China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

[sharon sanders]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

Culprit tick or worm on the new virus chaos
http://www.sina.com.cn 2010 年 09 月 14 日 10:36 City Evening News

"Henan tick insect bites event" as the culprit or to lock the virus a new type of Bunia, while the Ministry of Health is organizing experts to develop a "new type of human infection with HIV treatment program in Bunia," from the clinical diagnosis and treatment methods, the discovery of cases of infection, effective definition and treatment.

12, the experts said, the present, the virus is mainly transmitted by the ticks, can be treated, and the mortality is very low, the public not to panic.

Viruses isolated from patients

This reporter has learned, the Chinese Center for Disease Control authorities have been isolated from patients of a "new type of Bunia virus."

Some experts said, "Bunia virus" is a category, and "new Bunia virus" may be identified as a new virus, according to public information, Bunia virus natural infection found in many vertebrates and arthropods animals (mosquitoes, ticks, sandflies, etc.), may cause illness similar to influenza or dengue hemorrhagic fever (Li Swift ─ Valley fever and Crimean-Congo hemorrhagic fever, etc.) and encephalitis (California encephalitis).

The virus is not spread from person

The Ministry of Health is organizing experts to compile a "treatment program", has been temporarily using a "new type of human infection with the virus in Bunia," the claim, but whether it is the last name of the virus, the reporter has not been clearly established.

Experts stressed that the virus still need to follow the "fever with thrombocytopenia syndrome" monitor, and the virus spread by ticks, is currently no human cases of human infection.

Infections 3 to November

Members of the Group, Peking University First Hospital, Professor Xu Xiaoyuan stressed that this tick-borne disease with regional characteristics, and infections in 3-11 months, in the treatment, as long as symptomatic treatment, if there is a bacterial infection, using the appropriate antibiotics, can achieve good results, so no need to so panic the public.

Similar transmission rate and the Mosquito

In the mall, said the Ministry of Health expert group, in the future related to tick-borne epidemic of medical staff to accept free form in the pre knowledge of disease prevention and control training.

China CDC director Wang Shiwen of the virus, said the county mall appears essentially suspected cases of non-physical disease can be sure to tick-borne diseases, but people do not panic too much on the ticks insects. Ticks and mosquitoes, transmission rates of pathogens similar characteristics according to its dissemination and transmission, this disease is preventable and controllable.

● News>>>

Bunia virus is a large virus family, which has several sub-genera. There have been reports that the virus was first found in Uganda. The virus is not terrible, most patients mild symptoms, only a few older, their patients with low immunity will be converted into intensive. (Comprehensive "Beijing News", "Express", etc.)

http://news.sina.com.cn/o/2010-09-14/103618110160s.shtml

[sharon sanders]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

Zhong Nanshan says ticks can carry disease but he is not sure this is the case now.

Zhong Nanshan: ticks carrying insects unknown microorganisms can cause heavy bleeding organs
Source: Sohu blog (system default) by: Ye Yi
At six past four p.m. on September 15, 2010


Academician Zhong Nanshan said that so far unclear whether the ticks carried by insects which matter, some people say there is no body the virus, but not sure. In his view, only a tick insect media. Tick-worm itself is not terrible, terrible is that it carries an unknown microorganism. Coccidiosis makes people tick won thrombocytopenia, can not stop the bleeding, leading to massive bleeding and even death in various organs.

Coccidiosis is caused by ticks and attention to people's attention, mainly because of the widespread re-look health and health, this is social progress, is a good thing. Coccidiosis in the past does not mean that there is no spleen, but no one to count how many deaths.

Prevention of Tick-worm, the public how to do? Zhongyuan Shi suggested that the public activities in the field should be less in the grass, trees and other places a long time sitting and lying, For access to these areas, the proposed well protection, the best clothes to wear long trousers and shoes and socks; peacetime to develop good hygiene, washing hands, bathing, and more sun quilt. If you do not accidentally tick insect bites, shall, approaching the nearest hospital.

"Overall, relatively few in the South tick echinococcosis, is distributed to individual states." Zhongyuan Shi reminded the public to do a good job protection, but without excessive tension.

http://health.sohu.com/20100915/n274956751.shtml

[sharon sanders]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

There is a debate on the origin of these symptoms. Evidently tetracycline has been an effective treatment in the past which suggests some bacterial component to the infection or post infection.

Tick-borne viruses or new viruses currently no cure for Bunia
At 6:23 p.m. on the September 15, 2010 Economic Observer Online 【】 【Print】 Total Comments 0

Economic Observer Online special correspondent Tian Peng, insect bites, ticks Henan incidents "human granulocytic anaplasmosis" (Human granulocytic anaplasmosis, HGA) for the first time unknown to the general public, then immediately introduced a new term - "New Bunia human infection virus (new Bunia virus) ". Recently, Henan CDC officials said the media, isolated from the patient out of Bunia virus, then this statement has been attending the event tick worm experts confirmed the investigation. But the "new Bunia virus" is that "fever with thrombocytopenia syndrome," there are still many doubts pathogen. Some experts said that at present no cure for the treatment of this new virus.

May 2007, Xinyang City in Henan Province reported the first case of tick fever after insect bites with thrombocytopenia as the main manifestation of clinical cases. The next few years, many areas of Henan Province have discovered and reported this case. At first concerned the name of the suspected cases of anaplasmosis, in May 2010, China CDC tentatively named it "fever with thrombocytopenia syndrome."

CDC Deputy Director of Henan Province Henan Province in previous interviews to the media, also revealed that, in fact, in May this year, CDC in Henan Province of China have been found in parts of Bunia virus infection, the media may be ticks.

According to Health Department of Henan Province, Sept. 9 public information, "in recent years through the national, provincial disease control agency's efforts focused on the same cause may be found and confirmed that the clinical symptoms of fever with thrombocytopenia, a Bunia virus. To expand the monitoring of view, to discover suspicious cases, in May 2010 the Ministry of Health Organization and the Chinese Centre for Disease Control and Prevention and other relevant experts in the preparation of clinical issued a "fever with thrombocytopenia syndrome monitoring program (Trial)". "

This shows that the "new Bunia virus" back in May had discovered the relevant information but only until recently widely circulated by the media.

Virus or bacteria?

