{Reference Type}: Case Reports
{Title}: The first identification and retrospective study of Severe Fever with Thrombocytopenia Syndrome in Japan.
{Author}: Takahashi T;Maeda K;Suzuki T;Ishido A;Shigeoka T;Tominaga T;Kamei T;Honda M;Ninomiya D;Sakai T;Senba T;Kaneyuki S;Sakaguchi S;Satoh A;Hosokawa T;Kawabe Y;Kurihara S;Izumikawa K;Kohno S;Azuma T;Suemori K;Yasukawa M;Mizutani T;Omatsu T;Katayama Y;Miyahara M;Ijuin M;Doi K;Okuda M;Umeki K;Saito T;Fukushima K;Nakajima K;Yoshikawa T;Tani H;Fukushi S;Fukuma A;Ogata M;Shimojima M;Nakajima N;Nagata N;Katano H;Fukumoto H;Sato Y;Hasegawa H;Yamagishi T;Oishi K;Kurane I;Morikawa S;Saijo M;
{Journal}: J Infect Dis
{Volume}: 209
{Issue}: 6
{Year}: Mar 2014
{Factor}: 7.759
{DOI}: 10.1093/infdis/jit603
{Abstract}: <B>BACKGROUND: </B>Severe fever with thrombocytopenia syndrome (SFTS) is caused by SFTS virus (SFTSV), a novel bunyavirus reported to be endemic in central and northeastern China. This article describes the first identified patient with SFTS and a retrospective study on SFTS in Japan.<BR><B>METHODS: </B> Virologic and pathologic examinations were performed on the patient's samples. Laboratory diagnosis of SFTS was made by isolation/genome amplification and/or the detection of anti-SFTSV immunoglobulin G antibody in sera. Physicians were alerted to the initial diagnosis and asked whether they had previously treated patients with symptoms similar to those of SFTS.<BR><B>RESULTS: </B>A female patient who died in 2012 received a diagnosis of SFTS. Ten additional patients with SFTS were then retrospectively identified. All patients were aged ≥50 years and lived in western Japan. Six cases were fatal. The ratio of males to females was 8:3. SFTSV was isolated from 8 patients. Phylogenetic analyses indicated that all of the Japanese SFTSV isolates formed a genotype independent to those from China. Most patients showed symptoms due to hemorrhage, possibly because of disseminated intravascular coagulation and/or hemophagocytosis.<BR><B>CONCLUSIONS: </B>SFTS has been endemic to Japan, and SFTSV has been circulating naturally within the country.