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**Shiloh** · September 8, 2010, 04:37 PM

Re: Ticks Spread Fear and Death in Henan Province

Source: http://www.shanghaidaily.com/article...&type=National

RSS | Mobile Newspaper | Newsletter

National
Ticks kill 21 in hushed-up outbreak
By Meng Tiexia | 2010-9-9 | NEWSPAPER EDITION

HEALTH authorities in central China's Henan Province said last night that 18 people had died of infection from a series of tick bites that have been kept secret.

Another three fatalities were reported in Penglai City, east China's Shandong Province.

The 18 victims were among 557 reported cases of suspected human granulocytic anaplasmosis since the first case was reported in Xinyang City of Henan in May 2007, Xinhua news agency reported.

Most of the cases were found in Xinyang's Shangcheng and Guangshan counties and Shihe and Pingqiao districts, the provincial Public Health Department said.

The disease is often reported from May to August. And most people infected are between ages 40 to 70, according to officials...

Read more: http://www.shanghaidaily.com/article...#ixzz0yyp3QmMk

**Ronan Kelly** · September 8, 2010, 08:24 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

Henan villagers hit by tick-borne disease 0 CommentsPrint E-mail China Daily, September 9, 2010 Adjust font size: Fear has broken out in Shangcheng county, Henan province, after the outbreak of an unspecified tick-borne illness that has infected 119 people since January.

According to Yu Fang, director of Shangcheng county's center for disease control and prevention, one infected patient surnamed Wu died of the illness in the county.

A report by Xinhua News Agency said two people have died since May 2007 after contracting the infection from tick bites in Xinyang city, of which Shangcheng county is a part, citing provincial health authorities on Wednesday.

The two were among 245 reported cases in the city since May 2007 of suspected human granulocytic anaplasmosis, a bacterial disease with symptoms similar to the flu.

Most of the cases were found in Xinyang's Shangcheng and Guangshan counties and Shihe and Pingqiao districts, said Xu Bianli, deputy head of the Henan provincial center for disease control and prevention.

However, the Beijing News reported on Wednesday that over the past year and a half, "several people in Henan province's Shangcheng county have died due to tick bites, and locals were kept uninformed about the epidemic".

A spokesman for the Ministry of Health told China Daily that the ministry was aware of the disease, but declined to elaborate on the issue.

The Beijing News report said the villagers who suffered from the tick-borne illness show symptoms of fever, and a reduction in the number of platelets and white blood cells, which can lead to organ failure and death.

People in close contact with patients can also be infected if no precautions are taken.

Doctors said the disease is curable if treated soon enough.

But doctors at local medical clinics lacked knowledge of the disease as it was only identified in 2007, Xu Bianli was quoted by Xinhua as saying.

The Beijing News report said that although several people died from tick-borne disease last year in Shangcheng, many local doctors still did not recognize the disease. Instead they diagnosed it as a common cold or meningitis.

"Once a patient has been misdiagnosed, it is difficult for them to recover," said Wang Deqiang, vice-president of Shangcheng County People's Hospital.

The Shangcheng county government said in a news release on Wednesday that the national disease control and prevention center has been monitoring the disease to further investigate the illness.

"The number of cases infected with the tick-borne disease has started to decrease," it said.

Ticks have existed in the area for years. They are parasitic arachnids attaching themselves to human skin, sucking blood and transmitting diseases. They can grow from the size of sesame seeds to as big as soybeans after being sated with blood, according to local witnesses.

Henan villagers hit by tick-borne disease - China.org.cn

http://www.china.org.cn/china/2010-09/09/content_20893225.htm

tick,bite,disease,Henan

**Treyfish** · September 10, 2010, 12:37 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

<TABLE border=0 cellSpacing=0 cellPadding=0 width=484 jQuery1284139839212="19"><TBODY jQuery1284139839212="18"><TR><TD class="size18 black" height=26 vAlign=top colSpan=2 align=left>Insect bites kill 13 in China


