title: Viral shedding from diverse body fluids in a patient with severe fever with thrombocytopenia syndrome.
abstract: Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne disease characterized by high fever, thrombocytopenia, leukopenia, and multiple organ failure and is caused by a novel bunyavirus. Human-to-human transmission has been reported previously, but the mode of transmission has not been clarified thoroughly.
  
  
  
  We identified a case of a 73-year-old woman with SFTS and performed a semi-quantitative real-time reverse transcription PCR (real-time RT-PCR) assay on her blood, tracheal aspirate, gastric aspirate and urine to detect SFTS virus (SFTSV).
  
  
  
  During 7-day hospitalization, all the serum samples showed positive Ct values lower than 35 in both the S and M segments, suggesting the presence of the SFTSV RNA. After initiation of plasma exchange, serum SFTSV load markedly decreased, but still remained positive. The SFTS viral RNA was also detected in other body fluids, including tracheal aspirate and gastric aspirate.
  
  
  
  These results suggest that droplet transmission can occur through close contact with infected patients.
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Pusan National University Hospital, Busan, Republic of Korea.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Jeong
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea. Electronic address: infection@korea.ac.kr.
authors.forename: Joon Young
authors.initials: JY
authors.lastname: Song
authors.affiliation: Department of Laboratory Medicine, College of Medicine, Korea University Guro Hospital, Gurodongro, Gurogu, Seoul, Republic of Korea. Electronic address: malarim@korea.ac.kr.
authors.forename: Chae Seung
authors.initials: CS
authors.lastname: Lim
authors.affiliation: Department of Microbiology and the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ilseob
authors.initials: I
authors.lastname: Lee
authors.affiliation: Department of Microbiology and the Institute for Viral Diseases, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Man-Seong
authors.initials: MS
authors.lastname: Park
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Min Joo
authors.initials: MJ
authors.lastname: Choi
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Ho
authors.initials: JH
authors.lastname: Jeon
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Konyang University Hospital, Daejon, Republic of Korea.
authors.forename: Seong Hui
authors.initials: SH
authors.lastname: Kang
authors.affiliation: Department of Laboratory Medicine, College of Medicine, Korea University Guro Hospital, Gurodongro, Gurogu, Seoul, Republic of Korea.
authors.forename: Bo Kyeung
authors.initials: BK
authors.lastname: Jung
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin Gu
authors.initials: JG
authors.lastname: Yoon
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hak Jun
authors.initials: HJ
authors.lastname: Hyun
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Noh
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hee Jin
authors.initials: HJ
authors.lastname: Cheong
authors.affiliation: Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea; Asian Pacific Influenza Institute (APII), Korea University College of Medicine, Seoul, Republic of Korea.
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D001769:Blood / Q000821:virology; D001826:Body Fluids / Q000821:virology*; D005260:Female; D041981:Gastrointestinal Tract / Q000821:virology; D006801:Humans; D010217:Phlebotomus Fever / Q000821:virology*; D016856:Phlebovirus / Q000235:genetics / Q000302:isolation & purification*; D012367:RNA, Viral / Q000032:analysis; D013921:Thrombocytopenia / Q000821:virology*; D014132:Trachea / Q000821:virology; D014556:Urine / Q000821:virology; D017201:Virus Shedding
chemical_list: D012367:RNA, Viral
keywords: Bunyaviridae infections; Disease transmission; Phlebovirus