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Severe Fever with Thrombocytopenia Syndrome in Japan: Elucidating context-specific transmission routes and quantifying at-risk populations for an emerging zoonotic disease - NU/LSHTM project

Supervisors

Nagasaki University

LSHTM 

Project

Background

Severe Fever with Thrombocytopenia Syndrome Virus (SFTSV) was first reported in humans and ticks in 2009 across mountainous regions of Central China.[1,2] Since then, SFTSV has been identified in diverse arthropod vectors and mammalian hosts[3,4] across a widening geographic range and with increasing incidence.[4] China, South Korea, and Japan have the highest documented case counts at present.[4] Clinically, SFTS in humans is characterized by thrombocytopenia, leukocytopenia, and organ failure.[2] No vaccines or dedicated therapeutics are currently available, and case fatality ranges between 8-16%.[3,4]

Bites from Haemaphysalis longicornis ticks have been implicated as the primary transmission route leading to human infection with SFTSV.[3] However, tick bites are not always observed among cases, leading to hypotheses around transmission pathways involving reservoir mammalian hosts as part of the spillover process. In Japan, caring for sick companion animals or sick community animals has been identified as one likely transmission route.[5] While there is a growing body of evidence around SFTS in Japan, no effort has been undertaken to comprehensively map out risk pathways and to begin to investigate differences in their contributions to transmission in the context. 

Project

The student will undertake a multi-method approach to contribute high-quality evidence around potential transmission pathways in Japan and to define and quantify populations across levels of risk. The approach will include primary data collection, risk assessment, and modelling techniques. The student will work with a multidisciplinary team including epidemiologists, veterinarians, social scientists, disease modellers, and demographers, and their projects will be an integral part of a comprehensive program of research around SFTS. The evidence generated is expected to have practical applications, from development of recommendations for One Health surveillance activities to informing updates to risk communication efforts. In addition, evidence around at-risk groups will inform planning for trials to evaluate medical countermeasures in development and offer guidance on potential post-licensure use cases. 

References

  1. Zhang, Y. Z. et al. Hemorrhagic fever caused by a novel tick-borne Bunyavirus in Huaiyangshan, China. Zhonghua Liu Xing Bing Xue Za Zhi 32, 209–220 (2011).
  2. Yu, X.-J. et al. Fever with thrombocytopenia associated with a novel bunyavirus in China. N. Engl. J. Med. 364, 1523–1532 (2011).
  3. Liu, S. et al. Systematic review of severe fever with thrombocytopenia syndrome: virology, epidemiology, and clinical characteristics. Rev. Med. Virol. 24, 90–102 (2014).
  4. Cui, H. et al. Global epidemiology of severe fever with thrombocytopenia syndrome virus in human and animals: a systematic review and meta-analysis. Lancet Reg Health West Pac 48, 101133 (2024).
  5. Kobayashi, Y. et al. Severe Fever with Thrombocytopenia Syndrome, Japan, 2013–2017 - Volume 26, Number 4—April 2020 - Emerging Infectious Diseases journal - CDC. doi:10.3201/eid2604.191011.

The role of LSHTM and NU in this collaborative project 

The student will be located primarily in Nagasaki to conduct field work and engage with stakeholders but will also spend time at LSHTM for training and supervisory input.  The Nagasaki team will provide support in conducting epidemiological studies and establishing connections with important collaborators and stakeholders.  

LSHTM will provide methodological support and insight into data collection and analysis methods to best inform ongoing and future scope of work around disease and vaccine impact modelling.  

Particular prior educational requirements for a student undertaking this project

  • Essential: Knowledge of infectious disease epidemiology, with a Master’s degree (or equivalent) in epidemiology, biostatistics, public health or other relevant discipline.
  • Desired: Experience in systems thinking and/or conducting research with a One Health focus.

Skills we expect a student to develop/acquire whilst pursuing this project

  • Risk assessment.
  • Stakeholder mapping and engagement.
  • Infectious disease modelling.