title: Hemorrhagic fever caused by a novel tick-borne Bunyavirus in Huaiyangshan, China.
abstract: BACKGROUND
  From April to July in 2009 and 2010, unexplained severe hemorrhagic fever-like illnesses occurred in farmers from the Huaiyangshan mountains range.
  
  
  METHODS
  Clinical specimens (blood, urine, feces, and throat swabs) from suspected patients were obtained and stored. Mosquitoes and ticks in affected regions were collected. Virus was isolated from 2 patients and characterized by whole genome sequencing. Virus detection in additional patients and arthropods was done by virus-specific reverse transcription (RT) PCR. Clinical and epidemiological data of RT-PCR confirmed patients were analyzed.
  
  
  RESULTS
  An unknown virus was isolated from blood of two patients and from Haemaphysalis ticks collected from dogs. Whole genome sequence analysis identified the virus as a novel member of the family Bunyaviridae, most closely related to the viruses of the genus Phlebovirus within which it forms a separate lineage. Subsequently, infection was confirmed by RT-PCR in 33 of 58 suspected patients. The illness in these patients was characterized by fever, severe malaise, nausea, vomiting, and diarrhea. Prominent laboratory findings included low white cell- and platelet counts, coagulation disturbances, and elevation of liver enzymes. Hemorrhagic complications were observed in 3 cases, 5 (15%) patients died.
  
  
  CONCLUSIONS
  A novel tick-borne Bunyavirus causing life-threatening hemorrhagic fever in humans has emerged in the Huaiyangshan mountain areas of China. Further studies are needed to determine the epidemiology, geographic distribution and vertebrate animal ecology of this virus.
authors: State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China. yongzhenzhang@sohu.com
authors: Yong-Zhen
authors: YZ
authors: Zhang
authors: Dun-Jin
authors: DJ
authors: Zhou
authors: Yanwen
authors: Y
authors: Xiong
authors: Xiao-Ping
authors: XP
authors: Chen
authors: Yong-Wen
authors: YW
authors: He
authors: Qiangzheng
authors: Q
authors: Sun
authors: Bin
authors: B
authors: Yu
authors: Juan
authors: J
authors: Li
authors: Yong-An
authors: YA
authors: Dai
authors: Jun-Hua
authors: JH
authors: Tian
authors: Xin-Cheng
authors: XC
authors: Qin
authors: Dong
authors: D
authors: Jin
authors: Zhigang
authors: Z
authors: Cui
authors: Xue-Lian
authors: XL
authors: Luo
authors: Wei
authors: W
authors: Li
authors: Shan
authors: S
authors: Lu
authors: Wen
authors: W
authors: Wang
authors: Jin-Song
authors: JS
authors: Peng
authors: Wen-Ping
authors: WP
authors: Guo
authors: Ming-Hui
authors: MH
authors: Li
authors: Zhen-Jun
authors: ZJ
authors: Li
authors: Shaomin
authors: S
authors: Zhang
authors: Chen
authors: C
authors: Chen
authors: Yan
authors: Y
authors: Wang
authors: Menno D
authors: MD
authors: de Jong
authors: Jianguo
authors: J
authors: Xu
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D001483:Base Sequence; D002681:China / Q000453:epidemiology; D004285:Dogs; D005260:Female; D006482:Hemorrhagic Fevers, Viral / Q000453:epidemiology* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016851:Orthobunyavirus / Q000145:classification / Q000302:isolation & purification*; D012367:RNA, Viral / Q000235:genetics; D013987:Ticks / Q000821:virology*
chemical_list: D012367:RNA, Viral