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13 pages, 3272 KiB

Open AccessArticle

M Segment-Based Minigenome System of Severe Fever with Thrombocytopenia Syndrome Virus as a Tool for Antiviral Drug Screening

by Hiroshi Yamada, Satoshi Taniguchi, Masayuki Shimojima, Long Tan, Miyuki Kimura, Yoshitomo Morinaga, Takasuke Fukuhara, Yoshiharu Matsuura, Takashi Komeno, Yousuke Furuta, Masayuki Saijo and Hideki Tani

Viruses 2021, 13(6), 1061; https://doi.org/10.3390/v13061061 - 03 Jun 2021

Cited by 6 | Viewed by 2801

Abstract

Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne bunyavirus that causes severe disease in humans with case fatality rates of approximately 30%. There are few treatment options for SFTSV infection. SFTSV RNA synthesis is conducted using a virus-encoded complex with [...] Read more.

Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging tick-borne bunyavirus that causes severe disease in humans with case fatality rates of approximately 30%. There are few treatment options for SFTSV infection. SFTSV RNA synthesis is conducted using a virus-encoded complex with RNA-dependent RNA polymerase activity that is required for viral propagation. This complex and its activities are, therefore, potential antiviral targets. A library of small molecule compounds was processed using a high-throughput screening (HTS) based on an SFTSV minigenome assay (MGA) in a 96-well microplate format to identify potential lead inhibitors of SFTSV RNA synthesis. The assay confirmed inhibitory activities of previously reported SFTSV inhibitors, favipiravir and ribavirin. A small-scale screening using MGA identified four candidate inhibitors that inhibited SFTSV minigenome activity by more than 80% while exhibiting less than 20% cell cytotoxicity with selectivity index (SI) values of more than 100. These included mycophenolate mofetil, methotrexate, clofarabine, and bleomycin. Overall, these data demonstrate that the SFTSV MGA is useful for anti-SFTSV drug development research. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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12 pages, 979 KiB

Open AccessArticle

Loperamide Inhibits Replication of Severe Fever with Thrombocytopenia Syndrome Virus

by Shuzo Urata, Jiro Yasuda and Masaharu Iwasaki

Viruses 2021, 13(5), 869; https://doi.org/10.3390/v13050869 - 10 May 2021

Cited by 7 | Viewed by 2969

Abstract

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). SFTS is mainly prevalent in East Asia. It has a mortality rate of up to 30%, and there is no approved treatment against the [...] Read more.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). SFTS is mainly prevalent in East Asia. It has a mortality rate of up to 30%, and there is no approved treatment against the disease. In this study, we evaluated the effect of loperamide, an antidiarrheal and antihyperalgesic agent, on the propagation of SFTSV in a cell culture system. Methods: SFTSV-infected human cell lines were exposed to loperamide, and viral titers were evaluated. To clarify the mode of action of loperamide, several chemical compounds having shared targets with loperamide were used. Calcium imaging was also performed to understand whether loperamide treatment affected calcium influx. Results: Loperamide inhibited SFTSV propagation in several cell lines. It inhibited SFTSV in the post-entry step and restricted calcium influx into the cell. Furthermore, nifedipine, a calcium channel inhibitor, also blocked post-entry step of SFTSV infection. Conclusions: Loperamide inhibits SFTSV propagation mainly by restraining calcium influx into the cytoplasm. This indicates that loperamide, a Food and Drug Administration (FDA)-approved drug, has the potential for being used as a treatment option against SFTS. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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10 pages, 620 KiB

Open AccessArticle

Corticosteroids May Have Negative Effects on the Management of Patients with Severe Fever with Thrombocytopenia Syndrome: A Case–Control Study

by Takeshi Kawaguchi, Kunihiko Umekita, Atsushi Yamanaka, Seiichiro Hara, Tetsuro Yamaguchi, Eisuke Inoue and Akihiko Okayama

