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These results suggest that, in addition to the age of the patients, prevalence of different genotypes in each country might also be a factor in the varied mortality rates between countries. Previous studies demonstrated that aged ferrets mimic clinical signs fever, hematological changes of human SFTSV infection 27 — Further, severe illness was exhibited only in aged ferrets, which is similar to that seen in humans older than 60 years.
Therefore, we used aged ferrets to investigate genotype-dependent differences in the pathogenesis of SFTSV infection. Further, only 1 of 5 aged ferrets infected with genotypes R-8 and R-9 died from the infection, and these groups of ferrets exhibited only moderate body weight loss Supplemental Figure 4, H and I.
These results are similar to what was reported for genotypic variants of Rift Valley fever viruses, which exhibited different levels of virulence in a mouse model However, the low number of clinical cases of infection with certain SFTSV genotypes, especially of the reassortant genotypes, impedes the determination of the association between genotype and case mortality.
Further, recently, Song et al. However, in contrast to human cases, most fatalities occurred in 10—12 days after infection of ferrets, which is a relatively short time to induce full antibody responses against antigens. Therefore, it is hard to determine if there is an association between the absence of virus-specific B cell immunity and mortality in this study.
In this regard, further continuous surveillance of SFTS patients with genomic and pathogenic analyses of detailed clinical manifestations are needed to better understand the association between fatality and specific genotypes.
Overall, the evidence from this study increases our understanding of the genetic and pathogenic diversity of SFTSVs in East Asian countries. Virological and clinical analyses revealed that there are close associations among the clinical manifestations case fatality , patient age, and SFTSV genotype. In addition, continuous surveillance studies are needed to contribute to beneficial for the preventions of severe outbreaks of SFTSV infections.
To compare demographic characteristics of SFTS cases, information regarding age, sex, occupation, residential address, and presence or absence of death was also collected in an epidemiologic investigation of SFTS patients.
A total of full-length sequences of the L , M , and S segments from China, 43 from Japan, and from South Korea including this study were included in the analyses Supplemental Table 4. The reliability of the ML tree was evaluated by the bootstrap test with replications. Vero E6 cells were cultured in 6-well plates and then infected with each virus genotype at an MOI of 0. For virus titration in sera from infected animals, the number of viral RNA copies was measured as previously described Statistical analyses were performed using GraphPad Prism version 8.
P values less than 0. Conflict of interest: The authors have declared that no conflict of interest exists. Reference information: JCI Insight. National Center for Biotechnology Information , U. JCI Insight. Published online Jan Find articles by Seok-Min Yun. Find articles by Su-Jin Park. Find articles by Young-Il Kim. Find articles by Sun-Whan Park. Find articles by Min-Ah Yu. Find articles by Hyeok-Il Kwon.
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Find articles by Won-Ja Lee. Find articles by Youngmee Jee. Find articles by Joo-Yeon Lee. Find articles by Young Ki Choi. Author information Article notes Copyright and License information Disclaimer. Corresponding author. Seok-Min Yun: rk. Phone: Received Apr 12; Accepted Dec This article has been cited by other articles in PMC. Associated Data Supplementary Materials Supplemental data.
Keywords: Infectious disease, Virology. Keywords: Platelets. Introduction Severe fever with thrombocytopenia syndrome SFTS — an emerging tick-borne infectious disease with a high fatality rate and symptoms including severe fever and thrombocytopenia — was first reported in China in 1 , 2. Open in a separate window.
Figure 1. Distribution of SFTS cases between and Specify a start number with a maximum of 8 digits. Example: 1. QTS removes leading zeros in starting numbers. For example, becomes 1. Number of Users. Specify the number of users 1— Example: 5.
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