An imported case of genotype c severe fever with thrombocytopenia syndrome in shenzhen: clinical and molecular characteristics insights

doi:10.19871/j.cnki.xfcrbzz.2025.02.013

Abstract

Abstract: Severe fever with thrombocytopenia syndrome (SFTS) is an acute natural focal infectious disease caused by the SFTS virus (SFTSV), characterized by fever,gastrointestinal disturbances,thrombocytopenia,and leukopenia. This study reports a severe SFTS case of genotype C imported from Anhui Province to Shenzhen. The patient, an elderly male, resided in a rural area of Taihu County, Anqing City, Anhui Province (a known SFTS natural endemic focus with high tick vector density) and engaged in frequent farming activities two weeks prior to symptom onset, suggesting probable tick-borne transmission. The patient presented with acute onset of persistent fever, leukopenia, progressive thrombocytopenia (minimum 26×10⁹/L), and multi-organ dysfunction (elevated hepatic and myocardial enzymes), meeting diagnostic criteria for severe SFTS. Laboratory testing confirmed SFTSV nucleic acid positivity in both blood and throat swab specimens (Ct values: 27 and 33, respectively), with IgM seropositivity and IgG seronegativity.The whole-genome sequencing results showed that the strain of the case belonged to the C genotype, which was closely related to the Hubei isolate. Supportive therapies including platelet transfusion, intravenous immunoglobulin, and albumin supplementation resulted in clinical recovery after 13 days of treatment. By systematically reviewing the epidemiological history, clinical manifestations, and molecular characteristics of SFTSV, this study highlights the potential risk of cross-regional transmission of SFTSV strains and emphasizes the necessity for non-endemic regions to strengthen early identification and prevention measures for imported SFTS cases, providing critical insights for clinical management and epidemiological surveillance of SFTS.

Key words: Severe fever with thrombocytopenia syndrome, Clinical features, Genotype C, Imported case

CLC Number:

R512.99

Chen Nixuan, Wu Yanjie, Wan Jia, Chen Yihua, Kong Dongfeng, Zhang Zhen, Shi Xiaolu, Lyu Ziquan, Yang Fan, Wu Chunli, Wang Xiran, Ye Yuhui. An imported case of genotype c severe fever with thrombocytopenia syndrome in shenzhen: clinical and molecular characteristics insights[J]. Electronic Journal of Emerging Infectious Diseases, 2025, 10(2): 75-80.

