Novel bunya virus infection caused by tick bites can pass from person to person: expert

A total of 37 people in East China’s Jiangsu Province have been diagnosed with Severe Fever with Thrombocytopenia Syndrome (SFTS) this year, a disease caused by the novel bunya virus which is spread by ticks. Experts have warned that the virus can be transmitted from person to person.

Based on previous cases, the virus can be transmitted from infected animals or people to others via blood, respiratory tract and wounds, Sheng Jifang, an expert on the novel bunya virus and director of the infectious disease department with the First Affiliated Hospital of Zhejiang University School of Medicine, told the Global Times on Wednesday.

Sheng mentioned that a patient who was infected with the novel bunya virus three years ago and died later had infected 16 people that had contact with the patient’s dead body as the patient had bleeding because of severe infection. One of the infected people later died.

Therefore, medical staff and family members of patients should take necessary preventive and protective measures, Sheng said. She also suggested people should not go into the jungle or bushes. “Fortunately, ticks can’t fly. It should be safe just to avoid their territory,” Sheng said.

Ticks, from larvae to adults, feed on the blood of warm-blooded animals, according to Sheng. Novel bunya virus infections increase significantly in summer when the ticks breed actively. Therefore, the tick-borne virus could possibly cause a local epidemic.

Sheng said the novel bunya virus, which was first discovered in 2009 in Central China’s Henan and East China’s Anhui provinces has a fatality rate of 1 percent to 5 percent, and older people are more likely to get sick and die. There is no vaccine or specific medicine targeting the infection, so people need to get treatment as soon as possible once they are infected with the virus.

“The early symptoms are fatigue and fever; sometimes there will be a rash,” Sheng said.

The clinical manifestations of SFTS mainly include fever, lower quantities of platelets and white blood cells, and multi-organ dysfunction. Patients with mild cases of this disease can mostly heal themselves, but patients with severe cases often suffer from multi-organ dysfunction or even multi-organ failure.

Ticks are mainly found in mountainous regions, as well as areas where there are wild animals, Leng Peien, director of the vector control division with Shanghai’s Municipal Center for Disease Control and Prevention, told the Global Times. Some wetlands and forest parks in the city are also habitats for ticks.

So far, the novel bunya virus infections that have been discovered are mainly caused by tick bites, Leng said.

Ticks can carry many disease-causing viruses, such as Lyme disease and Tsutsugamushi disease, Sheng said. The insect is frequently seen in northeastern and southern regions of China. 

Lu’an in East China’s Anhui Province confirmed on July 11 that the tick-borne infectious disease SFTS has caused five deaths and hospitalized 23 people in Jinzhai county of the city since April. Qingdao in East China’s Shandong Province also reported four deaths, according to a media report in July.

Symptoms of Tickborne Illness

Many tickborne diseases can have similar signs and symptoms. If you have been bitten by a tick and develop the symptoms below within a few weeks, a health care provider should evaluate the following before deciding on a course of treatment:

  • Your symptoms
  • The geographic region in which you were bitten
  • Diagnostic tests, if indicated by the symptoms and the region where you were bitten

The most common symptoms of tick-related illnesses are:

  • Fever/chills: With all tickborne diseases, patients can experience fever at varying degrees and time of onset.
  • Aches and pains: Tickborne disease symptoms include headache, fatigue, and muscle aches. With Lyme disease you may also experience joint pain. The severity and time of onset of these symptoms can depend on the disease and the patient’s personal tolerance level.
  • Rash: Lyme disease, southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis, and tularemia can result in distinctive rashes:
    • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm, but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
    • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding “bulls eye” lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any arthritic or neurologic symptoms.
    • The rash seen with Rocky Mountain spotted fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of people with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots (macules) on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted (petechial) rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
    • In the most common form of tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of regional lymph glands, usually in the armpit or groin.
    • In about 30% of patients (and up to 60% of children), ehrlichiosis can cause a rash. The appearance of the rash ranges from macular to maculopapular to petechial, and may appear after the onset of fever.

Tickborne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decreases the risk of serious complications. So see your doctor immediately if you have been bitten by a tick and experience any of the symptoms described here.

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