</TD></TR><TR><TD height=8 colSpan=2></TD></TR><TR><TD style="LINE-HEIGHT: 18px; FONT-FAMILY: Verdana, Arial, Helvetica, sans-serif; COLOR: #616161; FONT-SIZE: 12px; FONT-WEIGHT: normal; TEXT-DECORATION: none" colSpan=2>2010-09-10 21:00:00 </TD></TR><TR><TD colSpan=2></TD></TR><TR><TD vAlign=top colSpan=2 align=left><TABLE style="BORDER-BOTTOM-COLOR: red; BORDER-TOP-COLOR: red; BORDER-RIGHT-COLOR: red; BORDER-LEFT-COLOR: red" border=0 cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD class=ash12normalV vAlign=top align=left><TABLE border=0 cellSpacing=0 cellPadding=0 width="100%" align=left><TBODY><TR><TD>At least 13 people have died and over 180 people have fallen ill after being bitten by blood-sucking insects in China, officials said Friday.
A total of 182 people in Shandong province have been bitten by ticks, the Shanghai Daily reported citing provincial health authorities..

Several deaths from tick bites have also been reported in Henan province.

Henan province's Centre for Disease Control (CDC) said earlier this week that 18 people in the province had died of the disease. The victims were among 557 reported cases of suspected infection from tick bites...

'It is still difficult to pinpoint the pathogen of the disease since it may be caused by a new virus,' said Wang Shiwen of the Chinese Centre for Disease Control and Prevention..

Cui Ning, a doctor at the infectious diseases ward of the hospital of the People's Liberation Army, said: 'The disease was, in many cases, wrongly diagnosed as cold, so many patients were not treated properly at first.'

http://sify.com/news/insect-bites-ki...kvadcjjeb.html

</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>

**Shiloh** · September 10, 2010, 02:32 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

Source: http://www.shanghaidaily.com/article...&type=National

Tick deaths still mystify experts
By Li Xinran | 2010-9-11 | NEWSPAPER EDITION

EXPERTS have yet to determine the type of pathogen carried by ticks that have killed at least 31 people in two Chinese provinces, health officials said yesterday.

The number includes 13 people in east China's Shandong Province, up from three dead reported on Wednesday.

Another 18 people died in the central Henan Province, the provincial Center for Disease Control said this week.

China's Center for Disease Control and Prevention temporarily has named the disease "fever-thrombocytopenia syndrome," but said much about it is unknown, including the exact pathogen that is making people sick, Li Dexin, a CDC virus chief, told a press conference...

Read more: http://www.shanghaidaily.com/article...#ixzz0zA0UzTCZ

**alert** · September 10, 2010, 03:56 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

Originally posted by Shiloh View Post

Source: http://www.shanghaidaily.com/article...&type=National

Tick deaths still mystify experts
By Li Xinran | 2010-9-11 | NEWSPAPER EDITION

EXPERTS have yet to determine the type of pathogen carried by ticks that have killed at least 31 people in two Chinese provinces, health officials said yesterday.

The number includes 13 people in east China's Shandong Province, up from three dead reported on Wednesday.

Another 18 people died in the central Henan Province, the provincial Center for Disease Control said this week.

China's Center for Disease Control and Prevention temporarily has named the disease "fever-thrombocytopenia syndrome," but said much about it is unknown, including the exact pathogen that is making people sick, Li Dexin, a CDC virus chief, told a press conference...

Read more: http://www.shanghaidaily.com/article...#ixzz0zA0UzTCZ

Despite the wording above, the article continues below, suggesting that most of the illnesses are indeed due to HGA:

Ticks can carry 83 viruses, 14 kinds of bacteria, 17 types of borrelia recurrentis and 32 protozoa, Li added.

The 13 victims in Shandong are among 82 reported cases of human granulocytic anaplasmosis in the province since May 2008, when the provincial CDC started monitoring the disease. Many of the patients were bitten by hard ticks, according to a statement from Shandong's health department.

Twenty-six of the HGA cases, including six deaths, were reported in coastal Penglai City.

Shandong is educating the public about the disease and training doctors in its treatment, it said.

The 18 deaths in Henan were among 557 reported cases of suspected HGA in the central province since May 2007. Most of the cases were found in Xinyang's Shangcheng and Guangshan counties and Shihe and Pingqiao districts.

Three experts have been sent by the Ministry of Health to look into the outbreak in Shangcheng County.