Viruses 2021, 13(5), 785; https://doi.org/10.3390/v13050785 - 28 Apr 2021

Cited by 14 | Viewed by 1996

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral hemorrhagic fever in China, Korea, and Japan. To date, no standardized treatment protocol for SFTS has been established. Corticosteroids (CS) may be administered to patients with SFTS and hemophagocytic syndrome, but its effectiveness and safety are still debatable. We conducted a retrospective case series review at four medical facilities in Miyazaki, Japan. Based on the medical records, clinical data, including the patients background, symptoms, physical findings, laboratory data at initial presentation, treatment, and outcome, were compared between the CS-treated and the non-CS-treated group. A total of 47 patients with confirmed SFTS in each hospital were enrolled in this study; there were 14 fatal cases and 33 nonfatal cases. The case fatality ratio was 29.8%. After adjusting patients’ background by propensity score matching, the case fatality ratio was higher (p = 0.04) and complications of secondary infections, including invasive pulmonary aspergillosis, tended to be more frequent (p = 0.07) in the CS-treated group than in the non-CS-treated group. These data suggested that administration of CS to patients with SFTS should be carefully considered. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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11 pages, 776 KiB

Open AccessArticle

Development of an RT-LAMP Assay for the Rapid Detection of SFTS Virus

by Shiori Sano, Shuetsu Fukushi, Souichi Yamada, Shizuko Harada, Hitomi Kinoshita, Satoko Sugimoto, Tomoki Yoshikawa, Takeshi Kurosu, Yuki Takamatsu, Masayuki Shimojima, Shoichi Toda, Yuka Hamada, Naoki Fujisawa, Takayuki Sugimoto and Masayuki Saijo

Viruses 2021, 13(4), 693; https://doi.org/10.3390/v13040693 - 16 Apr 2021

Cited by 12 | Viewed by 2959

Abstract

Detection of severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) during the early phase of the disease is important for appropriate treatment, infection control, and prevention of further transmission. The reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a nucleic acid amplification method that [...] Read more.

Detection of severe fever with thrombocytopenia syndrome (SFTS) virus (SFTSV) during the early phase of the disease is important for appropriate treatment, infection control, and prevention of further transmission. The reverse transcription loop-mediated isothermal amplification (RT-LAMP) is a nucleic acid amplification method that amplifies the target sequence under isothermal conditions. Here, we developed an RT-LAMP with a novel primer/probe set targeting a conserved region of the SFTSV L segment after extraction of viral RNA (standard RT-LAMP). Both the Chinese and Japanese SFTSV strains, including various genotypes, were detected by the standard RT-LAMP. We also performed RT-LAMP using the same primer/probe set but without the viral RNA extraction step (called simplified RT-LAMP) and evaluated the diagnostic efficacy. The sensitivity and specificity of the simplified RT-LAMP were 84.9% (45/53) and 89.5% (2/19), respectively. The simplified RT-LAMP can detect SFTSV in human sera containing >10^3.5 copies/mL viral RNA. The two RT-LAMP positive but quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) negative samples were positive in the conventional RT-PCR, suggesting that there was no false positive reaction in the RT-LAMP. Both the standard and simplified RT-LAMP are useful for detecting the SFTSV genome in patients during the early phase of the disease. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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6 pages, 490 KiB

Open AccessArticle

Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Virus in Small-Animal Veterinarians and Nurses in the Japanese Prefecture with the Highest Case Load

by Yumi Kirino, Keita Ishijima, Miho Miura, Taro Nomachi, Eugene Mazimpaka, Putu Eka Sudaryatma, Atsushi Yamanaka, Ken Maeda, Takayuki Sugimoto, Akatsuki Saito, Hirohisa Mekata and Tamaki Okabayashi

Viruses 2021, 13(2), 229; https://doi.org/10.3390/v13020229 - 02 Feb 2021

Cited by 16 | Viewed by 3269

Abstract

Severe fever with thrombocytopenia syndrome virus (SFTSV) is the causative agent of SFTS, an emerging tick-borne disease in East Asia, and is maintained in enzootic cycles involving ticks and a range of wild animal hosts. Direct transmission of SFTSV from cats and dogs [...] Read more.

