Novel Thogotovirus Associated with Febrile Illness and Death, United States, 2014 - Volume 21, Number 5—May 2015 - Emerging Infectious Disease journal - CDC

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Novel Thogotovirus Associated with Febrile Illness and Death, United States, 2014 - Volume 21, Number 5—May 2015 - Emerging Infectious Disease journal - CDC

Volume 21, Number 5—May 2015

Research

Novel Thogotovirus Associated with Febrile Illness and Death, United States, 2014

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• The Case-Patient
• Materials and Methods
• Results
• Discussion
• Suggested Citation

Figures

• Figure 1
• Figure 2
• Figure 3

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Olga I. Kosoy, Amy J. Lambert, Dana J. Hawkinson, Daniel M. Pastula, Cynthia S. Goldsmith, D. Charles Hunt, and J. Erin Staples 

Author affiliations: Centers for Disease Control and Prevention, Fort Collins, Colorado, USA (O.I. Kosoy, A.J. Lambert, D.M. Pastula, J.E. Staples); University of Kansas Medical Center, Kansas City, Kansas, USA (D.J. Hawkinson); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (C.S. Goldsmith); Kansas Department of Health and Environment, Topeka, Kansas, USA (D.C. Hunt)

Suggested citation for this article

Abstract

A previously healthy man from eastern Kansas, USA, sought medical care in late spring because of a history of tick bite, fever, and fatigue. The patient had thrombocytopenia and leukopenia and was given doxycycline for a presumed tickborne illness. His condition did not improve. Multiorgan failure developed, and he died 11 days after illness onset from cardiopulmonary arrest. Molecular and serologic testing results for known tickborne pathogens were negative. However, testing of a specimen for antibodies against Heartland virus by using plaque reduction neutralization indicated the presence of another virus. Next-generation sequencing and phylogenetic analysis identified the virus as a novel member of the genus Thogotovirus.

The genus Thogotovirus (family Orthomyxoviridae) contains >6 distinct viruses, including Araguari, Aransas Bay, Dhori, Jos, Thogoto, and Upolu viruses (1–3). These viruses have been primarily associated with either hard or soft ticks and have a wide geographic distribution (1–8). The only virus in this genus known to occur in the United States is Aransas Bay virus, which was isolated from soft ticks (Ornithodoros spp.) collected from a seabird nest off the coast of Texas (3).

Two viruses in the genus Thogotovirus (Thogoto and Dhori viruses) are currently known to cause human infection and disease. Antibodies against Thogoto virus have been identified in humans living in parts of Europe, Asia, and Africa (1,4,6,8). Two persons from Nigeria infected with this virus were identified in 1966. The first patient was a man with a febrile illness in whom neuromyelitis optica later developed. The second patient was a 14-year-old boy in whom meningitis developed and who died 6 days later because of complications of sickle cell disease (9).

Antibodies against Dhori virus in humans have been reported in a similar distribution as those against Thogoto virus (1,6,8,10). Five patients with disease have been described after accidental laboratory exposure to Dhori virus; encephalitis developed in 2 of these patients (11). We report a novel Thogotovirus associated with a febrile illness and death that occurred in a man in the United States in 2014.

Ms. Kosoy is a microbiologist at the Arboviral Diseases Branch, Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado. Her research interests are diagnosis of arboviral diseases and biology of arboviruses.

Acknowledgment

We thank Jason Velez for preparing cells; Kristen Burkhalter, Jan Pohl, Roger Nasci, Nicky Sulaiman, and Emily Pau for facilitation of development of the rapid Bourbon real-time RT-PCR; Amanda Panella for assistance with handling the samples; and Robert S. Lanciotti, Ingrid Rabe, and Marc Fischer for their input on diagnostic evaluation, and review of the manuscript.

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Figures

• Figure 1. Plaque reduction neutralization test of patient sample for Heartland virus, showing images of the same well obtained days 6, 7, and 8 postinoculation at a dilution of 1:20. Arrows...
• Figure 2. Electron microscopic images of novel Thogotovirus isolate. Filamentous (A) and spherical (B) virus particles with distinct surface projection are visible in culture supernatant that was fixed in 2.5% paraformaldehyde....
• Figure 3. Phylogenies of deduced amino acid sequences of representative genes of Bourbon virus in comparison to homologous sequences of selected orthomyxoviruses. A neighbor-joining method was used for inference of each...

Suggested citation for this article: Kosoy OI, Lambert AJ, Hawkinson DJ, Pastula DM, Goldsmith CS, Hunt DC, et al. Novel Thogotovirus species associated with febrile illness and death, United States, 2014. Emerg Infect Dis. 2015 May [date cited]. http://dx.doi.org/10.3201/eid2105.150150

DOI: 10.3201/eid2105.150150