At present, the "new Bunia virus" is a "fever with thrombocytopenia syndrome," there are still many doubts pathogen. Bian Hui Lee said: "We began monitoring in 2007 and began to take into account non-physical, now isolated from the serum of patients with non-small body, not sensitive to the high positive rate of the virus. But in treatment, the disease and very sensitive to tetracycline class of drugs, so many doubts now. "

According to the Ministry of Health in February 2008 release of "human granulocytic anaplasmosis prevention and control of technical guidelines (for Trial Implementation)" (the "Technical Guide") provides that no body for the infection, primarily using the tetracycline class of antibiotics, such as strong mildew Su, tetracycline.

And Huazhong University of Science and Technology, Union Hospital, Tongji Medical College, Department of Infectious Diseases Associate Professor Jie Shenghua, insisted that the tick is the culprit worm incident "no body." He had admitted to hospitals where more than 60 such patients. He gives the basis for two to prove their point of view, first, the patient's white blood cells drop very low, which is the symptoms of viral haemorrhagic fever contrary; Second, tetracycline and doxycycline effective on the patients, but also that causes no body.

Ministry of Health expert group to go to Henan, Beijing University First Hospital, director of infectious diseases, WANG Gui-qiang claimed, may be initially determined, after Henan's "tick insect bites to death," patients did not die at least part of the human granulocyte anaplasmosis, but invisible body disease infection can not be completely ruled out at present.

Dean Xu, Peking University Health Science yuan told reporters infectious diseases, "the Chinese Center for Disease Control to track the disease virus has been two or three years. This time the 'new type of Bunia, the virus' from people (blood samples), and insects in both separation out and the result was OK. Bunia virus is a great class, and now found a pathogenic strain of the virus, not a good name, called 'the new Bunia virus'. "

2008 release of "Technical Guide" mentioned: "The disease is similar to clinical symptoms and certain viral diseases, prone to misdiagnosis, severe cases can lead to death." And "a small number of patients, because of severe thrombocytopenia and coagulopathy , there skin, lung, gastrointestinal hemorrhage, etc., if not where can because of respiratory failure, acute renal failure and multiple organ failure such as disseminated intravascular coagulation death. "

According to the literature, ticks can carry a variety of insect pathogens, including parasites, bacteria and viruses, it can transmit multiple pathogens. If the cause of the disease is a virus and not a human granulocytic anaplasmosis pathogen - the prokaryotic no body, the treatment techniques is now very different.

"In the future (diagnosed as" new Bunia virus "infection) must be ruled out without body infection. Both are the same symptoms, but not the same pathogen. If confirmed, then, is the most important pathogen detection." Xu Yuan said. "Tested negative for other pathogens, the (" new Bunia virus ") positive, the group was mostly positive, have the same syndrome, both in this place, and then isolated from ticks in the virus, only can be confirmed. "Xu Yuan is being developed by the new" treatment guidelines "an important one of the participants.

No specific drugs can only "symptomatic treatment"

For the "new Bunia virus" infection, as no cure, only a "symptomatic treatment" strategy, the clinical use of broad-spectrum potent mainly based antiviral drugs. According to "Legal Evening News" reports, Peking University First Hospital, deputy director of infectious diseases subjects recalled Professor Yu Yanyan, their families in the infectious diseases have been admitted patients who came from Hebei, Bunia, after diagnosed as infected with the virus from the field go to the department, the patient condition has increased, although to a potent broad-spectrum antiviral drugs, but ultimately could not cure patients.

According to Wikipedia the definition of so-called "symptomatic treatment", (symptomatic treatment) aims to improve the symptoms of drug use as symptomatic treatment, or symptoms. Symptomatic treatment does not eliminate the cause, but in the diagnosis of unknown etiology is unknown or temporarily unable to cure the disease is essential. For some heavy critical disorder, symptomatic treatment may be more urgent than for treatment.

Bunia Virus Unit (Family: Bunyaviridae) is a major category, Bunia Virus Unit of natural infection found in many vertebrates and arthropods (mosquitoes, ticks, sandflies, etc.), human influenza or dengue fever can cause similar and hemorrhagic fever and encephalitis.

Has confirmed that the worm can spread by ticks and pathogenic virus of the Division of Crimean - Congo haemorrhagic fever (Crimean-Congo hemorrhagic fever, CCHF) virus, the virus is within the Law Division of Bunia virus virus genus (Genus : Nairovirus), and the existence of China's Xinjiang region of Xinjiang hemorrhagic fever virus, the same pathogen.

According to "New Century Weekly" reports that were identified in 2006 in Anhui Province man granulocytic anaplasmosis is also the first case of suspected symptoms of epidemic hemorrhagic fever, "pipe connected with the outside world are sprayed bleeding." The case has not collected the sample, then under the close contact with patients and four medical staff of five family members found in the blood phagocytophilum DNA diagnosis of non-corporeal man granulocytic anaplasmosis.

This "mass fever of unknown origin" was considered to be China's first cases of human granulocytic anaplasmosis, is the world's first human-to-human transmission (such pathogen is grown in the neutrophil, in addition to blood and insect bites, ticks difficult to have other forms of communication.) cases.

Zhang Lijuan involved in this work, told reporters: "It was excluded hemorrhagic fever." Virus disease by the Chinese CDC, the new director of Reid also said that although the beginning of Anhui cases diagnosed as hemorrhagic fever, "but later ruled out, not the bleeding Hot. "

New Li said: "In our country the spread of ticks have been found only in Xinjiang hemorrhagic fever virus Bunia, 'New Bunia virus' and Xinjiang hemorrhagic fever does not matter, belong to the same family, but not necessarily belong to the same virus genus within the Law . and have nothing to do with hemorrhagic fever. "What about a new virus, where the new, he said also" inconvenient said. "infected patients for antibiotic effective against confusion," bad interpretation. "

Xu Jianguo, director of Chinese Center for Disease Control of infectious diseases introduced by the involvement of infectious diseases from ticks and patient samples of insect pathogens isolated work. In their testing found no patients infected with non-physical, "certainly is a virus, there is no body no longer has."

http://news.ifeng.com/mainland/special/henanpichong/content-2/detail_2010_09/15/2523968_0.shtml

[alert]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

There is a debate on the origin of these symptoms. Evidently tetracycline has been an effective treatment in the past which suggests some bacterial component to the infection or post infection.

It is conceivable, even likely, that this is a compound outbreak. Some of these patients likely do have HGA, others likely have the novel Bunyavirus. Some may even have both agents, as one tick bite can transmit more than one disease. That is likely the reason it took 2-3 to discover the new virus, and also the reason why it is impossible to estimate the severity of the new virus.