HGA reduces white blood cell and platelet counts in the blood, possibly leading to organ failure and death. The disease can cause people to feel nauseous and have a fever.

It is curable if treated quickly.

"The disease was, in many cases, misdiagnosed as cold, so many patients were not treated properly at first," said Cui Ning, a doctor who spoke to Xinhua news agency.

Read more: http://www.shanghaidaily.com/article...#ixzz0zA7qE7bv

**alert** · September 10, 2010, 03:59 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

http://china.globaltimes.cn/society/2010-09/572134.html

China >> China Society Experts with Ministry of Health, CDC investigate HGA in Henan Source: Global Times [18:55 September 10 2010] Comments By Zheng Yi
Chinese authorities have sent experts to investigate the situation in the central province of Henan following deaths related to tick bites. They said there is no need for members of the public to panic or to be too concerned, as the disease can be prevented and controlled.
Experts with the Ministry of Health arrived in Xinyang city on Friday to investigate what are suspected to be cases of the disease Human granulocytic anaplasmosis (HGA), caused by ticks.
The Chinese Center for Disease Control and Prevention (CDC) has also dispatched experts to locate host animals where the ticks can be found before they bite human beings, Beijing News reported on Friday.
Wang Guiqiang, the director of the Department of Infectious Diseases at Peking University First Hospital, was quoted as saying that they would set up a warning system to prevent more people from dying of the disease, and he also said that overuse of steroids could worsen the condition of those who have been infected.
Wang added that the ticks first bite host animals and then bite human beings, which means that bacteria is transmitted from animals to human beings through the ticks, and that identifying infected hosts would be useful in controlling the spread of what is suspected to the HGA.
The disease first emerged in Southeast China's Anhui Province in 2006 but was only reported by the media in September 8 this year when several residents died after being bitten by ticks in Xinyang's Shangcheng county, causing much fear among the population in Henan Province.
In addition to Henan, there have been suspected cases of HGA ? leading to at least 33 deaths ? in other Chinese provinces, including Hubei, Shandong, Heilongjiang, Hainan, Sichuan, Yunnan, Jiangsu, as well as the Inner Mongolia Autonomous Region, Xinjiang Uyghur Autonomous Region and Tianjin Municipality.Most of the affected areas are either mountainous or rich in water resources, the People?s Daily website reported on Friday.
Cao Wuchun, a researcher at the CDC of the Chinese People's Liberation Army, told the Global Times that people bitten by ticks should normally be able to recover after using tetracycline or antibiotics for a week.
"The ticks do not contain a virus themselves but they are rather a medium for transmission, and most patients recover if they are just treated with medication on time," he said.
Cao added that doctors in mountainous areas should pay special attention to patients' symptoms to avoid mistakenly identifying a case of HGA as the common cold, as the two diseases have similar symptoms.
The Beijing CDC has reminded travelers in mountainous regions or forests to roll down their sleeves to prevent the ticks from biting them.
According to Wang Xilong, an expert with the parasitology department of Anhui Medical University, people should not try to pull the ticks out using tweezers because parts of the ticks would remain in the body. He suggested that people could tie a cloth near the bite to stop the blood from flowing to the tick - and this would make it fall off.

**alert** · September 10, 2010, 04:00 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

rthk.hk 香港電台網站

http://www.rthk.org.hk/rthk/news/englishnews/20100910/news_20100910_56_697575.htm

Probe into reported tick bite deaths

10-09-2010

Health authorities on the mainland are investigating what exactly caused the deaths of 18 people in Henan, after they were reportedly bitten by ticks. A spokesman for the Health Ministry said tick-borne diseases were not uncommon in China, but this time the bugs appeared to be carrying a new and unknown disease. He said the authorities would strengthen control and prevention of the problem.

**alert** · September 10, 2010, 04:03 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

http://www.promedmail.org/pls/apex/f?p=2400:1001:2718316816299350::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,84746

Archive Number 20100910.3274
Published Date 10-SEP-2010
Subject PRO/EDR> Anaplasmosis, human granulocytic - China: (HE) susp, RFI

ANAPLASMOSIS, HUMAN GRANULOCYTIC - CHINA: (HENAN) SUSPECTED, REQUEST FOR
INFORMATION
************************************************** *************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>

[1]
Date: Thu 9 Sep 2010
Source: Shanghai Daily [edited]
<http://www.shanghaidaily.com/article/?id=448793&type=National>

Health authorities in central China's Henan Province said last night [8 Sep
2010] that 18 people had died of infection from a series of tick bites that
have been kept secret. Another 3 fatalities were reported in Penglai City,
east China's Shandong Province.

