Objective To investigate the clinical epidemiological characteristics of laboratory confirmed cases of severe fever with thrombocytopenia syndrome (SFTS),and to provide data basis for its prevention and control. Methods Retrospective investigation was used to investigate randomly selected 20 laboratory confirmed death cases and 20 confirmed surviving cases of SFTS.The clinical symptoms,exposure history,diagnosis and treatment process and the distribution characteristics of laboratory test indexes were analyzed. Results The main clinical manifestations of SFTS patients were fever (100%),fatigue (92.5%) and loss of appetite (85%).80% of the patients lived in hilly or mountainous areas,72.5% had farming experience before the disease,and 12.5% had a clear history of tick bite.52.5% of the patients had three or more diagnosis and treatment experiences.There was significant difference in the distribution of doctor visits between surviving and dead patients (χ2trend=4.875,P=0.027).There were significant differences in laboratory test indicators of dead and surviving patients BUN (t=4.134,P＜0.001),HBDH (Z=-3.042,P=0.002),LDH (Z=-4.366,P=0.001),RET (Z=-2.787,P=0.005),CKMB (Z=-1.999,P=0.046),PLT (Z=-3.328,P=0.001),AST(Z=-2.438,P=0.015),UA(Z=-2.050,P=0.040),DD(Z=-2.178,P=0.029)and CREA (Z=2.742,P=0.006). Conclusions Most confirmed cases of SFTS in Hefei City had been exposed to rural areas.However,they are easy to be misdiagnosed because the early symptoms of SFTS mainly are fever and fatigueas.Hospitals at county level and below have low diagnostic and discriminatory capabilities.As a result,it takes patients unnecessary multiple visits to hospitals and longer diagnostic process.Patients with SFTS are more likely to be delayed treated and develop severe illness.It is essential to improve professional training for medical institutions and public health education for vulnerable population,to raise the diagnostic ability of rural hospitals and the health awareness of public.
Key words
Severe fever with thrombocytopenia syndrome /
Clinical characteristics /
Epidemic history /
Retrospective investigation
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Kato H,Saijo M.Epidemiology of SFTS in China[M]//SAIJO M.Severe Fever with Thrombocytopenia Syndrome.Singapore;Springer Singapore.2019: 71-94.
[2] Yu XJ,Liang MF,Zhang SY,et al.Fever with thrombocytopenia associated with a novel bunyavirus in China[J].N Engl J Med,2011,364(16): 1523-1532.
[3] Robles NJC,Han HJ,Park SJ,et al.Epidemiology of severe fever and thrombocytopenia syndrome virus infection and the need for therapeutics for the prevention[J].Clin Exp Vaccine Res,2018,7(1): 43-50.
[4] Xiaoxia H,Jiandong L,Aqian L,et al.Epidemiological Characteristics of Severe Fever with Thrombocytopenia Syndrome from 2010 to 2019 in Mainland China[J].International Journal of Environmental Research and Public Health,2021,18(6):doi: 10.3390/ijerph18063092.
[5] 黄晓霞,李阿茜,李德新,等.2018年中国发热伴血小板减少综合征流行特征分析[J].中国病毒病杂志,2020,10(6): 417-420.
[6] 李昱,周航,牟笛,等.中国2011-2014年发热伴血小板减少综合征流行特征分析[J].中华流行病学杂志,2015,36(6): 598-602.
[7] 曹琛,吴家兵,曹明华,等.安徽省2011-2015年发热伴血小板减少综合征流行特征分析[J].中华疾病控制杂志,2016,20(8): 792-5.
[8] Kim M,Heo ST,Oh H,et al.Prognostic Factors of Severe Fever with Thrombocytopenia Syndrome in South Korea[J].Viruses,2020,13(1): doi: 10.3390/v13010010.
[9] 邵志英,孙林林,李潇丹,等.重症发热伴血小板减少综合征实验室指标预测死亡风险分析[J].滨州医学院学报,2020,43(5): 340-343.
[10] 音铭,赵宗豪,杨云.95例发热伴血小板减少综合征患者死亡危险因素分析[J].安徽卫生职业技术学院学报,2020,19(4): 21-23,25.
[11] Gai ZT,Zhang Y,Liang MF,et al.Clinical progress and risk factors for death in severe fever with thrombocytopenia syndrome patients[J].J Infect Dis,2012,206(7): 1095-1102.
[12] Jia B,Wu W,Huang R,et al.Characterization of clinical features and outcome for human-to-human transmitted severe fever with thrombocytopenia syndrome[J].Infect Dis (Lond),2018,50(8): 601-608.
[13] Li DX.Severe fever with thrombocytopenia syndrome: a newly discovered emerging infectious disease[J].Clin Microbiol Infect,2015,21(7): 614-620.
[14] 宋丹丹,龚磊,吴家兵,等.安徽省发热伴血小板减少综合征部分流行地区蜱类分布调查[J].安徽预防医学杂志,2020,26(4):267-269.
[15] Wang S,Li J,Niu G,et al.SFTS virus in ticks in an endemic area of China[J].Am J Trop Med Hyg,2015,92(4): 684-9.
[16] Jiang XL,Zhang S,Jiang M,et al.A cluster of person-to-person transmission cases caused by SFTS virus in Penglai,China[J].Clin Microbiol Infect,2015,21(3): 274-279.
[17] Fang X,Hu J,Peng Z,et al.Epidemiological and clinical characteristics of severe fever with thrombocytopenia syndrome bunyavirus human-to-human transmission[J].PLoS Negl Trop Dis,2021,15(4): e0009037.
[18] Song YH,Sun ML,Wen KY,et al.Epidemiological analysis of severe fever with thrombocytopenia syndrome from 2010 to 2017,China.[J].Chin J Emerg Resusc Disaster Med,2018,3:1076–1079.
PDF(877 KB)