In the above article, Xinjang hemorrhagic fever is also mentioned, which I believe I read is the Chinese name for CCHF. It is not clear how similar the new virus is to CCHF, and the above posts seems to indicate they may not be that similar at all.

Also, that article contains confirmation that in the 2006 cluster, the fatal index case had no samples taken, but the blood of several of the nine contacts who became ill tested positve for the DNA of the HGA bacterium, so the presence of the novel virus (or any other agents) does little to explain that incident. This situation is far more complicated that it first seemed.

[alert]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

This article is over a week old, but the red text is new. The age of the patients may also be an important clue, as most tick-borne agents would affect all age groups equally, perhaps even affecting children at higher rates.

http://english.cntv.cn/program/china24/20100910/100792.shtml

Cause of Henan tick-bite related outbreak still elusive
09-10-2010 08:30 BJT

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Health officials in Central China's Henan province are still looking for causes of a tick-bite related outbreak. Officials say it is possible for them to contain the situation. So far, 18 people have died after being bitten by ticks.

The Henan Center for Disease Control began receiving reports of tick-borne diseases as early as May 2007. Most of the patients are middle aged and elderly.

Xu Dianli, deputy director of Henan Center for Disease Control, said, "The acute symptoms are fever, poor appetite, reduced blood platelet and white cell counts."

As of September 8th, the Henan CDC recorded 557 cases of such infections.

Xu Dianli said, "More than half of the patients couldn't recall any tick bites."

The CDC and its American and Australian counterparts have also been working together to find the cause, but progress has been slow.

Xu Dianli said, "We are still looking for the pathogen. That's why we are not sure about whether it's a single disease or multiple infections."

However, Xu says there is a way to cure patients.

Xu Dianli said, "Antibiotics have proven quite effective. We've included that in the therapy. Results are positive."

Xu says ticks are known to carry various diseases, transmitting them from animal to animal. But humans are also susceptible to some viruses and germs. Xu adds that early diagnoses will increase patient's odds of full recovery.

[alert]

Re: China - Henan/Shangdong Province: Ticks kill 31 - 33, possibly a new Bunyavirus

http://news.qq.com/a/20100911/000081.htm

CDC experts said China has not been established tick-borne disease pathogens
2010年09月11日02:34 新京报 我要评论( 0 ) At 2:34 on the September 11, 2010 The Beijing News I want to comment (0) 字号： T | T Font Size: T | T


"Tick-borne disease pathogens yet to be determined"

CDC experts said China does not rule out no body infection, is also possible that virus infection

AP latest Henan insect bites occur because people tick morbidity and even deaths caused by the situation. The Chinese CDC, Li, director of the new virus disease to answer a reporter's question yesterday pointed out that this occurred in Henan specific disease pathogens of tick-borne disease has not yet finalized.

Some patients found that the virus detection objects

It is understood that ticks can carry 83 known viruses, 14 bacteria, 17 types of relapsing fever spirochetes, protozoa and other 32 species. Li said a new variety of pathogens can cause "fever with thrombocytopenia syndrome", including non-physical infection and virus infections. This year in May, the Ministry of Health in Henan, Hubei, when monitoring, monitoring of the "fever with thrombocytopenia syndrome" disease, but this time what the specific pathogen causing the current still further studies.

"Does not exclude the possibility that no body to infection, but it could also be infected, because the detection of objects from some patients the virus found in Bunia." Reid said a new.

2009, China CDC study found that patients with fever and thrombocytopenia among some people is not no physical evidence of infection, "This reminds us that no body in addition to other, possibly other pathogens." Li-hsin, Chinese Center for Disease Control this year in Hebei, Hunan, enhanced monitoring, the main purpose is to study the pathogenicity of the law of development.

Reduce infections by avoiding bites

"Disease control departments are actively detect the specific cause of the disease." Ministry spokesman Deng Haihua that comprehensive epidemiological characteristics of these diseases and pathogen detection of the situation and found that the disease is now mainly ticks spread mainly insects.

Deng Haihua, said tick-borne disease is a common disease, before there is only the dissemination of new pathogens. For the tick-borne diseases, China has mature preventive control measures. Avoid insect bites tick the most important measures to reduce infection.

Progress

Three experts in the Ministry of Health arrived in Mall

Tick-borne Disease Control launched the investigation, clinical diagnosis of local patients

(Reporter Sun Xuyang) yesterday, the Ministry of Health expert group to reach Henan mall immediately after the launch of the tick-borne disease control, medical assistance, etc. investigation. Group that will be available for local patients to clinical diagnosis.

It is reported by the Chinese Center for Disease Control Expert Group by the Director of virus Wang Shiwen, China CDC Emergency Response Office of Disease Prevention and Control of Ding Fan, Peking University First Hospital, WANG Gui-qiang, director of infectious diseases and other components. Yesterday afternoon, the group arrived at mall immediately after the conference room at the county government, and provincial, municipal and county levels, the work of the responsible person will be held to hear reports.

After the scene, officials and experts are divided into two groups, traveled Mall County Mall County People's Hospital and the CDC.

Ministry of Health expert group Shi-Wen Wang told reporters that the panel did not limit the number of days this trip. County Mall The place tick-borne pathogens, and has not yet been determined, needs further study. Typical of regional disease, but the State has not set aside specific areas prone disease.

More severe, be mistaken for a cold

PLA 154 hospital's infection in the ward to see, there are several patients are receiving treatment. Cui Ning, director of the Hospital Infection told reporters that the hospital this year, a total of 137 such patients who received the patient most of the county from the Mall, currently receiving treatment in hospital a total of 7. Most of these critically ill patients had been misdiagnosed as flu, conducted by the local defense of the village resulting in delayed fluid therapy condition, 78 days after onset to our hospital.

Feng Jixiangke liangshuijing from County Mall villagers Leicheng Zhen, 55, 6 days after her illness came to 154 hospitals, so far do not know what illness. She said: "It was a heavy fever, body aches, nausea and vomiting for several days, initially thought it was cold, when the hospital has a high fever, trembling."

