A New Orthonairovirus Associated with Human Febrile Illness

文献类型： 外文期刊

第一作者： Zhang, Xiao-Ai

作者： Zhang, Xiao-Ai;Ma, Yi-Dan;Zhang, Yun-Fa;Hu, Zhen-Yu;Zhang, Jing-Tao;Han, Shuo;Wang, Gang;Li, Shuang;Wang, Xi;Zhang, Lei;Si, Guang-Qian;Peng, Cong;Wang, Rui;Ge, Hong-Han;Jiang, Bao-Gui;Li, Hao;Liu, Wei;Tang, Fang;Ma, Yi-Dan;Li, Nan;Li, Chang;Hu, Zhen-Yu;Wang, Xi;Li, Hao;Liu, Wei;Liang, Wen-Jun;Yuan, Hong-Xia;Zhao, Jia-Qi;Jiang, Lan-Fen

作者机构：

期刊名称：NEW ENGLAND JOURNAL OF MEDICINE （ 影响因子：78.5； 五年影响因子：84.9 ）

ISSN： 0028-4793

年卷期： 2024 年 391 卷 9 期

页码：

收录情况： SCI

摘要： Background In June 2019, a patient presented with persistent fever and multiple organ dysfunction after a tick bite at a wetland park in Inner Mongolia. Next-generation sequencing in this patient revealed an infection with a previously unknown orthonairovirus, which we designated Wetland virus (WELV).Methods We conducted active hospital-based surveillance to determine the prevalence of WELV infection among febrile patients with a history of tick bites. Epidemiologic investigation was performed. The virus was isolated, and its infectivity and pathogenicity were investigated in animal models.Results WELV is a member of the orthonairovirus genus in the Nairoviridae family and is most closely related to the tickborne Hazara orthonairovirus genogroup. Acute WELV infection was identified in 17 patients from Inner Mongolia, Heilongjiang, Jilin, and Liaoning, China, by means of reverse-transcriptase-polymerase-chain-reaction assay. These patients presented with nonspecific symptoms, including fever, dizziness, headache, malaise, myalgia, arthritis, and back pain and less frequently with petechiae and localized lymphadenopathy. One patient had neurologic symptoms. Common laboratory findings were leukopenia, thrombocytopenia, and elevated d-dimer and lactate dehydrogenase levels. Serologic assessment of convalescent-stage samples obtained from 8 patients showed WELV-specific antibody titers that were 4 times as high as those in acute-phase samples. WELV RNA was detected in five tick species and in sheep, horses, pigs, and Transbaikal zokors (Myospalax psilurus) sampled in northeastern China. The virus that was isolated from the index patient and ticks showed cytopathic effects in human umbilical-vein endothelial cells. Intraperitoneal injection of the virus resulted in lethal infections in BALB/c, C57BL/6, and Kunming mice. The Haemaphysalis concinna tick is a possible vector that can transovarially transmit WELV.Conclusions A newly discovered orthonairovirus was identified and shown to be associated with human febrile illnesses in northeastern China. (Funded by the National Natural Science Foundation of China and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences.) In June 2019, a man presented with fever and severe illness in Inner Mongolia. An orthonairovirus was identified as a potential cause. This agent was identified in an additional 16 patients and was found in ticks.

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