Cases of tick-borne encephalitis identified by metagenomic next-generation sequencing, China
Ming-Zhu Zhang, Cai Bian, Run-Ze Ye, Nan-Nan Yao, Yan-Li Chu, Ya-Fei Wu, Ji-Hu Yang, Xiao-Ping Kang, Jin-Ling Ye, Xiao-Wei Xu, Bing Bai, Ya-Ting Liu, Shi-Jing Shen, Xiao-Ming Cui, Wenqiang Shi, Dai-Yun Zhu, Na Jia, Lin Zhao, Yuan-Chun Zheng, Tao Jiang, Jia-Fu Jiang, Xiao-Min Zheng, Wu-Chun CaoABSTRACT
Background
Tick-borne encephalitis (TBE) is an infection of the central nervous system caused by the tick-borne encephalitis virus (TBEV). In the past decade, no Far Eastern TBEV subtype genome has been reported from patients, leaving its pathogenicity and genetic characteristics unknown.
Case Summary
We report two cases of TBE identified through metagenomic next-generation sequencing (mNGS) of acute-phase serum samples, one of which was fatal. Both patients exhibited pronounced neurological symptoms and marked muscle weakness. The fatal case additionally developed respiratory paralysis, leading to pulmonary dysfunction and secondary lung infection. Furthermore, we performed genomic characterization of the TBE virus isolated from both patients. The results showed that both strains belong to the Fe-TBEV subtype with 40 mutations.
Conclusion
The Fe-TBEV subtype remains a public health threat. mNGS is a useful complement to serology and PCR detection methods for TBE.