S evere fever with thrombocytopenia syndrome (SFTS) is caused by the species Dabie bandavirus (family Phenuiviridae, genus Bandavirus), generally called severe fever with thrombocytopenia syndrome virus (SFTSV) (1,2). Cases of SFTS were identified in patients in China during 2009 (3) and subsequently in Japan and South Korea (2,4). Clinical signs include high fever, fatigue, gastrointestinal symptoms, neurologic symptoms, thrombocytopenia, leukocytopenia, and multiorgan failure (5). SFTS is potentially fatal, and mortality rates have reached 27% in Japan (6). Although the clinical information regarding SFTS in most animals is unclear, cats show fatal symptoms similar to those in humans (7). Enzootic SFTSV transmission is primarily tickborne; tick bites can also spread the virus to humans (8) and animals (9). Human-to-human transmission occurs rarely through contact with infected blood, body fluids, or mucus (10) and possibly by aerosols (11). In this study, we provide evidence for the direct cat-to-human transmission of the virus, leading to a nosocomial outbreak of SFTSV infection. The Study Confirmatory testing of veterinary personnel samples was performed at the Laboratory of Microbiology, Miyazaki Prefecture Institute for the Public Health and Environment, Miyazaki, Japan. Cat sample analysis was performed at the Center for Animal Disease Control, University of Miyazaki. A 1-year-old male domestic cat was hospitalized on August 15, 2018, with jaundice, poor appetite, vomiting, and a rectal temperature of 40.4°C. Hematologic examination showed leukocytopenia (1,080 cells/µL, reference range 4-30 × 10 3 cells/µL), thrombocytopenia (19,000 cells/µL, reference range 9-90 × 10 4 cells/µL), and an increased level of total bilirubin (3.1 mg/dL, reference range 0-0.5 mg/dL) (12) (Table). The cat died 3 days after hospitalization. Serum samples, saliva samples, and anal swab specimens (sampled on the first day of hospitalization) were sent to the Center for Animal Disease Control, University of Miyazaki, for molecular test targeting the small segment RNA of SFTSV by reverse transcription PCR (RT-PCR) and real-time RT-PCR (3). The amounts of SFTSV RNA were quantified as RNA copies per milliliter of serum. We detected a viral load of 1.5 × 10 11 copies/mL (Table). During hospitalization, the cat came into contact with a veterinarian (44-year-old woman) and a veterinary technician (20-year-old woman). During contact, both veterinary personnel wore protective clothing (gloves and surgical masks), but their eyes remained unprotected; they were not bitten or scratched by the cat. In addition, neither was bitten by ticks. After the death of the cat, symptoms consistent with SFTS developed in both veterinary personnel (Figure 1). Ten days after the death of the cat, on August 27, the veterinarian (patient 1) was hospitalized with a high fever (body temperature 39.2°C),

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Primary infection with bovine respiratory syncytial virus (BRSV) predisposes cattle to secondary infection with bacteria that cause bovine respiratory disease complex (BRDC). However, the interaction between BRSV and bacteria is unclear. This in vitro study examined the adherence of Pasteurella multocida (PM) to BRSV-infected cells was assessed in colony forming unit assays, by flow cytometry analysis, and by indirect immunofluorescence analysis (IFA) of epithelial cells (A549, HEp-2, and MDBK). An in vitro model based on infection of BRSV-infected epithelial cells revealed that PM adherence to BRSV-infected cells was 2- to 8-fold higher than uninfected cells. This was confirmed by flow cytometry analysis and IFA. Epithelial cell expression of mRNA encoding cytokines and chemokines increased after exposure to PM, but increased further after co-infection with BRSV and PM. BRSV-mediated adherence of PM to epithelial cells may underlie the serious symptoms of BRDC.

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Severe fever with thrombocytopenia syndrome virus (SFTSV) is the causative agent of SFTS, an emerging tick-borne disease in East Asia, and is maintained in enzootic cycles involving ticks and a range of wild animal hosts. Direct transmission of SFTSV from cats and dogs to humans has been identified in Japan, suggesting that veterinarians and veterinary nurses involved in small-animal practice are at occupational risk of SFTSV infection. To characterize this risk, we performed a sero-epidemiological survey in small-animal-practice workers and healthy blood donors in Miyazaki prefecture, which is the prefecture with the highest per capita number of recorded cases of SFTS in Japan. Three small-animal-practice workers were identified as seropositive by ELISA, but one had a negative neutralization-test result and so was finally determined to be seronegative, giving a seropositive rate of 2.2% (2 of 90), which was significantly higher than that in healthy blood donors (0%, 0 of 1000; p < 0.05). The seroprevalence identified here in small-animal-practice workers was slightly higher than that previously reported in other high-risk workers engaged in agriculture and forestry in Japan. Thus, enhancement of small-animal-practice workers’ awareness of biosafety at animal hospitals is necessary for control of SFTSV.