Objectives This study investigated a cluster of secondary human-to-human transmission of severe fever with thrombocytopenia syndrome (SFTS) in a hospital setting, focusing on infection risk factors and the role of personal protective equipment (PPE).
Methods A descriptive epidemiological investigation was conducted following the death of an index patient with laboratory-confirmed SFTS. A total of 27 close contacts, including healthcare workers and a funeral director, were monitored for symptoms. Suspected cases underwent real-time reverse transcription polymerase chain reaction testing. Clinical features, PPE use, and exposure histories were analyzed. The Fisher exact test was used to assess associations between PPE use and infection. Viral genotyping and sequence analyses were performed to evaluate transmission routes.
Results The index patient deteriorated rapidly and died after repeated cardiopulmonary resuscitation (CPR), during which 8 secondary cases occurred. Most infections were identified among individuals involved in CPR or postmortem care without adequate PPE. Although not statistically significant, infection rates were higher among those who did not wear masks or who used low-filtration masks. Proper use of gloves, gowns, and goggles was associated with lower infection rates. Cycle threshold values in secondary cases (range, 34–39) were higher than in the index case (14.07), suggesting lower viral loads. Sequence analysis demonstrated 99.6%–100% homology between the index and secondary cases; all isolates were genotype B, indicating direct transmission.
Conclusion This study provides molecular and epidemiological evidence of nosocomial SFTS transmission. Inadequate PPE use during aerosol-generating procedures likely facilitated infection, underscoring the importance of strict adherence to PPE protocols and reinforced infection control practices.
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Severe fever with thrombocytopenia syndrome complicated by invasive pulmonary aspergillosis and septic shock: a case report highlighting the role of mNGS Bolin Wang, Mingyue Zhao, Qingfeng Chen, Feihu Zhang, Mingzhi Fan, Xinbao Lian Frontiers in Medicine.2026;[Epub] CrossRef
Objectives Severe fever with thrombocytopenia syndrome (SFTS) has no vaccine or treatment and an extremely high fatality rate. We aimed to analyze and evaluate the risk factors for death associated with SFTS.
Methods Among reports from 2018 to 2022, we compared and analyzed 1,034 inpatients aged 18 years or older with laboratory-confirmed SFTS who underwent complete epidemiological investigations.
Results Most of the inpatients with SFTS were aged 50 years or older (average age, 67.6 years). The median time from symptom onset to death was 9 days, and the average case fatality rate was 18.5%. Risk factors for death included age of 70 years or older (odds ratio [OR], 4.82); agriculture-related occupation (OR, 2.01); underlying disease (OR, 7.20); delayed diagnosis (OR, 1.28 per day); decreased level of consciousness (OR, 5.53); fever/chills (OR, 20.52); prolonged activated partial thromboplastin time (OR, 4.19); and elevated levels of aspartate aminotransferase (OR, 2.91), blood urea nitrogen (OR, 2.62), and creatine (OR, 3.21).
Conclusion The risk factors for death in patients with SFTS were old age; agriculture-related occupation; underlying disease; delayed clinical suspicion; fever/chills; decreased level of consciousness; and elevated activated partial thromboplastin time, aspartate aminotransferase, blood urea nitrogen, and creatine levels.
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Clinical Predictors of Mortality in Severe Fever with Thrombocytopenia Syndrome: An Updated Systematic Review and Meta-Analysis Ke-Xin Wang, Guo-Mei Xia, Yu-Han Liu, Shuai-Ru Jiao, Yu-Feng Gao, Sheng-Qun Deng Pathogens.2026; 15(7): 767. CrossRef
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