References

[1] WANG S, LI J, NIU G, et al.SFTS virus in ticks in an endemic area of China[J]. Am J Trop Med Hyg, 2015, 92(4): 684-689.
[2] 何益新, 黄永, 何嗣胜, 等. 铜陵市一起发热伴血小板减少综合征聚集性疫情流行病学调查研究[J]. 中国预防医学杂志, 2018, 19(7): 553-556.
[3] 黄文忠, 余向华, 吴红照, 等. 一起经接触传播的发热伴血小板减少综合征疫情调查[J]. 中国媒介生物学及控制杂志, 2015, 26(2): 172-175.
[4] 中华人民共和国卫生部. 发热伴血小板减少综合征防治指南(2010版)[J]. 中华临床感染病杂志, 2011, 4(4): 193-194.
[5] 徐若薇, 贾德胜, 路大峰, 等. 发热伴血小板减少综合征的流行病学特点及防控对策[J]. 中华卫生杀虫药械, 2022, 28(6): 551-555.
[6] 陈秋兰, 朱曼桐, 陈宁, 等. 2011-2021年全国发热伴血小板减少综合征流行特征分析[J]. 中华流行病学杂志, 2022, 43(6): 852-859.
[7] CUI N, LIU R, LU QB, et al.Severe fever with thrombocytopenia syndrome bunyavirus-related human encephalitis[J]. J Infect, 2015, 70(1): 52-59.
[8] 迪丽胡玛尔•扎衣尔, 张斌, 朱彬, 等. 发热伴血小板减少综合征发病机制及诊疗研究进展[J]. 中国病毒病杂志, 2024, 14(2): 189-195.
[9] 陈广, 陈韬, 舒赛男, 等. 重症发热伴血小板减少综合征诊治专家共识[J]. 传染病信息, 2022, 35(5): 385-393.
[10] LI A, LIU L, WU W, et al.Molecular evolution and genetic diversity analysis of SFTS virus based on next-generation sequencing[J]. Biosaf Health, 2021, 3(2): 105-115.
[11] 孙玉兰, 王志越, 宋丽君, 等. 北京市首例发热伴血小板减少综合征本土病例的病原学特征研究[J]. 疾病监测, 2023, 38: 1186-1192.
[12] 国家卫生健康委办公厅,国家中医药局综合司.发热伴血小板减少综合征诊疗方案(2023年版)[J]. 中国感染控制杂志, 2024, 23(7): 918-920.
[13] 霍雪平, 刘贞君, 谢琴秀. 重症发热伴血小板减少综合征预警指标分析[J/CD]. 新发传染病电子杂志, 2023, 8(5): 41-45.
[14] 肖玲燕, 史东阳, 刘永福, 等. 重症新型布尼亚病毒感染的临床特征和疗效分析[J/CD]. 新发传染病电子杂志, 2020, 5(1): 16-19.
[15] LI XK, DAI K, YANG ZD, et al.Correlation between thrombocytopenia and host response in severe fever with thrombocytopenia syndrome[J]. PLoS Negl Trop Dis, 2020, 14(10): e0008801.
[16] DING YP, LIANG MF, YE JB, et al.Prognostic value of clinical and immunological markers in acute phase of SFTS virus infection[J]. Clin Microbiol Infect, 2014, 20(11): 870-878.
[17] DENIC S, JANBEIH J, NAIR S, et al.Acute Thrombocytopenia, Leucopenia, and Multiorgan Dysfunction: The First Case of SFTS Bunyavirus outside China?[J]. Case Rep Infect Dis, 2011, 2011: 204056.
[18] KIM UJ, KIM DM, AHN JH, et al.Successful treatment of rapidly progressing severe fever with thrombocytopenia syndrome with neurological complications using intravenous immunoglobulin and corticosteroid[J]. Antivir Ther, 2016, 21(7): 637-640.
[19] LIU Y, TONG H, HE F, et al.Effect of intravenous immunoglobulin therapy on the prognosis of patients with severe fever with thrombocytopenia syndrome and neurological complications[J]. Front Immunol, 2023, 14: 1118039.
[20] LIU W, LU QB, CUI N, et al.Case-fatality ratio and effectiveness of ribavirin therapy among hospitalized patients in china who had severe fever with thrombocytopenia syndrome[J]. Clin Infect Dis, 2013, 57(9): 1292-1299.
[21] KOWDLEY KV.Hematologic Side Effects of Interferon and Ribavirin Therapy[J]. J Clin Gastroenterology, 2005, 39: S3.
[22] DING F, GUAN XH, KANG K, et al.Risk factors for bunyavirus-associated severe Fever with thrombocytopenia syndrome, china[J]. PLoS Negl Trop Dis, 2014, 8(10): e3267.
[23] HE F, ZHENG X, ZHANG Z.Clinical features of severe fever with thrombocytopenia syndrome and analysis of risk factors for mortality[J]. BMC Infect Dis, 2021, 21(1): 1253.
[24] 汪金生, 汤厚林, 高伟林, 等. 2011-2016年安徽省安庆市发热伴血小板减少综合征监测分析[J]. 疾病监测, 2018, 33(4): 324-328.
[25] 滕雪娇, 邓舒, 赵玉秋, 等. 2011-2022年安徽省发热伴血小板减少综合征流行特征分析[J]. 疾病监测, 2024, 39(1): 48-52.
[26] 汪金生, 龚磊, 李贤相, 等. 安庆市137例发热伴血小板减少综合征流行病学调查及传播媒介蜱虫监测结果[J]. 职业与健康, 2019, 35(4): 516-520.
[27] 王敬忠, 陈宏标, 彭志强, 等. 广东省首例输入性发热伴血小板减少综合征病例调查[J]. 中国感染控制杂志, 2021, 20(1): 86-90.
[28] 陈志高, 陈蕾, 梅树江, 等. 深圳市1例发热伴血小板减少综合征病例调查与应急处置[J]. 中国热带医学, 2022, 22(3): 284-288.
[29] 宋丹丹, 龚磊, 吴家兵, 等. 安徽省发热伴血小板减少综合征部分流行地区蜱类分布调查[J].安徽预防医学杂志, 2020, 26(4): 267-269, 280.
[30] YUN Y, HEO ST, KIM G, et al.Phylogenetic Analysis of Severe Fever with Thrombocytopenia Syndrome Virus in South Korea and Migratory Bird Routes Between China, South Korea, and Japan[J]. Am J Trop Med Hyg, 2015, 93(3): 468-474.
[31] BUCZEK AM, BUCZEK W, BUCZEK A, et al.The Potential Role of Migratory Birds in the Rapid Spread of Ticks and Tick-Borne Pathogens in the Changing Climatic and Environmental Conditions in Europe[J]. Int J Environ Res Public Health, 2020, 17(6): 2117.
[32] KIM EH, PARK SJ.Emerging Tick-Borne Dabie bandavirus: Virology, Epidemiology, and Prevention[J]. Microorganisms, 2023, 11(9): 2309.
[33] REN YT, TIAN HP, XU JL, et al.Extensive genetic diversity of severe fever with thrombocytopenia syndrome virus circulating in Hubei Province, China, 2018-2022[J]. PLoS Negl Trop Dis, 2023, 17(9): e0011654.