The 18 victims were among 557 reported cases of suspected human
granulocytic anaplasmosis [HGA] since the 1st case was reported in Xinyang
City of Henan in May 2007, Xinhua news agency reported. Most of the cases
were found in Xinyang's Shangcheng and Guangshan counties and Shihe and
Pingqiao districts, the provincial Public Health Department said.

The disease is often reported from May to August and most people infected
are between ages 40 to 70, according to officials. The cases mainly were
reported in rural areas where hygiene conditions are questionable, SINA.com
quoted Yu Xinbing, a parasite expert at Guangzhou-based Sun Yat-sen University.

Pets in urban areas rarely have the ticks because the owners regularly
clean them, Yu said.

HGA reduces white blood cell and platelet counts in the blood, leading to
organ failure and death. [The case fatality rate in HGA is quite low. Most
patients with HGA recover uneventfully. However, HGA can be severe and even
life threatening if untreated or initiation of antibiotic therapy is
delayed in elderly and in immunocompromised patients. - Mod.ML]

People in close contact with the patient can also be infected if no
precautions are taken. [Exposure to blood or bloody body fluids from a
patient with HGA has been implicated in person to person transmission --
see ProMED-mail post Anaplasmosis, nosocomial transmission - China: (AH)
20081120.3661. _Anaplasma phagocytophilum_ can survive in refrigerated
blood and anaplasmosis has also been transmitted through blood transfusion
(CDC. _Anaplasma phagocytophilum_ transmitted through blood transfusion --
Minnesota, 2007. MMWR 2008; 57(42): 1145-8. October 2008 [date cited];
available from <http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5742a1.htm>). -
Mod.ML] The disease is curable if treated soon enough.

An outbreak of tick bite infection was reported last year [2009] in Henan,
according to state radio. Besides Henan, tick bite cases have been reported
in 5 other provincial regions, all mountainous areas or areas with large
waterways. Among them were 3 villagers who were killed in July [2009] in
Penglai City, Shandong Province, according to the radio station.

Tick attacks first appeared in Xinyang in 2007 when several people reported
a skin rash after being bitten by the ticks. [Except for redness at the
site of the tick bite, skin rashes are rare in HGA]. The number of victims
started to climb up in 2009 when a few deaths were reported. This year's
[2010] situation has been the worst, Yang Fu, a village official in
Shangcheng County, told The Beijing News.

For most patients in Shangcheng, the 1st symptom was fever -- something
easily misdiagnosed by local village doctors.

[byline: Meng Tiexia]

--
communicated by:
ProMED-mail
<promed@promedmail.org>

******
[2]
Date: Thu 9 Sep 2010
Source: China.org.cn, CNTV report [edited]
<http://www.china.org.cn/video/2010-09/09/content_20897240.htm>

In Central China's Henan province, the health department has reported that
18 deaths were likely caused by a tickborne disease. So far 557 cases have
been reported, with most occurring in Shangcheng County of the province.
Local authorities in Henan say tickborne diseases, which mostly occur in
the summer, are believed to be the cause of a string of deaths. Most
patients who fall ill have been middle aged and the elderly.

Xu Bianli, vice director of Henan Disease Control Center, said, "It is an
acute disease with the symptoms of fever, nausea, and can lead to multiple
organ failure."

But Xu says it still cannot be confirmed if the disease was directly caused
by tick bites. Meanwhile experts from China's disease control center, the
US and Australia are in Henan, trying to find the cause of the disease. Xu
Bianli said, "We have not found the direct cause of the disease. It is
difficult to diagnose it now." However, he also noted that tickborne
diseases could be fully cured if people get immediate and necessary medical
treatment, including antibiotics. Local authorities have dispatched experts
in the disease-hit regions, and have also stepped up efforts in disease
prevention, including thorough sterilization and quarantines.