Severe fever with thrombocytopenia syndrome virus (SFTSV) is the causative agent of SFTS, an emerging tick-borne disease in East Asia, and is maintained in enzootic cycles involving ticks and a range of wild animal hosts. Direct transmission of SFTSV from cats and dogs to humans has been identified in Japan, suggesting that veterinarians and veterinary nurses involved in small-animal practice are at occupational risk of SFTSV infection. To characterize this risk, we performed a sero-epidemiological survey in small-animal-practice workers and healthy blood donors in Miyazaki prefecture, which is the prefecture with the highest per capita number of recorded cases of SFTS in Japan. Three small-animal-practice workers were identified as seropositive by ELISA, but one had a negative neutralization-test result and so was finally determined to be seronegative, giving a seropositive rate of 2.2% (2 of 90), which was significantly higher than that in healthy blood donors (0%, 0 of 1000; p < 0.05). The seroprevalence identified here in small-animal-practice workers was slightly higher than that previously reported in other high-risk workers engaged in agriculture and forestry in Japan. Thus, enhancement of small-animal-practice workers’ awareness of biosafety at animal hospitals is necessary for control of SFTSV. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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10 pages, 1391 KiB

Open AccessArticle

Pathological Characteristics of a Patient with Severe Fever with Thrombocytopenia Syndrome (SFTS) Infected with SFTS Virus through a Sick Cat’s Bite

by Masatoshi Tsuru, Tadaki Suzuki, Tomoyuki Murakami, Kumiko Matsui, Yuuji Maeda, Tomoki Yoshikawa, Takeshi Kurosu, Masayuki Shimojima, Tomome Shimada, Hideki Hasegawa, Ken Maeda, Shigeru Morikawa and Masayuki Saijo

Viruses 2021, 13(2), 204; https://doi.org/10.3390/v13020204 - 29 Jan 2021

Cited by 29 | Viewed by 3408

Abstract

A woman in her fifties showed symptoms of fever, loss of appetite, vomiting, and general fatigue 2 days after she was bitten by a sick cat, which had later died, in Yamaguchi prefecture, western Japan, in June 2016. She subsequently died of multiorgan [...] Read more.

A woman in her fifties showed symptoms of fever, loss of appetite, vomiting, and general fatigue 2 days after she was bitten by a sick cat, which had later died, in Yamaguchi prefecture, western Japan, in June 2016. She subsequently died of multiorgan failure, and an autopsy was performed to determine the cause of death. However, the etiological pathogens were not quickly identified. The pathological features of the patient were retrospectively re-examined, and the pathology of the regional lymph node at the site of the cat bite was found to show necrotizing lymphadenitis with hemophagocytosis. The pathological features were noted to be similar to those of patients reported to have severe fever with thrombocytopenia syndrome (SFTS). Therefore, the lymph node section was retrospectively tested immunohistochemically, revealing the presence of the SFTS virus (SFTSV) antigen. The sick cat showed similar symptoms and laboratory findings similar to those shown in human SFTS cases. The patient had no history of tick bites, and did not have skin lesions suggestive of these. She had not undertaken any outdoor activities. It is highly possible that the patient was infected with SFTSV through the sick cat’s bite. If a patient gets sick in an SFTS-endemic region after being bitten by a cat, SFTS should be considered in the differential diagnosis. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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13 pages, 2065 KiB

Open AccessArticle

The Polarity of an Amino Acid at Position 1891 of Severe Fever with Thrombocytopenia Syndrome Virus L Protein Is Critical for the Polymerase Activity

by Kisho Noda, Yoshimi Tsuda, Fumiya Kozawa, Manabu Igarashi, Kenta Shimizu, Jiro Arikawa and Kumiko Yoshimatsu

Viruses 2021, 13(1), 33; https://doi.org/10.3390/v13010033 - 27 Dec 2020

Cited by 6 | Viewed by 3441

Abstract

Severe fever with thrombocytopenia syndrome virus subclone B7 shows strong plaque formation and cytopathic effect induction compared with other subclones and the parental strain YG1. Compared to YG1 and the other subclones, only B7 possesses a single substitution in the L protein at [...] Read more.

