Fever with Thrombocytopenia Associated with a Novel Bunyavirus in China

被引：1503

作者：

Yu, Xue-Jie ^{[2
,11
]}

Liang, Mi-Fang ^{[1
]}

Zhang, Shou-Yin ^{[3
]}

Liu, Yan ^{[7
,11
]}

Li, Jian-Dong ^{[1
]}

Sun, Yu-Lan ^{[1
]}

Zhang, Lihong ^{[11
]}

Zhang, Quan-Fu ^{[1
]}

Popov, Vsevolod L. ^{[11
]}

Li, Chuan ^{[1
]}

Qu, Jing ^{[1
]}

Li, Qun ^{[2
]}

Zhang, Yan-Ping ^{[1
]}

Hai, Rong ^{[3
]}

Wu, Wei ^{[1
]}

Wang, Qin ^{[1
]}

Zhan, Fa-Xian ^{[5
]}

Wang, Xian-Jun ^{[4
]}

Kan, Biao ^{[3
]}

Wang, Shi-Wen ^{[1
]}

Wan, Kang-Lin ^{[3
]}

Jing, Huai-Qi ^{[3
]}

Lu, Jin-Xin ^{[3
]}

Yin, Wen-Wu ^{[2
]}

Zhou, Hang ^{[2
]}

Guan, Xu-Hua ^{[5
]}

Liu, Jia-Fa ^{[5
]}

Bi, Zhen-Qiang ^{[4
]}

Liu, Guo-Hua ^{[6
]}

Ren, Jun ^{[7
]}

Wang, Hua ^{[8
]}

Zhao, Zhuo ^{[9
]}

Song, Jing-Dong ^{[1
]}

He, Jin-Rong ^{[3
]}

Wan, Tao ^{[1
]}

Zhang, Jing-Shan ^{[3
]}

Fu, Xiu-Ping ^{[3
]}

Sun, Li-Na ^{[1
]}

Dong, Xiao-Ping ^{[2
]}

Feng, Zi-Jian ^{[2
]}

Yang, Wei-Zhong ^{[2
]}

Hong, Tao ^{[1
]}

Zhang, Yu ^{[10
]}

Walker, David H. ^{[11
]}

Wang, Yu ^{[2
]}

Li, De-Xin ^{[1
]}

机构：

[1] Natl Inst Viral Dis Control & Prevent, State Key Lab Mol Virol & Genet Engn, Beijing 102206, Peoples R China

[2] Chinese Ctr Dis Control & Prevent, Chinese CDC, Beijing 102206, Peoples R China

[3] Natl Inst Communicable Dis Control & Prevent, State Key Lab Infect Dis Control & Prevent, Beijing, Peoples R China

[4] Shandong Prov CDC, Jinan, Shandong, Peoples R China

[5] Hubei Prov CDC, Wuhan, Hubei, Peoples R China

[6] Henan Prov CDC, Zhengzhou, Henan, Peoples R China

[7] Anhui Prov CDC, Hefei, Anhui, Peoples R China

[8] Jiangshu Prov CDC, Nanjing, Jiangshu, Peoples R China

[9] Liaoning Prov CDC, Shenyang, Liaoning, Peoples R China

[10] Hubei Prov Dept Hlth, Wuhan, Hubei, Peoples R China

[11] Univ Texas Galveston, Med Branch, Dept Pathol, Galveston, TX 77550 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2011年 / 364卷 / 16期

关键词：

HUMAN GRANULOCYTIC ANAPLASMOSIS;

D O I：

10.1056/NEJMoa1010095

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND 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. METHODS 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. RESULTS 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. CONCLUSIONS A novel phlebovirus was identified in patients with a life-threatening illness associated with fever and thrombocytopenia in China.

引用

页码：1523 / 1532

页数：10

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