Ticks are known to carry various diseases, transmitting them from animal to
animal. In China, tickborne disease have been confined most to rural areas
in Henan and Guangdong provinces and the Guangxi Zhuang Autonomous Region.

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[Human granulocytic anaplasmosis (HGA), formerly known as human
granulocytic ehrlichiosis, is a tickborne disease caused by a
rickettsia-like bacterium, called _Anaplasma phagocytophilum_. Many people
with HGA experience headaches, fever, chills, and muscle aches that can be
confused with other common infections. The symptoms tend to be most severe
in aged and immunosuppressed people. Some individuals who become infected
with _A. phagocytophilum_ do not become ill or experience only very mild
symptoms and do not seek medical treatment. However, it is clear from the
2nd news release above that there is uncertainty concerning the diagnosis
in these fatalities in Henan, China. We await further clarification. A
detailed discussion of HGA can be found in the moderator's comments in the
prior ProMED-mail post, Anaplasmosis, nosocomial transmission - China: (AH)
20081120.3661.

Henan province is located in the eastern central part of China and is the
2nd most populated province of China after Guangdong
(<http://en.wikipedia.org/wiki/Henan>). Xinyang is subtropical and
mountainous and is the southernmost administrative division in Henan
province; Xinyang administers 2 districts and 8 counties
(<http://en.wikipedia.org/wiki/Xinyang>).

For a map of China with geographic divisions see
<http://www.lib.utexas.edu/maps/middle_east_and_asia/china_pol01.jpg>. Of
note, Henan province is adjacent to Shandong province to the north east and
Anhui province to the east, where other cases of HGA have been reported.
The HealthMap/ProMED-mail interactive map of China is available at
<http://healthmap.org/r/06JJ>.

Additional information on ticks, including pictures, is available at
<http://www.lib.uiowa.edu/haRDIN/MD/cdc/ticks.html>. - Mod.ML]

[see also:
Anaplasmosis, ehrlichiosis - USA: (WI, MN) Alert 20100515.1593
2009
---
Anaplasmosis - USA: (WI) 20090909.3186
2008
---
Anaplasmosis, nosocomial transmission - China: (AH) 20081120.3661
Anaplasmosis, human granulocytic - USA: (MN), ex transfusion 2007
20081024.3362
Undiagnosed hem. disease - China (02): (SD), anaplasmosis 20080805.2400
Anaplasmosis, human granulocytic - Canada: 1st rep., (AB) 20080731.2352
2007
---
Ehrlichiosis, fatal - USA (MO) 20070607.1849
2003
---
Ehrlichiosis, human granulocytic - USA (MA) 20030903.2211
Ehrlichiosis, human monocytic - USA (NC) 20030625.1571
1999
---
Ehrlichiosis, human - Mexico 19990713.1173
1998
---
Ehrlichiosis, human granulocytic - USA (Connecticut) 19980713.1318
Ehrlichiosis, human granulocytic - Sweden 19980418.0719
1995
---
Human granulocytic ehrlichiosis (5) 19950802.0625
Human granulocytic ehrlichiosis - Europe? 19950723.0581]

.................ml/mj/sh

**alert** · September 10, 2010, 04:08 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

This is from post a previous HGA outbreak in China. This outbreak sure sounds as if it is due to HGA.

http://www.promedmail.org/pls/apex/f?p=2400:1001:1613018362997723::::F2400_P1001_BACK_PAGE,F2400_P1001_ARCHIVE_NUMBER,F2400_P1001_USE_ARCHIVE:1001,20081120.3661,Y

In anaplasmosis, non-specific symptoms, which normally occur within
1-2 weeks following the bite of an infected tick, may vary from mild
to severe and include fever, chills, malaise, headache, muscle aches
and pain, and absence of skin rash. Laboratory findings include
anemia, leukopenia, thrombocytopenia, and elevated serum
transaminases. Half the symptomatic patients require hospitalization,
which is associated with older age, higher neutrophil counts, lower
lymphocyte counts, anemia, the presence of morulae in leukocytes, or
underlying immune suppression. Severe complications include a septic
or toxic shock-like syndrome, coagulopathy, acute respiratory
distress syndrome, acute abdominal syndrome, rhabdomyolysis,
myocarditis, acute renal failure, hemorrhage, brachial plexopathy,
demyelinating polyneuropathy, cranial nerve palsies, and
opportunistic infections. Approximately 5 to 7 percent of patients
require intensive care, and the disease can be fatal.

