Clinical Scorecard: New Tick-Borne Virus Identified in China

At a Glance

Key Highlights

• ALTNV was identified in patients with suspected severe fever with thrombocytopenia syndrome (SFTS) who tested negative for Dabie bandavirus (DBV).
• Among 3,163 patients with fever and recent tick exposure, 10.4% had ALTNV RNA or immunoglobulin M antibodies; 15.1% of DBV-negative patients had evidence of ALTNV infection.
• Among 56 patients infected only with ALTNV, fatigue and gastrointestinal symptoms were common; all recovered without reported lasting complications.
• Thirty-eight patients had both ALTNV and DBV; seven died, but the study could not determine whether ALTNV contributed to greater disease severity.
• ALTNV RNA was detected in 1.29% of 47,428 ticks sampled across 15 provinces, with the highest rate in Haemaphysalis longicornis.

Guideline-Based Recommendations

Diagnosis

• The study confirmed ALTNV using two reverse-transcription quantitative polymerase chain reaction assays targeting different genomic regions, followed by further PCR testing and Sanger sequencing.
• An enzyme-linked immunosorbent assay was used to detect ALTNV immunoglobulin M.
• The authors state that specific molecular and antibody tests may be needed to distinguish ALTNV from DBV; further assay validation is required.

Management

Monitoring & Follow-up

• Further surveillance is needed to establish ALTNV’s geographic distribution.

Risks

• ALTNV and DBV occur in the same regions and can produce similar clinical findings.
• Coinfected patients more frequently had respiratory symptoms and kidney impairment than patients with DBV alone; the study could not establish whether ALTNV contributed to greater severity.

Patient & Prescribing Data

The study screened 3,163 patients with fever and recent tick exposure. It described 56 patients with ALTNV alone and 38 with ALTNV and DBV coinfection.

The article reports no treatment regimen or prescribing data. All 56 patients with ALTNV alone recovered without reported lasting complications.

Clinical Best Practices

• Consider ALTNV as a potential cause of fever and thrombocytopenia after tick exposure, including in patients who test negative for DBV.
• Use molecular and antibody testing to distinguish ALTNV from DBV where testing is available; the study notes that further assay validation is needed.

Related Resources & Content

• The New England Journal of Medicine report on Asian longhorned tick nairovirus