Clinical Scorecard: 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

At a Glance

Key Highlights

• SFTS is caused by severe fever with thrombocytopenia syndrome virus (SFTSV).

• The reported case-fatality rate ranges from 6% to 30%; the current average annual fatality rate in China is 4.83%.

• SFTS has been reported in China, South Korea, Japan, and other parts of Asia.

• Healthcare workers without adequate protection are at high risk when exposed to patients’ blood or bodily fluids.

• The cluster involved seven symptomatic individuals: five family members and two healthcare workers.

Guideline-Based Recommendations

Diagnosis

• Suspected cases require relevant exposure and the presence of fever, leukopenia, and thrombocytopenia.

• Laboratory confirmation may involve SFTSV RNA detection by RT-PCR, IgG seroconversion or a fourfold or greater increase in IgG antibody titer, or virus isolation.

Management

• Apply contact and aerosol precautions when treating patients with unexplained fever and hemorrhagic manifestations.

• Use isolation gowns, medical protective masks, and goggles or face shields during potentially high-risk procedures.

Monitoring & Follow-up

• Observe close contacts for 14 days after their last exposure and arrange medical evaluation and serum testing if fever develops.

Risks

• Unprotected contact with infected blood or bodily fluids can transmit SFTSV to family caregivers and healthcare workers.

Patient & Prescribing Data

People with tick exposure or unprotected contact with patients with SFTS may be at risk. No vaccine or specific therapy for SFTS was available according to the source.

Clinical Best Practices

• Maintain clinical awareness when patients with unexplained fever and bleeding have traveled from endemic regions.

• Obtain a thorough exposure history and implement rigorous infection-control precautions.

Related Resources & Content

• Study: “A family and healthcare-associated cluster of severe fever with thrombocytopenia syndrome in Shanghai, China: an epidemiological investigation in a nonendemic area” — Yiyi Zhu, Wencheng Wu, Zheng Teng, Yaxu Zheng, Yuanping Wang, Wei Wang, Jian Chen, and Hao Pan; International Journal of Infectious Diseases, Volume 171 (2026), article 108995; accepted July 20, 2026; access the study.

• Guidance: “Guideline for Prevention and Treatment of Severe Fever with Thrombocytopenia Syndrome (2010 Version)” — Ministry of Health of the People’s Republic of China; Chinese Journal of Clinical Infectious Diseases, Volume 4, Issue 4 (2011), pages 193–194.