A Retrospective Study Of Clinical Features Of Novel Bunyavirus Infection In Anhui Province

Objective To understand the clinical characteristics and the factors of deseases and deaths of Novel Bunyavirus infection in Anhui Province;And to increase the awareness and prognosis of Novel Bunyavirus infection by clinicians,to further provide the basis of curing fever and Thrombocytopenia Syndrome.Materials and Methods Source The subjects were from Anhui Medical University Affiliated Chaohu Hospital and the First Affiliated Hospital of Anhui Medical University.105 cases of Novel Bunyavirus infection cases are about the patients from January 1,2012 to December 31,2015 in Anhui Medical University Affiliated Chaohu Hospital and from January 1,2014 to December 31,2015 in Anhui Medical University First Hospital.MethodsAt first,we collected the suspected cases.Then according to the severity of the disease,we divided them into normal group and severe group,analyzing the epidemiological data,clinical symptoms and signs and laboratory indicators.And then we divided these cases into the cured and the dead,reanalyzed retrospectively in the epidemiology,clinical symptoms,signs and laboratory indicators and other differences.We also divide the process into 3 stages in accordance with the chronological order to observe the indicators in the lab and analyze the risky factors in death.Measurement data and numeration data were statistically analyzed with means ± standard deviations and x2 test respectively.Two sided P<0.05 was considered statistically significant.Results From January 2012 to December 2015,there were 105 diagnostic cases,including 58 men(55.2%)and 46 women(43.8%),aged between17 and 86.There were 72 cases in the severe group,aged 35-86,and 27 cases in the common group,aged 17-81.The difference between the two groups in ages was statistically significant(t = 4.601,P = 0.000).There were 65 cases(90.3%)in the severe group.Among all the observed cases,there were 27 deaths,and the case fatality rate(CFR)was 25.7%,incuding 26 farmers(96.3%).Among them,44.4% of women died,so there was no difference between men and women.The SFTS in Anhui Province occured in double peaks,mainly in May and June,followed by October.There were obvious differences between the severe group and the general group if the patients had been bitten by ticks or had had outdoor activities(?2= 11.269,P = 0.009;?2= 23.165,P = 0.000).There was no obvioust difference between the two groups in the time when they got ill or when they were in hospital(t=1.647,P = 0.186;t = 20.275,P = 0.165).However,the difference between the two groups was statistically significant(t = 4.091,P <0.001)in the time when the body temperature return to normal.There were significant differences in headache,vomiting,lymphadenopathy,disturbance of consciousness,coagulation dysfunction and tick bites history(P <0.05).The levels of ALT,AST,LDH,ALB,CK,amylase(AMY),lipase(LIP),proteinuria,hematuria,potassium and fasting glucose were statistically significant(P <0.05).Vomiting,disturbance of consciousness,a clear history of tick ticks and 15 days before the onset of clear outdoor activity history,high levels of AST and low levels of ALB SFTS resuted in severe deseases.Compared with the dead group and the cured group,the disturbance of consciousness and being bitten by ticks are the most dangerous factors.The SFTSV infection patients were divided into three stages: In the first stage,there is no indicator showing that it was closely related to the death of SFTS.In the second stage,high-level AST and low-level WBC are related to the death.High-level LDH in the disease are risky factors for death during the later period.Single use of gamma globulin and ribavirin for the treatment of SFTSV infection has no clinical effect.Conclusions Fever with thrombocytopenia syndrome(SFTS)is a new serious hemorrhagic fever,which first appeared in rural areas in China.The main clinical manifestations are fatigue,apathetic,nausea,vomiting,diarrhea and other gastrointestinal symptoms,accompanied by Peripheral blood leukocytes,thrombocytopenia,a small number of cases of rapid progression,awareness,coagulation dysfunction,due to shock,respiratory failure,disseminated intravascular coagulation(DIC)and other multiple organ failure and death.The clinical findings of SFTS patients in Anhui Province were similar to those reported in other studies,but the severity of the disease was more severe.The mortality rate was 25.7%.This new infectious disease has been a serious threat to public health.Whether in the severe group or in the death group ticks bitter history is a risky factor.Since we have no clear and effective treatment measures today,to avoid tick bites is important measures to prevent infection and spread SFTSV.This study comprehensively analyzed the impact of various factors on the outcome of death in various stages,using multivariate statistical methods.The results can help clinicians make judgements on the patients infected with SFTSV,grasp the patient's conditional development better,and reduce patient mortality.