Anaplasmosis should be suspected in patients with the acute onset of
unexplained fever, chills, and headache, often in association with
thrombocytopenia, leukopenia, and/or increased liver enzyme levels
with a history of tick exposure within the prior 3 weeks. The
diagnosis of anaplasmosis can be confirmed by a 4-fold increase in
antibody titer by IFA [indirect immunofluorescent assay] in acute and
convalescent phase serum samples, PCR [polymerase chain reaction]
amplification of anaplasma DNA in a clinical specimen, immunostaining
of _A. phagocytophilum_ antigen in a tissue sample, or isolation of
_A. phagocytophilum_ from a clinical specimen in cell culture
(Centers for Disease Control and Prevention.
Ehrlichiosis/Anaplasmosis 2008 Case definition. September 2008 [date
cited] Available at
<http://www.cdc.gov/ncphi/disss/nndss/casedef/ehrlichiosis_2008.htm>).

Treatment with doxycycline 100 mg twice daily orally or intravenously
for 10 days for all symptomatic patients suspected of having
anaplasmosis is recommended for a minimal total course of 10 days.
This treatment regimen should be adequate therapy for patients with
anaplasmosis alone and for patients who are co-infected with Lyme
disease, but is not effective therapy for patients who are
co-infected with babesiosis.

**Treyfish** · September 10, 2010, 08:29 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

September 8, 2010: total 557 patients in Henan thrombocytopenia syndrome and 18 deaths

来源：新华网时间：2010-09-09

: xk

。

Xinhua Zhengzhou, September 8 (Xinhua simply just) in Henan Province Health Department Information Office of the eight on the evening of external communications, Henan Province, from May 2007 reported the first suspected of Xinyang City tick insect poisoning, anaplasmosis) ') " no physical disease cases has been further investigation and monitoring by the province, the latest statistics of the event is: As of September 8, 2010, Henan Province, were detected in the 557 cases of such syndrome cases, 18 cases of death, focusing in Xinyang City, County Mall, Shihe River District, .

。

At present, the Henan Provincial Health Department has deployed experts to tick insect poisoning "disastrous" County Mall site investigation guidance, and to convene an urgent meeting of relevant departments to further enhance the fever with thrombocytopenia syndrome prevention and control.

。

According to reports, the discovery of the fever in Henan with thrombocytopenia syndrome, onset time mainly from May to August, age 40 to 70 years old mostly.

。

Disease with fever and white blood cells, thrombocytopenia and multiple organ dysfunction as the main features of the incubation period 1-2 weeks, most acute onset, sustained high fever, up to 40 degrees Celsius. The clinical manifestations were malaise, fatigue, headache, muscle aches and nausea, vomiting, anorexia and diarrhea.

可伴有心肝肾等多脏器功能损害。

May be associated with heart, liver and other multiple organ dysfunction.

In view of these patients is unclear etiology, characterized by fever with thrombocytopenia were the main symptoms, initially suspected of anaplasmosis by name, in May 2010, China CDC tentatively named it "fever with thrombocytopenia syndrome . "
To further proved the cause of the disease, a clear clinical and epidemiological characteristics and control methods, May 31, 2010, the Ministry of Health and the National Centre for Disease Control and Prevention's request, Xinyang City, Henan Province, County Mall, Luoshan County, new county, the county information and Guangshan counties fever with thrombocytopenia syndrome monitoring.

作。

Currently, special monitoring of this syndrome is well underway.

http://translate.googleusercontent.c...gq9qIHUNbejCqg

**Treyfish** · September 10, 2010, 08:38 PM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

September 10, 2010: Henan, said insect Poisoning from ticks Bunia virus isolated

2010-09-10

。

CDC Deputy Director of Henan Province Henan Province in said isolated from the patient had Bunia virus . The virus can cause clinical symptoms of fever with thrombocytopenia, however, do not fear it, treatment is effective.

。

Recently, cases of 557 cases of Henan, Henan Province, Xinyang City Mall counties are tick insect bites and died subsequently, Henan Provincial Health Department, said experts had been deployed to the scene to investigate and guide the work.

