Zhen-Dong Yang1, Jian-Gong Hu2, Qing-Bin Lu3, Chen-Tao Guo4, Ning Cui1, Wei Peng5, Li-Yuan Wang4, Shu-Li Qin1, Hong-Yu Wang4, Pan-He Zhang2, Xiao-Ai Zhang2, Wei Liu6, Wu-Chun Cao2. 1. The 154 Hospital, Peoples Liberation Army, Xinyang 464000, PR China. 2. State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China. 3. School of Public Health, Peking University, Beijing 100191, PR China. Electronic address: qingbinlu@bjmu.edu.cn. 4. State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China; Graduate School of Anhui Medical University, Hefei 230032, PR China. 5. The Shangcheng County People's Hospital, Shangcheng, PR China. 6. State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing 100071, PR China. Electronic address: lwbime@163.com.
Abstract
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS), caused by novel bunyavirus (SFTSV) is a potentially fatal disease that was first identified in China. Person to person transmission through contact with blood or body fluids was considered as an important infection route. OBJECTIVES: The study is designed to investigate the longitudinal viral loads following SFTSV infection and to identify factors affecting viral shedding in SFTS patients. METHODS: A prospective, observational study was performed on 208 laboratory-confirmed SFTSV infected patients in Xinyang, Henan Province. Sequential serum samples were collected on admission and during the hospitalization for quantification of SFTSV RNA by real-time RT-PCR. RESULTS: The viral RNA was undetectable in 55.6% of the patients on admission into the hospital, becoming detectable in most cases until three days and attained maximum level on six days after disease onset. This was followed by an obvious decrease thereafter, but maintained detectable for over 20 days. Viral load was independently predictable of severe disease outcome throughout the hospitalization. Viral load of >10(7)copies/mL was predictable of fatal outcome. The serum levels of PLT, WBC, LDH, AST and CK were significantly associated with viral loads level. CONCLUSIONS: The diagnosis of SFTSV infection based on PCR test should be performed at least three days after disease onset. Peaking viral loads were attained around six days after disease, posing a highest risk of human-to-human transmission.
BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS), caused by novel bunyavirus (SFTSV) is a potentially fatal disease that was first identified in China. Person to person transmission through contact with blood or body fluids was considered as an important infection route. OBJECTIVES: The study is designed to investigate the longitudinal viral loads following SFTSVinfection and to identify factors affecting viral shedding in SFTS patients. METHODS: A prospective, observational study was performed on 208 laboratory-confirmed SFTSV infected patients in Xinyang, Henan Province. Sequential serum samples were collected on admission and during the hospitalization for quantification of SFTSV RNA by real-time RT-PCR. RESULTS: The viral RNA was undetectable in 55.6% of the patients on admission into the hospital, becoming detectable in most cases until three days and attained maximum level on six days after disease onset. This was followed by an obvious decrease thereafter, but maintained detectable for over 20 days. Viral load was independently predictable of severe disease outcome throughout the hospitalization. Viral load of >10(7)copies/mL was predictable of fatal outcome. The serum levels of PLT, WBC, LDH, AST and CK were significantly associated with viral loads level. CONCLUSIONS: The diagnosis of SFTSVinfection based on PCR test should be performed at least three days after disease onset. Peaking viral loads were attained around six days after disease, posing a highest risk of human-to-human transmission.
Authors: Herwati Dualis; Abraham Chin Zefong; Lim Kai Joo; Narinderjeet Kaur Dadar Singh; Syed Sharizman Syed Abdul Rahim; Richard Avoi; Mohammad Saffree Jeffree; Mohd Rohaizat Hassan; Mohd Yusof Ibrahim; Azizan Omar Journal: Ann Med Surg (Lond) Date: 2021-06-11