Severe fever with thrombocytopenia syndrome virus subclone B7 shows strong plaque formation and cytopathic effect induction compared with other subclones and the parental strain YG1. Compared to YG1 and the other subclones, only B7 possesses a single substitution in the L protein at the amino acid position 1891, in which N is changed to K (N1891K). In this study, we evaluate the effects of this mutation on L protein activity via a cell-based minigenome assay. Substitutions of N with basic amino acids (K or R) enhanced polymerase activity, while substitutions with an acidic amino acid (E) decreased this activity. Mutation to other neutral amino acids showed no significant effect on activity. These results suggest that the characteristic of the amino acid at position 1891 of the L protein are critical for its function, especially with respect to the charge status. Our data indicate that this C-terminal domain of the L protein may be crucial to its functions in genome transcription and viral replication. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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10 pages, 1282 KiB

Open AccessArticle

Prognostic Factors of Severe Fever with Thrombocytopenia Syndrome in South Korea

by Misun Kim, Sang Taek Heo, Hyunjoo Oh, Suhyun Oh, Keun Hwa Lee and Jeong Rae Yoo

Viruses 2021, 13(1), 10; https://doi.org/10.3390/v13010010 - 23 Dec 2020

Cited by 5 | Viewed by 2359

Abstract

Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne infectious disease, is difficult to differentiate from other common febrile diseases. Clinically distinctive features and climate variates associated with tick growth can be useful predictors for SFTS. This retrospective study (2013–2019) demonstrated the role of [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS), a tick-borne infectious disease, is difficult to differentiate from other common febrile diseases. Clinically distinctive features and climate variates associated with tick growth can be useful predictors for SFTS. This retrospective study (2013–2019) demonstrated the role of climatic factors as predictors of SFTS and developed a clinical scoring system for SFTS using climate variables and clinical characteristics. The presence of the SFTS virus was confirmed using reverse transcription polymerase chain reaction (RT-PCR) tests. In the univariate analysis, the SFTS-positive group was significantly associated with higher mean ambient temperature and humidity compared with the SFTS-negative group (22.5 °C vs. 18.9 °C; 77.9% vs. 70.7%, all p < 0.001). In the multivariate analysis, poor oral intake (Odds ratio [OR] 5.87, 95% CI: 2.42–8.25), lymphadenopathy (OR 7.20, 95% CI: 6.24–11.76), mean ambient temperature ≥ 20 °C (OR 4.62, 95% CI: 1.46–10.28), absolute neutrophil count ≤ 2000 cells/μL (OR 8.95, 95% CI: 2.30–21.25), C-reactive protein level ≤ 1.2 mg/dL (OR 6.42, 95% CI: 4.02–24.21), and creatinine kinase level ≥ 200 IU/L (OR 5.94, 95% CI: 1.42–24.92) were significantly associated with the SFTS-positive group. This study presents the risk factors, including ambient temperature and clinical characteristics, that physicians should consider when suspecting SFTS. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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Review

Jump to: Research, Other

16 pages, 812 KiB

Open AccessReview

Clinical Update of Severe Fever with Thrombocytopenia Syndrome

by Jun-Won Seo, Dayoung Kim, Nara Yun and Dong-Min Kim

Viruses 2021, 13(7), 1213; https://doi.org/10.3390/v13071213 - 23 Jun 2021

Cited by 57 | Viewed by 9603

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness characterized by fever, leukopenia, thrombocytopenia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting resulting from infection with the SFTS virus (SFTSV). The SFTSV is transmitted to humans by tick bites, primarily [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile illness characterized by fever, leukopenia, thrombocytopenia, and gastrointestinal symptoms such as diarrhea, nausea, and vomiting resulting from infection with the SFTS virus (SFTSV). The SFTSV is transmitted to humans by tick bites, primarily from Haemaphysalis longicornis, Amblyomma testudinarium, Ixodes nipponensis, and Rhipicephalus microplus. Human-to-human transmission has also been reported. Since the first report of an SFTS patient in China, the number of patients has also been increasing. The mortality rate of patients with SFTS remains high because the disease can quickly lead to death through multiple organ failure. In particular, an average fatality rate of approximately 20% has been reported for SFTS patients, and no treatment strategy has been established. Therefore, effective antiviral agents and vaccines are required. Here, we aim to review the epidemiology, clinical manifestations, laboratory diagnosis, and various specific treatments (i.e., antiviral agents, steroids, intravenous immunoglobulin, and plasma exchange) that have been tested to help to cope with the disease. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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7 pages, 691 KiB

