Yuan Li, Tian Tingting, Li Aqian, Du Shanshan, Wang Shiwen, Li Dexin, Huang Xiaoxia, Li Jiandong
National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China.
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Beijing, People's Republic of China.
PLoS Negl Trop Dis. 2025 Jul 24;19(7):e0013283. doi: 10.1371/journal.pntd.0013283. eCollection 2025 Jul.
Severe fever with thrombocytopenia syndrome (SFTS) is an emerging viral disease transmitted mainly through the bite of Haemaphysalis longicornis, and can cause clusters through contact transmission, and its incidence shows a rising and spreading trend in China. This study aimed to analyze the occurrence process of human-to-human transmission clusters and provide evidence for effective implementation of interventions.
Data about SFTS human-to-human transmission clusters were extracted from 42 published articles. R 4.4.1 and Microsoft Excel software were used to process and analyze the epidemiological and clinical data extracted.
37 clusters occurring from 1996 to 2023 were retrieved, of which 2 (5.41%) involved third-generation transmission, 7 (18.92%) involved 16 asymptomatic infections, and 9 (24.32%) involved 17 medical personnel. There were 37 index cases with a case fatality rate of 97.30%, 135 secondary cases with a case fatality rate of 12.40%, and an overall of 31.33%. The first treatment of the index case was mainly in primary medical institutions (24, 64.86%) and the most common symptoms were fever, fatigue and gastrointestinal symptoms. The index cases were distributed from March to October each year, the peak was from April to July, and the incubation period was 5-21 days, mostly in middle-aged and elderly farmers. Clusters were mainly distributed in Jiangsu Province (9 clusters), followed by Henan, Shandong and Zhejiang Provinces (6 clusters each). The clusters occurred mostly in the progress of care (72.97%), funeral (64.86%) and treatment of patients (24.32%), involving relatives (75.76%), medical workers (12.12%), villagers (9.85%) and morticians (2.27%). Almost all clusters were spread by contact with patients' blood and bloody secretions (97.30%).
SFTS human-to-human transmission clusters sometimes occur in China, with a high case fatality rate. It is necessary to strengthen public health education, and improve the early diagnosis and treatment ability of medical workers, to avoid nosocomial infection or family (community) transmission.
发热伴血小板减少综合征（SFTS）是一种新出现的病毒性疾病，主要通过长角血蜱叮咬传播，可经接触传播引起聚集性发病，在我国其发病率呈上升和蔓延趋势。本研究旨在分析人传人聚集性发病的发生过程，为有效实施干预措施提供依据。
从42篇已发表文章中提取SFTS人传人聚集性发病的数据。使用R 4.4.1和Microsoft Excel软件对提取的流行病学和临床数据进行处理与分析。
检索到1996年至2023年发生的37起聚集性发病事件，其中2起（5.41%）涉及三代传播，7起（18.92%）涉及16例无症状感染者，9起（24.32%）涉及17名医务人员。有37例首例病例，病死率为97.30%；135例二代病例，病死率为12.40%，总体病死率为31.33%。首例病例首次就诊主要在基层医疗机构（24例，64.86%），最常见症状为发热、乏力和胃肠道症状。首例病例发病时间分布在每年3月至10月，高峰在4月至7月，潜伏期为5至21天，以中老年农民为主。聚集性发病主要分布在江苏省（9起），其次为河南、山东和浙江省（各6起）。聚集性发病大多发生在护理过程中（72.97%）、丧葬过程中（64.86%）和患者治疗过程中（24.32%），涉及亲属（75.76%）、医护人员（12.12%）、村民（9.85%）和殡仪人员（2.27%）。几乎所有聚集性发病均通过接触患者血液和血性分泌物传播（97.30%）。
我国有时会发生SFTS人传人聚集性发病事件，病死率较高。有必要加强公众健康教育，提高医务人员的早期诊断和治疗能力，避免医院感染或家庭（社区）传播。
