A New Orthonairovirus Associated with Human Febrile Illness

作者：Xiao‐Ai Zhang, Yidan Ma, Yun-Fa Zhang, Zhenyu Hu, Jingtao Zhang, Shuo Han, Gang Wang, Shuang Li, X. L. Wang, Fang Tang, Wen-Jun Liang, Yuan Hong-xia, Jiaqi Zhao, Lan-Fen Jiang, Lei Zhang, Guang‐Qian Si, Cong Peng, Rui Wang, Hong‐Han Ge, Nan Li, Bao-Gui Jiang, Chang Li, Hao Li, Wei Liu · 发表于：New England Journal of Medicine · 年份：2024 · DOI：10.1056/nejmoa2313722 · 被引用次数：55 · 研究领域：Viral Infections and Vectors、Viral Infections and Outbreaks Research、Zoonotic diseases and public health

Background In June 2019, a patient presented with persistent fever and multiple organ dysfunction after a tick bite at a wetland park in Inner Mongolia. Next-generation sequencing in this patient revealed an infection with a previously unknown orthonairovirus, which we designated Wetland virus (WELV). Methods We conducted active hospital-based surveillance to determine the prevalence of WELV infection among febrile patients with a history of tick bites. Epidemiologic investigation was performed. The virus was isolated, and its infectivity and pathogenicity were investigated in animal models. Results WELV is a member of the orthonairovirus genus in the Nairoviridae family and is most closely related to the tickborne Hazara orthonairovirus genogroup. Acute WELV infection was identified in 17 patients from Inner Mongolia, Heilongjiang, Jilin, and Liaoning, China, by means of reverse-transcriptase–polymerase-chain-reaction assay. These patients presented with nonspecific symptoms, including fever, dizziness, headache, malaise, myalgia, arthritis, and back pain and less frequently with petechiae and localized lymphadenopathy. One patient had neurologic symptoms. Common laboratory findings were leukopenia, thrombocytopenia, and elevated d -dimer and lactate dehydrogenase levels. Serologic assessment of convalescent-stage samples obtained from 8 patients showed WELV-specific antibody titers that were 4 times as high as those in acute-phase samples. WELV RNA was detected in five tick...