Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis

Severe Fever with Thrombocytopenia Syndrome (SFTS) is a life-threatening emerging infectious disease caused by the SFTS virus. The aim of this systematic review and meta-analysis was to gain new insights into the routes of transmission to humans and assess whether tick bites are the dominant mechani...

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Main Authors: Darae Woo, Ian C. Michelow, Yongyeon Choi, Hyelan Lee, Sangshin Park
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Infection and Public Health
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Online Access:http://www.sciencedirect.com/science/article/pii/S1876034125000346
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author Darae Woo
Ian C. Michelow
Yongyeon Choi
Hyelan Lee
Sangshin Park
author_facet Darae Woo
Ian C. Michelow
Yongyeon Choi
Hyelan Lee
Sangshin Park
author_sort Darae Woo
collection DOAJ
description Severe Fever with Thrombocytopenia Syndrome (SFTS) is a life-threatening emerging infectious disease caused by the SFTS virus. The aim of this systematic review and meta-analysis was to gain new insights into the routes of transmission to humans and assess whether tick bites are the dominant mechanism, as previously reported in the medical literature. Original articles were searched through Embase, Medline, and Global Health from 2009 to 2022. We performed meta-analyses to pool adjusted odds ratio (aOR) estimates using a fixed-effects model. Of 1683 articles, 41 eligible articles from three countries met the inclusion criteria, and five case-control studies were included in the meta-analysis. The most commonly reported route of transmission in the systematic review of individual participant data was person-to-person contact, particularly through exposure to blood or body fluids. Other routes included tick bites and contact with infected animals, especially cats and dogs. The meta-analysis included studies reporting transmission through human contact (n = 1), tick bites (n = 4), and animal contact (n = 1). Human contact via exposure to bodily fluids significantly increased the odds of infection (aOR: 6.27, 95 % CI: 1.23–42.81). Tick bites had a pooled aOR of 6.36 (95 % CI: 3.34–12.11). Among animal contacts, only dog contact was significant (OR: 3.60, 95 % CI: 1.04–12.51). The typical settings for SFTS transmission were human or animal hospitals, homes, and natural tick habitats. Education and effective interventions to prevent human-to-human spread, in addition to preventing transmission by tick bites, are urgently needed.
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spelling doaj-art-9475836e9bc142f0964cb76d97394f582025-08-20T02:58:51ZengElsevierJournal of Infection and Public Health1876-03412025-06-0118610268510.1016/j.jiph.2025.102685Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysisDarae Woo0Ian C. Michelow1Yongyeon Choi2Hyelan Lee3Sangshin Park4Graduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea; Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea; Accountable Care Hospital Connected Care Support Team, Center for Public Healthcare, National Medical Center, Seoul, Republic of KoreaDepartment of Pediatrics, Division of Infectious Diseases and Immunology, Connecticut Children’s and University of Connecticut School of Medicine, Hartford, CT, United StatesGraduate School of Urban Public Health, University of Seoul, Seoul, Republic of KoreaGraduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea; Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of KoreaGraduate School of Urban Public Health, University of Seoul, Seoul, Republic of Korea; Department of Urban Big Data Convergence, University of Seoul, Seoul, Republic of Korea; Corresponding author at: Graduate School of Urban Public Health, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Republic of Korea.Severe Fever with Thrombocytopenia Syndrome (SFTS) is a life-threatening emerging infectious disease caused by the SFTS virus. The aim of this systematic review and meta-analysis was to gain new insights into the routes of transmission to humans and assess whether tick bites are the dominant mechanism, as previously reported in the medical literature. Original articles were searched through Embase, Medline, and Global Health from 2009 to 2022. We performed meta-analyses to pool adjusted odds ratio (aOR) estimates using a fixed-effects model. Of 1683 articles, 41 eligible articles from three countries met the inclusion criteria, and five case-control studies were included in the meta-analysis. The most commonly reported route of transmission in the systematic review of individual participant data was person-to-person contact, particularly through exposure to blood or body fluids. Other routes included tick bites and contact with infected animals, especially cats and dogs. The meta-analysis included studies reporting transmission through human contact (n = 1), tick bites (n = 4), and animal contact (n = 1). Human contact via exposure to bodily fluids significantly increased the odds of infection (aOR: 6.27, 95 % CI: 1.23–42.81). Tick bites had a pooled aOR of 6.36 (95 % CI: 3.34–12.11). Among animal contacts, only dog contact was significant (OR: 3.60, 95 % CI: 1.04–12.51). The typical settings for SFTS transmission were human or animal hospitals, homes, and natural tick habitats. Education and effective interventions to prevent human-to-human spread, in addition to preventing transmission by tick bites, are urgently needed.http://www.sciencedirect.com/science/article/pii/S1876034125000346Severe fever with thrombocytopenia syndromeVirus, ticks, thrombocytopeniaRoutes of transmission
spellingShingle Darae Woo
Ian C. Michelow
Yongyeon Choi
Hyelan Lee
Sangshin Park
Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
Journal of Infection and Public Health
Severe fever with thrombocytopenia syndrome
Virus, ticks, thrombocytopenia
Routes of transmission
title Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
title_full Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
title_fullStr Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
title_full_unstemmed Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
title_short Transmission of Severe Fever with Thrombocytopenia Syndrome (SFTS) to humans: A systematic review of individual participant data and meta-analysis
title_sort transmission of severe fever with thrombocytopenia syndrome sfts to humans a systematic review of individual participant data and meta analysis
topic Severe fever with thrombocytopenia syndrome
Virus, ticks, thrombocytopenia
Routes of transmission
url http://www.sciencedirect.com/science/article/pii/S1876034125000346
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