Clinical and Etiological Characteristics of Severe Hemorrhagic Fever Caused by Coinfection of Thrombocytopenia Syndrome Bunyavirus and Hemorrhagic Fever Virus

——Coinfection of SFTSV with HTNV may lead to severe HFRS

Xiaohu Han^{1,2, #}, Yongxiang Zhao^3,#, Ruihao Peng^4,#, Qijun Chen^1,2, Ya Wen³, Yudan Bi¹, Yichen Zhou¹, Yao Chen⁵, Hua Deng⁶, Feng Jiang^1,2,*, Zeliang Chen^1,2,4,7,*

1.College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, Shenyang 110866, Liaoning;

2.Key Laboratory of Livestock Infectious Diseases, Ministry of Education (Shenyang Agricultural University), Shenyang 110866, Liaoning.

3.The Sixth People’s Hospital of Dandong City, Dandong 118002, Liaoning.

4.Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510275, Guangdong.

5.Liaoning center for Agricultural Development Service, Shenyang 110033, Liaoning;

6.Manzhouli international travel health care center, Manzhouli 024199, Inner Mongolia;

7.Key Laboratory of Zoonose Prevention and Control at Universities of Inner Mongolia Autonomous Region, Innovative Institute of Zoonoses, Medical College (Inner Mongolia Minzu University), Tongliao 028000, Inner Mongolia.

# The authors contributed equally to this work.

* The corresponding authors.

Correspondence: Feng Jiang, College of Animal Science and Veterinary Medicine, Shenyang Agricultural University, No.120, Dongling Road, Shenhe District, Shenyang 110866, Liaoning, China (+86 13664130526,jf8849@syau.edu.cn)

40-word summary of the article’s main point:

In areas where both ticks and mice are endemic, physicians should consider the possibility of SFTSV and HTNV coinfection when diagnosing severe forms of HFRS in order to achieve precise treatment.