According to experts, the first discovery in 2006 no body, is a type of bacteria after the Chinese Center for Disease Control began monitoring human anaplasmosis, research in many parts of the country in carrying out the disease prevention and control. AP

[alert]

Re: China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

A few points worth mentioning here, as there is a lot of information in this article. First, the seasonality of this illness tends to support a tick-borne illness, as exposure to ticks would be virtually non-existent in the winter. There are many reasons why many of the suspected victims might not report tick bites - even elsewhere in the world, not everyone who contracts a tick-borne illness remembers a tick bite. The fact that even half the suspected cases report tick bites strongly implicates ticks, as the fraction of the population as a whole that has recently been bitten by ticks is very low, even in rural areas. It is also possible that many unrelated cases are being mistakenly included here, as we don't have a precise etiology. Both HGA and CCHF do happen in that area, both are symptomatically consistent, and both are tickborne, too.

The "SARS or chlamydia" error mentioned near the start of this article refers to the identification of Chlamydia pneumoniae bacteria from two fatal suspected (and thus excluded, but no one knew that at the time) SARS cases in February 2003.

http://news.qq.com/a/20100919/000764.htm

Henan tick bite alarm has not been lifted insect pathogen is still not clear

At 10:47 on September 19, 2010 Outlook Newsweek Qin Yazhou

"Outlook" article: Henan "tick insect bites," alert not except

Primary Health and SARS sounding short board, warning of higher transparency compared to the epidemic, "insect bites tick disease and death" matter of that warning is far from being lifted

Text / "Outlook" Newsweek reporter Qin Yazhou

Articles writing, at the September 17, Henan "insect bites tick disease and death," the investigation is continuing. Ministry of Health and Disease Prevention and Control Centre (China CDC) has not yet issued a formal conclusion on the pathogenic culprit.

Prior to that, many media reports, China CDC isolated from some patients is a "new type of Bunia virus", a high degree of suspicion for the disease culprit.

The statement did not unanimously accepted in the industry. Have treated patients experienced experts advise, under the authority of departments to be cautious conclusions, not guilty of "SARS chlamydia of" error.

This summer, Henan, Shandong and other provinces Jin Qianren 12 due to insect bites tick disease, dozens of deaths. Tick-worm, the thousands of years hidden in the mountain grass or leaves on the back of the "Dracula", then enter a high-profile public view.

Experience to judge the health system officials, as the temperature decreased, insect bites, tick the event will be greatly reduced, and some medical institutions have been found from a clinical cure for the disease is "preventable and treatable, controllable."

The idea that China's primary public health and SARS sounding short board, warning of higher transparency compared to the epidemic, "insect bites tick disease and death" matter of that warning is far from being lifted.

Tick kills insects

Who have experience of rural life on insect bites, ticks are no strangers, but never realized it would be deadly.

Henan health department said that since the May 2007 report of Xinyang City, Henan Province, since the first suspected cases, further investigation and monitoring by the province, as of September 8, Henan Province, were detected in the cases of 557 cases of these syndromes, death 18 cases.

In fact, in recent years, Hubei, Anhui, Shandong Province, the local area, similar cases have occurred, in which individual cases of severe disease due to multiple organ damage and death.

Xinyang City, Henan Province, County Mall is a disease of the "disastrous." This year in January ~ September 8, County Mall straight to the higher authorities reported a total of 120 cases, of which 1 died. In 2009, a mall County Center for Disease Control reported 87 straight to the superior clinical symptoms similar cases, of which 2 died.

CDC main Ren Yufang County Mall, said: "Now almost certain, is not transmitted from person to person. The main cases of these diseases is characterized by: fever, WBC, thrombocytopenia."

County Mall for patients with similar symptoms is the only designated hospital shop county People's Hospital. Associate Director of the hospital a physician should be told Martin made "Outlook" Newsweek: "The patient has a fever, general malaise and other flu-like symptoms, blood tests showed significantly reduced number of platelets and white blood cells. Clinical findings, doxycycline and oxygen difloxacin and other drugs more obvious effects of such diseases. "

Ministry of Health expert group investigating four counties in the mall suspected cases of tick insect bites and found death, death with age are too large, and their potential number of underlying diseases such as diabetes, high blood pressure or kidney disease.

Some experts believe that the deaths occurred, another reason is that the misdiagnosis of primary care health facilities.

Staff reporter learned that the disease is more prone to misdiagnosis and delayed treatment. Delay in treatment, the patient may appear toxic shock, disseminated intravascular coagulation and multiple organ failure can directly affect the condition and prognosis.

Henan health department officials said, by three years of control efforts, Henan Province, has been training for all levels and types of clinical doctors and disease control staff Jinqian Ren. Through the promotion of local people on the prevention and treatment of these diseases has increased awareness rate of knowledge, some people in the labor and life, to take basic personal protective measures, cases of timely treatment rate has improved greatly.

Staff reporter learned that this year, King County, Taiwan Township mall reported a total of 10 patients with suspected cases of tick insect bites, accounting for the entire mall County reported nearly 10% of cases. Currently, 10 patients have been cured.

King Tai Xiang Lu chomchon 59-year-old farmer Yang Yunzhi, was "headache, fever, exhaustion", in Shangcheng County People's Hospital, was diagnosed with "suspected cases", on June 4 were cured and discharged. Staff reporter saw her, she was in our yard Abstract peanuts. She told reporters: "Now the body is basically the way back to the sick before, and that strength has not before it."

King Kong Taiwan townships Dr Yang Chuanhai epidemic, said: "Our main task is widely publicized, patients have fever, and immediately sent to the county people's hospital blood test. We Township 10 patients are cured, now is the busy season , basically to help with farm chores at home. "

Wang Gangxiang universalist in the mall County Kawamura, get off of correspondents walk about 3 miles to get to was diagnosed with "suspected cases" of the 74-year-old off-qin Wu. Reporter saw Wu and his wife are off-Qin Xia Wan Star chatting in the yard. Xia Wan Star told Articles: "Wu Qin off sick after the leg pain may not stand up, when the most serious condition, high fever, coma, and now disease cured."

County People's Hospital Medical Mall, according to chief Wang Wei introduced, a mall this year, the Hospital of the 40 treated patients, 23 critically ill patients are transferred in a timely manner a. The other patients, and some cured and discharged, and some get better and discharged.

Unknown etiology

Shangcheng County farmers Yexian Zhen Wang Gangxiang universalist Kawamura, April 11 this year in the tea garden tea at home, are headache, fever. Evening of the 17th was sent to the PLA 154 hospital treatment. She told correspondents: "Two years ago, and last year's tea, I have been tick insect bite off people and hard about not sick. This year, not sure whether it had not been tick insect bites, cure very ill. Us picking a lot of people were also normal mosquito bite, others are not sick, sick to my one. "

Premier Li Feng Wang Gangxiang Institutes of Health, said the township this year, suspected cases were found in 5 cases, one case was diagnosed as major hospitals in Beijing after lupus erythematosus, excluded, and the remaining 4 patients were not clear about whether it was tick insect bites too.

