Clinical Report: New Tick-Borne Virus Identified in China

Overview

Researchers identified Asian longhorned tick nairovirus (ALTNV), a distinct orthonairovirus, in febrile patients in China, including patients who tested negative for Dabie bandavirus (DBV), the cause of severe fever with thrombocytopenia syndrome (SFTS). In a screening cohort of 3,163 patients with fever and recent tick exposure, 10.4% had ALTNV RNA or immunoglobulin M evidence of infection; among those testing negative for DBV, 15.1% had evidence of ALTNV infection. Patients with ALTNV alone recovered without reported lasting complications, while the study could not establish whether ALTNV contributed to greater severity in coinfected patients.

Background

SFTS, caused by DBV, can present with fever, thrombocytopenia, and other laboratory abnormalities. More than 30% of patients given a clinical diagnosis of SFTS test negative for DBV, indicating that other pathogens may produce similar findings. ALTNV was identified through hospital surveillance of febrile patients with tick exposure in regions where tick-borne diseases are common. The virus was also detected in ticks collected across multiple Chinese provinces, including Haemaphysalis longicornis, the Asian longhorned tick.

Data Highlights

Key Findings

• RNA sequencing identified ALTNV in patients with suspected SFTS who tested negative for DBV; genomic analysis classified it as a distinct orthonairovirus.
• Researchers isolated the virus from RNA-positive patient serum in cultured cells and confirmed its identity using immunofluorescence; electron microscopy showed orthonairovirus structural features.
• Laboratory confirmation used two RT-qPCR assays targeting different genomic regions, followed by additional PCR testing and Sanger sequencing; an ELISA was used to detect ALTNV IgM.
• Among 56 patients infected only with ALTNV, fatigue and gastrointestinal symptoms were common, and all recovered without reported lasting complications.
• Among 38 patients coinfected with ALTNV and DBV, respiratory symptoms and kidney impairment were more frequent than in patients with DBV alone; seven coinfected patients died. The study could not determine whether ALTNV contributed to greater severity.
• ALTNV RNA was detected in 1.29% of 47,428 ticks sampled across 15 provinces, with the highest reported rate in H. longicornis; laboratory experiments showed this tick could transmit the virus to mice.

Conclusion

ALTNV was identified in febrile patients and ticks in China and can produce clinical findings that overlap with SFTS. Its contribution to disease severity in coinfected patients and its broader distribution remain undetermined.

Related Resources & Content

1. New England Journal of Medicine, 2026 -- A Zoonotic Orthonairovirus from Febrile Patients in China
2. Open Forum Infectious Diseases, 2025 -- Identification of Tick-borne Encephalitis Virus in Ixodes Ticks Collected in Proximity to Ulaanbaatar, Mongolia
3. International Journal of Infectious Diseases, 2026 -- Investigation of a Family and Healthcare-Related Outbreak of Severe Fever with Thrombocytopenia Syndrome in Shanghai, China: An Epidemiological Study in a Non-Endemic Region
4. International Journal of Infectious Diseases, 2026 -- Enhancing data collection on socio-behavioral exposure pathways for emerging tickborne disease through engagement with surviving cases and their household members
5. ADA News — China’s mosquito offensive: what you need to know about chikungunya virus
6. A Zoonotic Orthonairovirus from Febrile Patients in China
7. Viral haemorrhagic fevers: epidemiology, characteristics, diagnosis and management
8. Diagnosis, management, and prevention of Crimean-Congo haemorrhagic fever: a Delphi-based consensus study in Türkiye
9. A Zoonotic Orthonairovirus from Febrile Patients in China | New England Journal of Medicine
10. Diagnosis, management, and prevention of Crimean-Congo haemorrhagic fever: a Delphi-based consensus study in Türkiye - ScienceDirect
11. 发热伴血小板减少综合征合并细菌/真菌感染诊治与防控专家共识
12. Frontiers | Research progress on antiviral drugs and vaccines for severe fever with thrombocytopenia syndrome
13. Field Investigation of Two Urban Cases of Severe Fever with Thrombocytopenia Syndrome — Nanjing City, Jiangsu Province, China, 2025