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      Epidemiological and Etiological Characteristics of Fever, Thrombocytopenia and Leukopenia Syndrome in Henan Province, China, 2011–2012

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          Abstract

          The Fever, Thrombocytopenia and Leukopenia Syndrome (FTLS) is caused by a bunyavirus known as the FTLS virus (FTLSV), which was recently discovered in China. We examined the epidemiological and etiological features of 637 laboratory-confirmed cases of FTLS with onset from January 2011 to December 2012 in Henan Province, China. The highest incidence of FTLS occurred between May and August: 76.5% of all laboratory-confirmed cases occurred during those four months. Of the laboratory-confirmed cases, 60.9% were in the 46–69 years old age groups; 96.1% (612/637) occurred in farmers; 98.1% (625/637) were reported from Xinyang Prefecture. During the same time period, 2047 cases were reported in China. The nucleotide and amino acid sequences of FTLSV strains identified during 2011–2012 in Henan Province were ≥96% identical. This findings provides insight for developing public-health interventions for the control and prevention of FTLS in epidemic area.

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          Most cited references15

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          Alphaherpesvirinae and Gammaherpesvirinae glycoprotein L and CMV UL130 originate from chemokines

          Herpesviridae is a large family of DNA viruses divided into three subfamilies: Alpha-, Beta- and Gammaherpesvirinae. The process of herpesvirus transmission is mediated by a range of proteins, one of which is glycoprotein L (gL). Based on our analysis of the solved structures of HSV2 and EBV gH/gL complexes, we propose that Alphaherpesvirinae and Gammaherpesvirinae glycoprotein L and Betaherpesvirinae UL130 originate from chemokines. Herpes simplex virus type 2 gL and human cytomegalovirus homolog (UL130) adopt a novel C chemokine-like fold, while Epstein-Barr virus gL mimics a CC chemokine structure. Hence, it is possible that gL interface with specific chemokine receptors during the transmission of Herpesviridae. We conclude that the further understanding of the function of viral chemokine-like proteins in Herpesviridae infection may lead to development of novel prophylactic and therapeutic treatment.
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            Case-fatality ratio and effectiveness of ribavirin therapy among hospitalized patients in china who had severe fever with thrombocytopenia syndrome.

            The wide distribution and high case-fatality ratio of severe fever with thrombocytopenia syndrome (SFTS) have made it a significant public health problem. This study was designed to identify the predictors of fatal outcomes and to evaluate the effectiveness of antiviral therapy in treating SFTS virus (SFTSV)-infected patients. A cross-sectional study was performed in a general hospital located in Xinyang city, whereas the largest number of patients with SFTS in China were treated during 2011-2012. The primary outcome for the treatment effect analysis was death. Other outcomes included sequential platelet levels and viral loads observed throughout the hospitalization and the interval between the initiation of ribavirin therapy and the return of the platelet count to a normal level. A total of 311 SFTSV-infected patients were included in the study. The most frequent clinical presentations were fever, weakness, myalgia, and gastrointestinal symptoms. Each patient had thrombocytopenia, leukopenia, or both. The case-fatality ratio (CFR) was 17.4% (95% confidence interval [CI], 13.1%-21.6%). Older age (odds ratio [OR], 1.061; 95% CI, 1.023-1.099; P = .001), decreased level of consciousness (OR, 5.397; 95% CI, 2.660-10.948; P 1200 U/L; OR, 2.620; 95% CI, 1.073-6.399; P = .035) and creatine kinase (>800 U/L; OR, 2.328; 95% CI, 1.129-4.800; P = .022) were significantly associated with fatal outcome. The CFRs were similar between patients who received ribavirin and those who did not. Ribavirin treatment showed no significant effect on either platelet counts or viral loads during hospitalization of patients with fatal or nonfatal cases. These findings can improve knowledge about the characteristics of patients with fatal outcomes and the use of antiviral drug for SFTS.
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              Epidemiologic features of severe fever with thrombocytopenia syndrome in China, 2011-2012.

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2014
                14 March 2014
                : 9
                : 3
                : e91166
                Affiliations
                [1 ]Henan Center for Disease Control and Prevention, Zhengzhou, China
                [2 ]College of Public Health, Zhengzhou University, Zhengzhou, China
                [3 ]Xinyang Center for Disease Control and Prevention, Xinyang, China
                Institut Pasteur of Shanghai, Chinese Academy of Sciences, China
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Conceived and designed the experiments: XYH BLX. Performed the experiments: YHD XNH HXM. Analyzed the data: HFW AGY KK HMC LZ GHL. Contributed reagents/materials/analysis tools: XYH AGY BLX. Wrote the paper: XYH BLX.

                Article
                PONE-D-13-31993
                10.1371/journal.pone.0091166
                3954591
                24633131
                c5a65ffb-90ea-4a93-ac52-9c4f975ce3a3
                Copyright @ 2014

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 31 July 2013
                : 11 February 2014
                Page count
                Pages: 6
                Funding
                This research was supported by Henan Medical Science Project (200702016), Henan Province Health Department and National Health and Fimaly Planning Commission of the People’s Republic of China Co-build Project (201101017), and China-Australia Health and HIV/AIDS Facility (EID35). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Microbiology
                Virology
                Emerging Viral Diseases
                Viral Classification
                Emerging Infectious Diseases
                Population Biology
                Epidemiology
                Infectious Disease Epidemiology
                Medicine
                Epidemiology
                Infectious Disease Epidemiology
                Infectious Diseases
                Viral Diseases

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