。

Henan Province in, told reporters that since May 2007 in Henan Province Xinyang City, reported the first case of fever with thrombocytopenia as the main symptoms of suspected anaplasmosis cases has been monitored by the province to preliminary statistics, as of September 8, 2010 , Henan Province, 557 cases were found in such cases, death in 18 cases. Cases focus on the Xinyang City, County Mall, Shihe River District, Guangshan County Peace Bridge area.

?。

"We discovered in 2007, now identified as a suspected tick insect bites, no physical disease syndrome has been detected in cases within the province, and reported to relevant departments, has never concealed the matter does not exist." Bian Hui Lee said.

。

The ticks which occurred after the insect bite fever with thrombocytopenia syndrome are not included in the statutory infectious disease. Tick-borne viruses, worms, can infect human cells, resulting in human platelets, white blood cells dropped, and infectious.

。

Bunia virus "in May 2010, the Chinese Centre for Disease Control and Prevention case in parts of our province found Bunia infection, the media might as ticks, and human granulocytic anaplasmosis the same." Xu Bian Li said.
Bunia natural infection found in many vertebrates and arthropods (mosquitoes, ticks, sandflies, etc.), can infect mice, and can in some mammals, birds and mosquito cell culture growth; on people can cause flu-like or the disease dengue fever, hemorrhagic fever (Rift Valley fever and Crimean-Congo haemorrhagic fever ─) and encephalitis (California encephalitis). A mosquito-borne, tick-borne, sand-fly-borne spread of type 3. Some of the virus in the arthropod media, via the eggs, mating, or embryonic communication.

。

"We began monitoring in 2007 to the beginning without taking into account the physical, now isolated from the serum of patients with non-small body, not sensitive to the high rate of virus-positive. But in the treatment of this illness on tetracyclines and very sensitive, so now a lot of doubts. "Bian Hui Lee said.

2010年5月，

May 2010, the Ministry of Health Organization and the Chinese Centre for Disease Control and Prevention and other relevant experts to develop clinical issued a "fever with thrombocytopenia syndrome monitoring program (pilot)", according to program requirements, Health Department to further organize fever with thrombocytopenia syndrome monitoring, focusing on the same cause may be discovered and confirmed that the clinical symptoms of fever with thrombocytopenia, a Bunia virus.

。

Do not panic, "do not panic about this disease, treatment is better, mainly concentrated in the onset of 5 to 8 months, in particular 5 to 6 months, age of onset in the majority of adults." Bian Hui Lee said.

。

Disease Control Department, Health Department of Shandong Province, said yesterday that there is no tick insect bites received an official document of death.
Penglai City CDC office staff reporter, said: "Penglai thrombocytopenia syndrome cases occurred, and many years ago there. We are concerned, but not the media reported, some related insects with ticks. On the number of Patients currently disclose. "

。

According to experts, one after another hospital had admitted directly under Penglai part of "fever and white blood cells, thrombocytopenia," cases, not only occur in Penglai.In recent years, other provinces and cities nationwide have similar case reports, national authorities are monitoring the disease, research.

。

Feedback from the expert to see that such cases is not yet proven to be the spread of vector insects, and no evidence of transmission between people.
But experts advise, summer and autumn are insect-borne infectious diseases, high season, for example, mosquitoes transmit malaria , dengue fever, Japanese encephalitis and other diseases; flies can transmit cholera, typhoid, dysentery, hepatitis and other diseases; rats can spread epidemic hemorrhagic fever and other diseases.

一

In general, the lower incidence of insect-borne infectious diseases, even where the incidence is also possible, the complex causes of individual deaths, most of the original basis of disease.

http://translate.googleusercontent.c...hkzq2XL0CQmHnw

**alert** · September 11, 2010, 01:08 AM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

Very interesting find, Treyfish. Bunyavirus is the family of viruses to which CCHF belongs. It could be possbile that some of this outbreak is due to a novel Bunyavirus.

There have been reports out of China over the past two years (including ProMED posts like http://www.promedmail.org/pls/apex/f...0080805.2400,Y ) of person-to-person spread of HGA, something that has not been seen elsewhere in the world. It might make more sense if some novel Bunyavirus was responsible, as CCHF itself is known to spread person-to-person.