County Mall, 67, farmer Li Gongrong Feng Jixiangke liangshuijing as dizziness, headache first townships by cold treatment, her condition did not improve, then cured in the mall County People's Hospital. She was feeling mainly generalized weakness, headache, chills, cold, blood tests revealed neutropenia and thrombocytopenia. Can not remember whether she was tick off insect bites.

Staff reporter learned that ticks insects are common in the mall County, bites also occur, many medical personnel and patients want to know the consequences if the tick insect bites such serious, then why did not previous cases?

Yang Chuanhai said: "In the past the mountains than it is now more than insects, biting insects are insects that not only ticks one, why the last of these insects or ticks insect bites a person not sick, but in recent years began to get sick?"

Yang Chuanhai holding stack of rural doctors in rural King Kong-Taiwan-related knowledge on the disease, the test scripts. He rolled his answer sheet, shaking his head said: "Tick insect bites can cause this disease, I think it is basically impossible. Tick insect bites, many people are too, why only a small number of human cases?"

Correspondents in cases of high Shangcheng the King County rural Taiwan, Feng Jixiangke, Wang Gangxiang and right Dianxiang up to the township hospital medical staff and some patients have been cured understanding of insect bites tick disease is caused Most of them said, "do not know", "can not tell."

Mall County CDC for the mall this year, the Hospital of 40 patients admitted to the epidemiological survey showed that only 14 people can be sure you tick incidence of insect bites before being over, the other patients is uncertain.

The investigation concluded that the disease has three characteristics: 1, time of onset was significantly seasonal, cases and more concentrated in the 4 to 9 months in September so far found only one case; 2, the incidence in the Middle Hills region more hilly areas; 3, farmers accounted for 94.17% of the total incidence, age of onset of most of 50 years, incidence of workers exposed to most of the history of a field, engaged in farming, mowing, picking and other outdoor activities.

According to the CDC party secretary Zhang Shaoxing County Mall introduction, Hubei, Anhui, and border counties and cities in the county mall, have also occurred in recent years a large number of cases with similar symptoms, but the cause has not been clear. This year in May, the Chinese Center for Disease Control has mall County as a "fever with thrombocytopenia syndrome" to monitor the county.

Buddhist to the Chinese CDC director, said the virus this year in May, the Ministry of Health in Henan, Hubei, when monitoring, monitoring of the "fever with thrombocytopenia syndrome" disease, but the exact cause by which pathogens, are also being further studies.

China CDC believes that insect bites may be transmission tick "fever with thrombocytopenia syndrome" as a major means of such diseases.

In addition to warning is not

It is reported that the Chinese are known to carry ticks and insects can 83 virus, 14 species of bacteria, 17 species Relapsing fever spirochetes, of 32 kinds of protozoa, in all possible vectors of disease organisms, insects ticks ranked second only to mosquito.

Tick-worm expert, Dean of Life Sciences, Hebei Normal University, Liu Jingze that ticks are common pests in rural areas, but until recent years have reported insect bites tick disease may be attributed to: first, the original wild animals, insects tick hosts, such as rabbits, cattle, sheep, etc. decreased, ticks insects began to attack people, attack people or more; second, tick insect populations increase, need to find more hosts.

Liu Jingze said: "At present, the degree of human disturbance on the environment, the depth, scope, reach unprecedented proportions, changes in the environment, but also to attack some of the original non-human animals become terrible up."

Interviewed experts pointed out that although the living environment of insects tick bites lead to determine the spread of the epidemic may occur only locally, but enough to bring China's scientific community, and alerts of new issues.

Liu Jingze said: "The outbreak occurred on this is, at present, the type of tick bites and disease-causing pathogens have not determined the basis of our study illustrates how weak."

Shanghai Institute of Insect Sciences Research Centre of Life Sciences, HUANG Yong-ping said: "Our research in the field in the virus, although rapid progress, but complete, there are sequences of basic research is still quite inadequate. Solve these problems, need to attract attention at national level . "

In recent years, from SARS to avian flu and then to influenza H1N1, the community has gone through a number of the fear of new infectious diseases. In epidemic prevention and control of the process, the public gradually recognized: the epidemic stops transparent.

Henan Province in the "insect bites tick disease and death" incident, some media quoted one of Xinyang City Health Bureau, insider as saying, "This year in April, the mayor listened to reports on the health system, leading the conclusion that conclusion, in the transmission of pathogens and not figure out the case, the large masses of information likely to cause panic, resulting in instability. "

This means that the local government to "safeguard stability" in the name of the epidemic to the public, concealed.

In response to that question, on September 8, Henan Province Health Department, said CDC Deputy Director DIAO, from 2007 onwards, Xinyang and Nanyang disease control departments of the two places to start on the monitoring of disease-free body, and suspected cases included in the scope of direct reporting network, there is no concealed conditions.

What Henan "insect bites tick disease and death" in the end will be what conclusion, this issue will continue to monitor. □ □

[Giuseppe]

Re: China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

Rival Teams Identify a Virus Behind Deaths in Central China (Science, edited)


[Source: Science, <cite cite="http://www.sciencemag.org/cgi/content/summary/330/6000/20?sa_campaign=Email/toc/1-October-2010/10.1126/science.330.6000.20">Rival Teams Identify a Virus Behind Deaths in Central China -- Stone 330 (6000): 20 -- Science</cite>. 10/01/10, edited.]

Science 1 October 2010:Vol. 330. no. 6000, pp. 20 - 21
DOI: 10.1126/science.330.6000.20

Infectious Diseases:

Rival Teams Identify a Virus Behind Deaths in Central China

Richard Stone


Every summer for 3 years, hundreds of people in central China came down with an illness characterized by high fever and gastrointestinal distress; as many as 30% of the victims died. By early 2007, scientists had fingered the killer as human granulocytic anaplasmosis, an emerging bacterial infection from tick bites. But last December, a different team identified a new kind of bunyavirus, a family that includes infamous members such as hantavirus and Rift Valley fever virus. The finding unmasks a dangerous new emerging virus?not a bacterial outbreak?and explains why antibiotics failed to stop it. Behind the scenes, however, a fierce argument has broken out over who discovered the virus.

