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Monday 8 July 2019
A New Segmented Virus Associated with Human Febrile Illness in China - A review

The article we suggest to read this week is "A New Segmented Virus Associated with Human Febrile Illness in China", published on The New England Journal of Medicine last May.


Routine surveillance for tickborne diseases in China led to the identification of a patient from the town of Alongshan who had a febrile illness with an unknown cause. Analyses revealed a previously unknown segmented RNA virus, which we designated Alongshan virus (ALSV), that belongs to the unclassified jingmenvirus group in the family Flaviviridae, which includes the genera flavivirus, pestivirus, hepacivirus, and pegivirus. ALSV was also detected in additional patients with fever and headache as well as in ticks and mosquitoes in the region. The authors describe the discovery, isolation, and characterization of the virus.

ALSV is able to infect multiple human cell lines, induce pathologic changes in mice, and cause inflammatory responses in patients. Although ALSV is genetically different from Jingmen tick virus (JMTV), it is more closely related to JMTV than it is to other jingmenviruses. JMTV was first isolated from Rhipicephalus microplus in China, and it has a wide range of hosts, including cattle, dogs, and goats, and a wide geographic distribution in China. JMTV variants have also been identified in other countries.

ALSV infection should be differentiated from thrombocytopenia syndrome virus (SFTSV), tickborne encephalitis virus (TBEV), human anaplasmosis, rickettsiosis, and leptospirosis.

The authors suspect that ALSV is transmitted by the tick I. persulcatus, whose common hosts include most mammals (e.g., sheep, cattle, horses, dogs, rabbits, humans) and occasionally some birds. I. persulcatus is widely distributed in Asia and eastern Europe. However, mosquitoes cannot be excluded as a possible vector, as ALSV RNA was detected in mosquitoes in the province of Jilin in northeastern China, and the RNA from these mosquitoes was found to be genetically related to that from the patients and ticks assessed by the authors.

The authors conclude highlighting that ALSV may be the cause of a previously unknown febrile disease, and that more studies should be conducted to determine the geographic distribution of this disease outside its current areas of identification.

AUTHORS: Ze-Dong Wang, Bo Wang, Feng Wei, Shu-Zheng Han, Li Zhang, Zheng-Tao Yang, and others.

Full article is available on the The New England Journal of Medicine webiste.