thrombocytopenia syndrome bunyavirus through contact with infectious blood. J Infect Dis 207:736–739CrossRefGoogle Scholar
  18. Tani H, Fukuma A, Fukushi S, Taniguchi S, Yoshikawa T, Iwata-Yoshikawa N, Sato Y, Suzuki T, Nagata N, Hasegawa H, Kawai Y, Uda A, Morikawa S, Shimojima M, Watanabe H, Saijo M (2016) Efficacy of T-705 (Favipiravir) in the treatment of infections with lethal severe fever with thrombocytopenia syndrome virus. mSphere 1:pii:e00061-15Google Scholar
  19. Wang Y, Deng B, Zhang J, Cui W, Yao W, Liu Pl (2014) Person-to-person asymptomatic infection of severe fever with thrombocytopenia syndrome virus through blood contact. Intern Med 53:903–906CrossRefGoogle Scholar
  20. World Health Organization (2014a) Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in health-care settings, with focus on Ebola. WHO, GenevaGoogle Scholar
  21. World Health Organization (2014b) Clinical management of patients with viral haemorrhagic fever: a pocket guide for the front-line health worker. WHO, GenevaGoogle Scholar
  22. Wright JG, Jung S, Holman RC, Marano NN, McCuiston JH (2008) Infection control practices and zoonotic disease risks among veterinarians in the United States. J Am Vet Med Assoc 232:1863–1872CrossRefGoogle Scholar
  23. Yoo JR, Heo ST, Park D, Kim H, Fukuma A, Fukushi S, Shimojima M, Lee KH (2016) Family cluster analysis of severe fever with thrombocytopenia syndrome virus infection in Korea. Am J Trop Med Hyg 95:1351–1357CrossRefGoogle Scholar
  24. 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 (2011) Fever with thrombocytopenia associated with a novel bunyavirus in China. N Engl J Med 364:1523–1532CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.International University of Health and Welfare School of MedicineChibaJapan

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