**alert** · September 11, 2010, 09:42 AM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

Not enough new here to post the text, but this source seems to think this is all the result of HGA.

A closer reading of the incident linked in the above post really does seem to imply that confirmed H2H transmission of HGA has occurred in China. It is unclear whether this outbreak is entirely due to HGA, or whether other agents such as CCHF or a novel bunyavirus might be involved. An HGA patient should respond to antibiotics, whereas the proper treatment for CCHF would be ribavirin.

http://health.asiaone.com/Health/News/Story/A1Story20100911-236664.html

**Giuseppe** · September 11, 2010, 09:53 AM

Re: Henan/Shangdong Province: Ticks kill 21 in hushed-up outbreak

On the Bunyaviridae taxonomy:

From International Committee on Taxonomy of Viruses: http://www.ictvonline.org/virusTaxon...p?version=2009

Family: Bunyaviridae (5 Genera)
Genus: Hantavirus (23 Species)
Species: Andes virus
Species: Bayou virus
Species: Black Creek Canal virus
Species: Cano Delgadito virus
Species: Dobrava-Belgrade virus
Species: El Moro Canyon virus
Species: Hantaan virus
Species: Isla Vista virus
Species: Khabarovsk virus
Species: Laguna Negra virus
Species: Muleshoe virus
Species: New York virus
Species: Prospect Hill virus
Species: Puumala virus
Species: Rio Mamore virus
Species: Rio Segundo virus
Species: Saaremaa virus
Species: Seoul virus
Species: Sin Nombre virus
Species: Thailand virus
Species: Thottapalayam virus
Species: Topografov virus
Species: Tula virus
Genus: Nairovirus (7 Species)
Species: Crimean-Congo hemorrhagic fever virus
Species: Dera Ghazi Khan virus
Species: Dugbe virus
Species: Hughes virus
Species: Qalyub virus
Species: Sakhalin virus
Species: Thiafora virus
Genus: Orthobunyavirus (48 Species)
Species: Acara virus
Species: Akabane virus
Species: Alajuela virus
Species: Anopheles A virus
Species: Anopheles B virus
Species: Bakau virus
Species: Batama virus
Species: Benevides virus
Species: Bertioga virus
Species: Bimiti virus
Species: Botambi virus
Species: Bunyamwera virus
Species: Bushbush virus
Species: Bwamba virus
Species: California encephalitis virus
Species: Capim virus
Species: Caraparu virus
Species: Catu virus
Species: Estero Real virus
Species: Gamboa virus
Species: Guajara virus
Species: Guama virus
Species: Guaroa virus
Species: Kaeng Khoi virus
Species: Kairi virus
Species: Koongol virus
Species: M'Poko virus
Species: Madrid virus
Species: Main Drain virus
Species: Manzanilla virus
Species: Marituba virus
Species: Minatitlan virus
Species: Nyando virus
Species: Olifantsvlei virus
Species: Oriboca virus
Species: Oropouche virus
Species: Patois virus
Species: Sathuperi virus
Species: Shamonda virus
Species: Shuni virus
Species: Simbu virus
Species: Tacaiuma virus
Species: Tete virus
Species: Thimiri virus
Species: Timboteua virus
Species: Turlock virus
Species: Wyeomyia virus
Species: Zegla virus
Genus: Phlebovirus (9 Species)
Species: Bujaru virus
Species: Chandiru virus
Species: Chilibre virus
Species: Frijoles virus
Species: Punta Toro virus
Species: Rift Valley fever virus
Species: Salehebad virus
Species: Sandfly fever Naples virus
Species: Uukuniemi virus
Genus: Tospovirus (8 Species)
Species: Groundnut bud necrosis virus
Species: Groundnut ringspot virus
Species: Groundnut yellow spot virus
Species: Impatiens necrotic spot virus
Species: Tomato chlorotic spot virus
Species: Tomato spotted wilt virus
Species: Watermelon silver mottle virus
Species: Zucchini lethal chlorosis virus

Announcement

China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

China - Henan/Shangdong Province: Unknown disease kills 31 - 33, possibly a new Bunyavirus carried by ticks

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