Open AccessReview

The Role of Non-Structural Protein NSs in the Pathogenesis of Severe Fever with Thrombocytopenia Syndrome

by Jumana Khalil, Hiroki Kato and Takashi Fujita

Viruses 2021, 13(5), 876; https://doi.org/10.3390/v13050876 - 11 May 2021

Cited by 16 | Viewed by 3152

Abstract

Viral non-structural proteins, such as NSs of the newly emerging severe fever with thrombocytopenia syndrome virus, are well established virulence factors, mediating viral pathogenesis and disease progression through various mechanisms. NSs has been described as a potent interferon antagonist and NF-κB agonist, two [...] Read more.

Viral non-structural proteins, such as NSs of the newly emerging severe fever with thrombocytopenia syndrome virus, are well established virulence factors, mediating viral pathogenesis and disease progression through various mechanisms. NSs has been described as a potent interferon antagonist and NF-κB agonist, two divergent signaling pathways in many immune responses upon a viral encounter. In this review, we highlight the many mechanisms used by NSs on the host that promote viral replication and hyper-inflammation. Understanding these host-pathogen interactions is crucial for antiviral therapy development. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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9 pages, 246 KiB

Open AccessReview

Vaccine Development for Severe Fever with Thrombocytopenia Syndrome

by Tomoki Yoshikawa

Viruses 2021, 13(4), 627; https://doi.org/10.3390/v13040627 - 06 Apr 2021

Cited by 13 | Viewed by 3568

Abstract

Severe fever with thrombocytopenia syndrome (SFTS), which is caused by SFTS virus (SFTSV), is a tick-borne emerging zoonosis with a high case-fatality rate. At present, there is no approved SFTS vaccine, although the development of a vaccine would be one of the best [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS), which is caused by SFTS virus (SFTSV), is a tick-borne emerging zoonosis with a high case-fatality rate. At present, there is no approved SFTS vaccine, although the development of a vaccine would be one of the best strategies for preventing SFTS. This article focused on studies aimed at establishing small animal models of SFTS that are indispensable for evaluating vaccine candidates, developing these vaccine candidates, and establishing more practical animal models for evaluation. Innate immune-deficient mouse models, a hamster model, an immunocompetent ferret model and a cat model have been developed for SFTS. Several vaccine candidates for SFTS have been developed, and their efficacy has been confirmed using these animal models. The candidates consist of live-attenuated virus-based, viral vector-based, or DNA-based vaccines. SFTS vaccines are expected to be used for humans and companion dogs and cats. Hence for practical use, the vaccine candidates should be evaluated for efficacy using not only nonhuman primates but also dogs and cats. There is no practical nonhuman primate model of SFTS; however, the cat model is available to evaluate the efficacy of these candidate SFTS vaccines on domesticated animals. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

Other

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8 pages, 21216 KiB

Open AccessCase Report

Severe Fever with Thrombocytopenia Syndrome Accompanied by Invasive Pulmonary Aspergillosis: An Autopsy Case

by Kosho Iwao, Takeshi Kawaguchi, Masatoshi Kimura, Chihiro Iwao, Mao Rikitake, Ayako Aizawa, Yumi Kariya, Motohiro Matsuda, Syunichi Miyauchi, Ichiro Takajo, Takumi Kiwaki, Tsuyoshi Fukushima, Hiroaki Kataoka, Tadaki Suzuki, Akihiko Okayama and Kunihiko Umekita

