Abstract
ObjectiveSevere fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease caused by a novel bunyavirus-SFTSV. The seroprevalence of anti-SFTSV antibodies including immunoglobulin G (IgG) and immunoglobulin M (IgM), specific to SFTSV in the general population has been investigated in various epidemiological studies with inconsistent results. Here, we clarify this discrepancy and reach a more comprehensive result by mean of a meta-analysis.MethodsAll relevant articles were searched in the electronic databases (PubMed, Web of science, Embase, Chinese National Knowledge Infrastructure database, Chinese Wanfang database) up to November 2016. The pooled seroprevalence and 95% confidence intervals (95% CIs) were calculated by random- or fixed- model on the basis of heterogeneity.ResultsIn total, 21 studies containing 23,848 blood samples from 7 provinces were included in this meta-analysis. The minimum and maximum reported seroprevalences of SFTSV among humans in China were 0.23% and 9.17%, respectively. The overall pooled seroprevalence of SFTSV antibodies was 4.3% (95%CI: 3.2%-5.5%). The pooled prevalence was 5.9% (95%CI: 4.7%-7.0%) in Zhejiang province, 4.9% (95%CI: 4.1–5.8%) in Anhui province, 3.9% (95%CI: 1.3%-6.4%) in Shandong province, and 0.7% (95%CI: 0.2%-1.1%) in Jiangsu province. Stratified by occupation, the pooled prevalence of farmer was 6.1% (95%CI: 3.4%-8.9%) and others (mainly are students) was 3.3% (95%CI: 2.4%-4.2%). Additionally, seroprevalence of SFTSV in people who lived in the same village with the patient were higher than that of people who lived in a different village. Seropositive rates in sampling years after 2012 were higher than that before 2012. The prevalence of SFTSV did not differ by age or gender. Sensitive analysis by omitting one study at a time indicated the results of the pooled seroprevalence were robust.ConclusionsSeroprevalence of SFTSV among healthy population in central and eastern China is high. Surveillance efforts on mild or asymptomatic infections among endemic persons are needed.
Highlights
Severe fever with thrombocytopenia syndrome (SFTS) is a notifiable infectious disease characterized by fever, weakness, leukopenia, thrombocytopenia, gastrointestinal symptoms, and central nervous system manifestations [1,2,3]
Seroprevalence of SFTS virus (SFTSV) in people who lived in the same village with the patient were higher than that of people who lived in a different village
SFTSV is most likely to be transmitted by tick bite according to evidence from tick exposure history and SFTSV detection in ticks such as Haemaphysalis longicornis ticks, and virus gene sequence analysis showed the virus in ticks closely related to those circulating in humans [7,8,9,10]
Summary
Severe fever with thrombocytopenia syndrome (SFTS) is a notifiable infectious disease characterized by fever, weakness, leukopenia, thrombocytopenia, gastrointestinal symptoms, and central nervous system manifestations [1,2,3]. The causative agent of SFTS is a novel member of the Phlebovirus in the family Bunyaviridae, SFTS virus (SFTSV), which was first isolated from human beings in rural areas of central China by Yu et al in 2009 [1]. About the latter, the disease was reported in Korea and Japan in 2012, and a disease similar to SFTS has been reported in the United States [4, 5]. Person to person transmission by contacting with infected patient’s blood or mucous has been reported in China [13,14,15]
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