(...)
-
------

[alert]

Re: China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

It is clear that scientists have discovered a novel bunyavirus that is responsible for at least some of these cases. But they have also confirmed person-to-person spread of the HGA bacterium as well (at least twice - Anhui 2006 and Shandong 2008), something reported nowhere else in the world. So it seems there is more than one thing going on here.

Rival Teams Identify a Virus Behind Deaths in Central China (Science, edited)


[Source: Science, <cite cite="http://www.sciencemag.org/cgi/content/summary/330/6000/20?sa_campaign=Email/toc/1-October-2010/10.1126/science.330.6000.20">Rival Teams Identify a Virus Behind Deaths in Central China -- Stone 330 (6000): 20 -- Science</cite>. 10/01/10, edited.]

Science 1 October 2010:Vol. 330. no. 6000, pp. 20 - 21
DOI: 10.1126/science.330.6000.20

Infectious Diseases:

Rival Teams Identify a Virus Behind Deaths in Central China

Richard Stone


Every summer for 3 years, hundreds of people in central China came down with an illness characterized by high fever and gastrointestinal distress; as many as 30% of the victims died. By early 2007, scientists had fingered the killer as human granulocytic anaplasmosis, an emerging bacterial infection from tick bites. But last December, a different team identified a new kind of bunyavirus, a family that includes infamous members such as hantavirus and Rift Valley fever virus. The finding unmasks a dangerous new emerging virus?not a bacterial outbreak?and explains why antibiotics failed to stop it. Behind the scenes, however, a fierce argument has broken out over who discovered the virus.

(...)
-
------

[alert]

Re: China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

http://www.promedmail.org/pls/apex/f?p=2400:1001:662850525059732::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85122

Archive Number 20101002.3573
Published Date 02-OCT-2010
Subject PRO/AH/EDR> Anaplasmosis, human granulocytic - China (03): susp.


ANAPLASMOSIS, HUMAN GRANULOCYTIC - CHINA (03): SUSPECTED
************************************************** *******
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

******
[1]
Date: Sat 11 Sep 2010 [Received by ProMED 1 Oct 2010]
Source: Google News [edited]
<http://www.google.com/hostednews/afp/article/ALeqM5jT-fDJWWxSJK5FvgjBI47NF_E1Sg>


Health authorities in China are scrambling to allay public fears about
a tick-borne disease that has killed more than 30 people since 2007
[and sickened many more], but admitted they do not know how many have
been infected.

The illness known as human granulocytic anaplasmosis (HGA) has spread
to 12 provinces including Henan in central China and Shandong in the
east, where the deaths have been reported, the China Daily reported
Saturday [11 Sep 2010].

HGA is treatable if detected early. Symptoms include fever, headache
and muscle aches, but the infection can reduce a patient's white blood
cell and platelet count, leading to organ failure and death. The
illness has mainly affected those aged 40 to 70 [years], state media
reported.

"So far we have no details on the general epidemic situation across
the country," health ministry spokesman Deng Haihua told a press
conference on Friday [10 Sep 2010], calling on authorities in affected
provinces to report any cases. But Deng downplayed suggestions of an
official cover-up of the outbreaks, saying it was simply difficult to
raise public awareness about a little-known infectious disease.

Henan authorities only announced Wednesday [8 Sep 2010] that 557
people had been infected with HGA since May 2007, 18 of them fatally,
after a state-run newspaper reported on a fresh outbreak in the city
of Xinyang that began months ago. A total of 182 cases have been
identified in Shandong since May 2008. HGA was 1st detected in Anhui
province in 2006. The health ministry subsequently issued guidelines,
which stipulate that suspected cases be reported within 24 hours of
detection, the China Daily said.

The health ministry has sent experts to Henan province to assist in
epidemic control work by helping to educate local doctors about the
disease, the paper said. "It is still difficult to pinpoint the
pathogen of the disease since it may be caused by a new virus," Wang
Shiwen, an expert at the Chinese Centre for Disease Control and
Prevention, was quoted as saying by Xinhua news agency. [HGA is a
tick-borne disease that is caused not by a virus, but by a
rickettsia-like bacterium _Anaplasma phagocytophilum_. - Mod.ML]

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: Sat 11 Sep 2010 [Received by ProMED 1 Oct 2010]
Source: Asiaone Health [edited]
<http://health.asiaone.com/Health/News/Story/A1Story20100911-236664.html>


China's top health authorities admitted on Friday [10 Sep 2010] they
still did not have the exact number of patients suffering from the
disease from tick bites. By Friday, the infection recognized as human
granulocytic anaplasmosis (HGA), had reportedly spread to 12 provinces
including Henan and Shandong, causing at least 31 deaths.

However, the Ministry of Health (MOH) at a Friday news conference
still couldn't tell the exact number of such cases reported
nationwide, though officials stressed that the ministry is aware of
the situation and has taken actions and provided prevention advice to
the public. "So far we have no details on the general epidemic
situation across the country," said Deng Haihua, spokesman of the
ministry. Information about the exact epidemic situation in each
affected province should be available from the local surveillance and
reporting system of infectious diseases, he said.

After detecting the 1st HGA case in Anhui province in 2006, the
ministry issued a guideline on HGA prevention and control in 2008,
which stipulates that local health authorities report suspected cases
within 24 hours upon detection. However, many tended to ignore this
order, as HGA was not listed among the nearly 40 infectious diseases
required by law to be reported, experts said. Only after the Beijing
News broke a story early this week about the outbreak in Xinyang,
Henan province, did the provincial health authority on Wednesday make
the outbreaks public -- 557 reported cases including 18 deaths [in
Henan province].

Health authorities of Shandong province also announced on Friday [10
Sep 2010] that 182 HGA cases, including 13 deaths, had been detected
locally since May 2008. By Friday, they were the only 2 [provinces] to
have publicized occurrences of HGA.

Under current law on infectious disease prevention and control, local
health administrations are required to publicize local epidemics. But
the ministry is still pushing local health authorities to make timely
reports of public health concerns, particularly public health
emergencies and outbreaks, Deng said. "We still have a long way to go
in that regard," he said. But he also dismissed criticism that the HGA
outbreaks were deliberately covered up and not made public, citing the
complexity of publicizing an unknown disease.

Vivian Tan, spokeswoman for the WHO Beijing Office, told China Daily
on Friday that they had officially requested more information from the
Ministry of Health, and the WHO is willing to offer technical
assistance if requested. "So far there has been no such request. We
are standing by to help as required," she said.