Viruses 2021, 13(6), 1086; https://doi.org/10.3390/v13061086 - 07 Jun 2021

Cited by 10 | Viewed by 2507

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease in China, Korea, and Japan caused by the SFTS virus (SFTSV). SFTS has a high mortality rate due to multiorgan failure. Recently, there are several reports on SFTS patients with mycosis. [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease in China, Korea, and Japan caused by the SFTS virus (SFTSV). SFTS has a high mortality rate due to multiorgan failure. Recently, there are several reports on SFTS patients with mycosis. Here, we report a middle-aged Japanese SFTS patient with invasive pulmonary aspergillosis (IPA) revealed by an autopsy. A 61-year-old man with hypertension working in forestry was bitten by a tick and developed fever, diarrhea, and anorexia in 2 days. On day 4, consciousness disorder was appearing, and the patient was transferred to the University of Miyazaki Hospital. A blood test showed leukocytopenia, thrombocytopenia, as well as elevated levels of alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, and creatine kinase. The SFTSV gene was detected in serum using a reverse-transcription polymerase chain reaction. On day 5, respiratory failure appeared and progressed rapidly, and on day 7, the patient died. An autopsy was performed that revealed hemophagocytosis in the bone marrow and bleeding of several organs. IPA was observed in lung specimens. SFTSV infection may be a risk factor for developing IPA. Early diagnosis and treatment of IPA may be important in patients with SFTS. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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5 pages, 982 KiB

Open AccessCase Report

Residual and Late Onset Symptoms Appeared in a Patient with Severe Fever with Thrombocytopenia in a Convalescence Stage

by Kohei Kanda, Noriko Kinoshita, Satoshi Kutsuna, Keiji Nakamura, Ayako Okuhama, Akira Shimomura, Takeshi Inagaki, Tomoki Yoshikawa, Takeshi Kurosu, Masayuki Shimojima, Masayuki Saijo and Norio Ohmagari

Viruses 2021, 13(4), 657; https://doi.org/10.3390/v13040657 - 10 Apr 2021

Cited by 2 | Viewed by 2240

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by Dabie bandavirus (formerly SFTS virus, SFTSV). Its manifestations during the convalescent phase have not been widely described. We report a patient presenting with hematospermia, fatigue, myalgia, alopecia, insomnia, and [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by Dabie bandavirus (formerly SFTS virus, SFTSV). Its manifestations during the convalescent phase have not been widely described. We report a patient presenting with hematospermia, fatigue, myalgia, alopecia, insomnia, and depression during the recovery phase of SFTS. Since these symptoms are widely observed in patients with viral hemorrhagic fevers, there might be common mechanisms between SFTS and other viral hemorrhagic fevers. Close monitoring may be required during the recovery phase of SFTS. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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8 pages, 903 KiB

Open AccessBrief Report

Kinetics of Serological Response in Patients with Severe Fever with Thrombocytopenia Syndrome

by Sang Hyun Ra, Min Jae Kim, Min-Chul Kim, Se Yoon Park, Seong Yeon Park, Yong Pil Chong, Sang-Oh Lee, Sang-Ho Choi, Yang Soo Kim, Keun Hwa Lee, Sung-Han Kim and Sun-Ho Kee

Viruses 2021, 13(1), 6; https://doi.org/10.3390/v13010006 - 25 Dec 2020

Cited by 6 | Viewed by 2646

Abstract

Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV). We investigated the detailed kinetics of serologic response in patients with SFTS. Twenty-eight patients aged ≥18 years were enrolled between July 2015 and October 2018. SFTS was confirmed by detecting SFTSV [...] Read more.

Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV). We investigated the detailed kinetics of serologic response in patients with SFTS. Twenty-eight patients aged ≥18 years were enrolled between July 2015 and October 2018. SFTS was confirmed by detecting SFTSV RNA in their plasma using reverse transcription polymerase chain reaction. SFTSV-specific IgG and IgM were measured using immunofluorescence assay (IFA) and enzyme-linked immunosorbent assay (ELISA). We found that SFTSV-specific IgG was detected at days 5–9 after symptom onset, and its titer was rising during the course of disease. SFTSV-specific IgM titer peaked at around week 2–3 from symptom onset. The SFTSV-specific seropositive rates for days 5–9, 10–14, 15–19, and 20–24 from symptom onset using IFA and ELISA were 63%, 76%, 90%, and 100%, and 58%, 86%, 100%, and 100%, respectively, for IgG, whereas they were 32%, 62%, 80%, and 100%, and 53%, 62%, 70%, and 100%, respectively, for IgM. The delayed IgM response could be attributed to the low sensitivity of SFTSV-specific IgM IFA or ELISA and/or impaired immune responses. The IgM test using IFA or ELISA that we used in this study is, therefore, insufficient for the early diagnosis of SFTS. Full article

(This article belongs to the Special Issue Severe Fever with Thrombocytopenia Syndrome Virus)

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