Chinese experts are yet to determine the type of pathogen carried by
ticks, Li Dexin, director of the Chinese Center for Disease Control
and Prevention, said at the Friday conference. Most of the patients
suffering from tick-borne pathogens had fevers and low blood cell
counts. Some of the patients died of intestinal complications. Now,
the center has temporarily named the disease "fever-thrombocytopenia
syndrome," but many kinds of pathogens are likely to cause the
syndrome, said Li. Ticks can carry 83 kinds of viruses and 14 kinds of
bacteria, he added.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

******
[3]
Date: Fri 1 Oct 2010
Source: China.org [edited]
<http://www.china.org.cn/china/2010-09/14/content_20924743.htm>


A new bunyavirus has already been isolated as a possible pathogen of
the tick bite cases in several Chinese provinces including Henan. But
so far experts cannot yet confirm that the virus is the culprit
causing the infections, said Wang Shiwen, a researcher with the
virology institute of the Chinese Center for Disease Control and
Prevention. Despite [the fact] that the pathogen remains unclear,
"there is no need to panic as the disease can be cured with timely
detection and treatment," he said at a workshop on the epidemic in
Shangcheng county, Henan on Sunday [26 Sep 2010]. [True only if it is
anaplasmosis, which is caused by bacteria which respond to antibiotics
-- viruses don't. - Mod.JW].

Bunyaviruses are largely transmitted in nature by vertebrates and
arthropods like mosquitoes, ticks and sandflies, experts said.
Symptoms of infections in humans include hemorrhagic fever and
meningitis. Transmitted in a similar way as pathogens carried by
mosquitoes, the illness is also preventable, he added.

Chinese health authorities have been trying hard to lessen public fear
about the tick-borne disease, which as of 10 Sep 2010 has reportedly
spread to 12 provinces including Henan and Shandong, and claimed at
least 31 lives.

Experts sent by the Ministry of Health to the site in Henan outlined
preventative measures on Sunday, including that medical staff in
infected areas should receive training on the prevention and treatment
of the disease recognized as human granulocytic anaplasmosis (HGA).

The affected areas, however, have yet to be recognized, Wang said. A
preliminary study showed that women and the elderly are most at risk
of contracting the disease. "They usually work the farmland and are
thus more likely to be exposed to tick bites," Wang said.

The Ministry of Health has designated experts to develop new clinical
guidelines for the diagnosis and treatment of the tick-borne disease.
The last set of guidelines was issued in 2008. Training on diagnosis
and treatment has been organized by experts including Wang, who
arrived in Shangcheng county on Friday to teach local medics. After
the 1st such case was detected in 2007, the Henan provincial health
authority announced 557 reported cases, including 18 deaths, on
Wednesday [29 Sep 2010].

After the media inquired whether officials failed to publicize the
epidemic in a timely manner, authorities from the Henan provincial
center for disease control and prevention (CDC) said the procedure to
confirm that a fatality was caused by a certain infection is
complicated and takes time. Xu Bianli, deputy director of the Henan
CDC, said the statistical departments have a difficult time collecting
data as some victims suffering from the disease died at home, largely
off the government's radar. Investigations have already been launched
regarding neglected cases disclosed by media reports, he noted.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[Human granulocytic anaplasmosis (HGA), formerly known as human
granulocytic ehrlichiosis, is a tick-borne disease caused by a
rickettsia-like bacterium called _Anaplasma phagocytophilum_. Many
people with HGA experience headaches, fever, chills, and muscle aches
that can be confused with other common infections. The symptoms tend
to be most severe in aged and immunosuppressed people. Some
individuals who become infected with _A. phagocytophilum_ do not
become ill or experience only very mild symptoms and do not seek
medical treatment.

Anaplasmosis should be suspected in patients with the acute onset of
unexplained fever, chills, and headache, often in association with
thrombocytopenia, leukopenia, and/or increased liver enzyme levels
with a history of tick exposure within the prior 3 weeks. Wright
stains of peripheral blood smears or buffy-coat preparations
demonstrate cytoplasmic inclusions consisting of vacuolar
microcolonies of _A. phagocytophilum_ within neutrophils in 20 to 80
percent of patients with anaplasmosis.

The diagnosis of anaplasmosis can be confirmed by a 4-fold increase in
antibody titer by IFA (indirect immunofluorescent assay) in acute and
convalescent phase serum samples, PCR (polymerase chain reaction)
amplification of anaplasma DNA in a clinical specimen, immunostaining
of _A. phagocytophilum_ antigen in a tissue sample, or isolation of
_A. phagocytophilum_ from a clinical specimen in cell culture (Centers
for Disease Control and Prevention. Ehrlichiosis/Anaplasmosis 2008
Case definition. September 2008 [date cited] Available at
<http://www.cdc.gov/ncphi/disss/nndss/casedef/ehrlichiosis_2008.htm>).

However, it is clear from the 3 news releases above and those reported
in a prior ProMED post (Anaplasmosis, human granulocytic - China: (HE)
susp, RFI 20100910.3274) that there is uncertainty concerning the
diagnosis in these cases in China. We await further clarification. A
detailed discussion of HGA can be found in the moderator's comments in
the prior ProMED-mail post, Anaplasmosis, nosocomial transmission -
China: (AH) 20081120.3661.

Henan province is located in the eastern central part of China and is
the 2nd most populated province of China after Guangdong
(<http://en.wikipedia.org/wiki/Henan>). Xinyang is subtropical and
mountainous and is the southernmost administrative division in Henan
province. Henan province is adjacent to Shandong province to the
northeast and Anhui province to the east.

[alert]

Re: China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

And this ProMED post gives us most of the answers. Since this virus is a phlebovirus (genus), while CCHF is a nairovirus, this virus is only distantly related to CCHF, even though both are Bunyaviruses. At least 35 people have tested positive for this virus, and 11 complete sequences have been published, so the Bunyavirus is NOT an innocent bystander in an HGA outbreak. This explains very well the 2008 incident in Shandong - the 4-5 patients in that outbreak were likely infected with both HGA and this virus. It does not explain the 2006 incident, where there was apparent confirmed H2H transmission of HGA, so that outbreak requires additional explanation (such as contaminated samples).

The estimated CFR of this virus is about 30&#37;. And they believe it is vector borne, but the vector may or may not be a tick.

In the spirit of non-geographical naming, they are referring to this virus as SFTS virus, but the other group wants to call it Dabie Mountain virus.

http://www.promedmail.org/pls/apex/f?p=2400:1001:8819879696145670::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,85169

Archive Number 20101005.3613
Published Date 05-OCT-2010
Subject PRO/EDR> Fatal illness, novel phlebovirus-associated - China


FATAL ILLNESS, NOVEL PHLEBOVIRUS-ASSOCIATED - CHINA
************************************************** *
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

Date: 1 Oct 2010
Source: Science, Vol. 330. no. 6000, pp. 20 - 21 [abbr., edited]
DOI: 10.1126/science.330.6000.20
<http://www.sciencemag.org/cgi/content/full/330/6000/20>
(subscription required)


Rival Teams Identify a Virus Behind Deaths in Central China
-----------------------------------------------------------
When Xue-jie Yu came to China last year [2009] to probe a lethal
fever outbreak, everyone -- Yu included -- assumed he would provide
damning testimony against a known suspect. Every summer for 3 years,
hundreds of people in central China came down with an illness
characterized by high fever and gastrointestinal (GI) distress. Many
victims bled profusely, and an alarming number of the sick -- rough
estimates are as high as 30 percent in some areas -- died. By early
2007, scientists at the Chinese Center for Disease Control and
Prevention (CDC) here fingered the killer as human granulocytic
anaplasmosis (HGA), an emerging bacterial infection from tick bites.
But to Yu, an expert on tick-borne diseases at the University of
Texas Medical Branch in Galveston, things didn't add up.

"The fatality rate was too high," Yu says, and in his experience it
was "rare" for HGA patients to have GI symptoms. Working at the
Chinese CDC's National Institute of Communicable Disease Control and
Prevention (NICDC) here, Yu tested blood samples for Anaplasma
phagocytophilum, the HGA bacterium and came up empty. Last December
[2009], his team identified a new kind of bunyavirus. The finding, in
a paper submitted to The New England Journal of Medicine (NEJM),
unmasks a dangerous new emerging virus.

Behind the scenes, however, a fierce argument has broken out over who
discovered the virus. This summer, a Chinese CDC team led by
hantavirus expert Li Dexin, director of the agency's Institute of
Virology, also uncovered a bunyavirus. They have submitted a deeper
analysis of the pathogen, including complete RNA sequences of 11
strains, to The Lancet. Yu charges Li's group with trying to rob him
of the discovery.

Several key questions are disputed or unanswered. For starters,
researchers do not know how lethal the virus is. The mortality rate
may be high in China in part because clinics often prescribe the
steroid dexamethasone to bring down high fevers; steroids suppress
the immune system, which usually worsens infections. And although the
infection shows a seasonal pattern associated with tick-borne
diseases; cases begin in early spring and peak in midsummer before
tapering off by autumn. The [putative] vector is still a mystery.

One indisputable fact is that the emerging disease has claimed scores
of lives -- mostly of farmers -- in China's heartland. The 1st
documented outbreak was in 2006, in Anhui Province. At that time, a
HGA was suspected. Curiously, however, none of the patients recalled
having been bitten by ticks. And when outbreaks recurred in 2007 and
2008, the disease did not respond to antibiotics.

That summer [presumably 2009], the pathogen surfaced in Henan and
Hubei provinces. In June, Yu went to Hubei's capital, Wuhan, to
collect blood samples from patients. Yu spotted virus particles that
December in cell culture using electron microscopy. Then in February,
he says, a member of his Texas lab, Yan Liu, "cracked the code of the
viral genome." Two days after he informed scientists at the Chinese
CDC about his findings. Chinese CDC Director Wang Yu was intrigued by
Xue-jie Yu's findings and invited him to share them at a 15 April
meeting at CDC headquarters to plot strategy for studying the
disease. Among the attendees were Li and CDC virologist Liang Mifang;
they found Yu's presentation unconvincing. "He said he isolated a
bunyavirus, but he had gotten just fragments," says Liang. Yu
confirms that the virologists were dismissive.

Yu and his colleagues have named the virus Dabie Mountain virus after
the range that straddles the borders of Hubei, Anhui, and Henan
provinces where they collected samples. But Yu was not invited back
to China this summer [2010] to continue his research. "I am the 1st
scientist to discover the viral pathogen for an emerging infectious
disease who has no access to study the virus and the disease anymore," he says.

In May [2010], the Chinese CDC set up surveillance for the pathogen
in Henan and Hubei provinces. The disease flared up in 4 other
provinces as well, and Li's team collected blood and serum from all 6
affected provinces. They amplified viral RNA sequences and from more
than 500 clones linked 14 to bunyavirus. They also isolated
bunyavirus in cell culture and sequenced 11 strains. They have named
it severe febrile and thrombocytopenic syndrome (SFTS) virus and have
classified it in the _Phlebovirus_ genus of bunyaviruses. Li's group
also detected the virus in 35 patients from 3 provinces. "It's solid
work. They clearly show that a new virus is causing disease," says a
U.S. scientist who has seen the data and asked to remain anonymous.

The squabbling has put Wang, the Chinese CDC's director, in an
awkward position. There is "no doubt," he says, that Xue-jie Yu
"discovered the novel bunyavirus." While noting that Yu's results are
not as "rich" as Li's team's, Wang says, "everyone knows what a
scientific breakthrough is, and what is accumulating work." After the
NEJM paper is published, he hopes, "other papers can go smoothly. But
it may take Wang's best diplomatic skills to get any collaboration on
the emerging virus to go smoothly.

[Byline: Richard Stone]

--
Communicated by:
Kunihiko Iizuka

[It is clear from these events that a novel bunyavirus belonging to
the genus _Phlebovirus_ is prevalent during the summer months in
several central provinces of China that may be associated with an
undiagnosed lethal disease distinct from the tick-transmitted
bacterial human granulocytic anaplasmosis (HGA). The virus does not
appear to be transmitted by ticks but the vector has not been
identified, nor has the association of this virus with a 'severe
febrile and thrombocytopenic syndrome' been unequivocally
established. Once the dispute between the 2 groups (which has been
simplified in this abbreviated account) investigating this virus has
been resolved, some clarity may emerge. Interested readers are
referred to the full account in 'Science'_.

The different members of the genus _Phlebovirus_ of the family
_Bunyaviridae_ are transmitted by phlebotomine flies, culicoides
mosquitoes or ticks. The vector of the provisionally named Dabie
Mountain phlebovirus has yet to be established. - Mod.CP]