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Phylogenetic Analysis of Severe Fever with Thrombocytopenia Syndrome Virus in South Korea and Migratory Bird Routes Between China, South Korea, and Japan

Yeojun YunEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Sang Taek HeoEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Gwanghun KimEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Roger HewsonEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Hyemin KimEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Dahee ParkEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Nam-Hyuk ChoEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Won Sup OhEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Seong Yeol RyuEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Ki Tae KwonEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Jolyon M. MedlockEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Keun Hwa LeeEwha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

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Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease. The SFTS virus (SFTSV) has been detected in the Haemaphysalis longicornis, which acts as a transmission host between animals and humans. SFTSV was first confirmed in China in 2009 and has also been circulating in Japan and South Korea. However, it is not known if a genetic connection exists between the viruses in these regions and, if so, how SFTSV is transmitted across China, South Korea, and Japan. We therefore hypothesize that the SFTSV in South Korea share common phylogenetic origins with samples from China and Japan. Further, we postulate that migratory birds, well-known carriers of the tick H. longicornis, are a potential source of SFTSV transmission across countries. Our phylogenetic analysis results show that the SFTSV isolates in South Korea were similar to isolates from Japan and China. We connect this with previous work showing that SFTSV-infected H. longicornis were found in China, South Korea, and Japan. In addition, H. longicornis were found on migratory birds. The migratory bird routes and the distribution of H. longicornis are concurrent with the occurrence of SFTSV. Therefore, we suggest that migratory birds play an important role in dispersing H. longicornis-borne SFTSV.

Author Notes

* Address correspondence to Keun Hwa Lee, Department of Microbiology and Immunology, Jeju National University School of Medicine, 15 Aran 13-gil, Jeju 690-767, South Korea. E-mail: yomust7@jejunu.ac.kr
† These authors contributed equally to this work.

Financial support: This work was supported by the research grant of the Jeju National University in 2012.

Authors' addresses: Yeojun Yun, Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea, E-mail: yyun@ewha.ac.kr. Sang Taek Heo, Hyemin Kim, Dahee Park, and Keun Hwa Lee, Jeju National University School of Medicine, Jeju, South Korea, E-mails: neosangtaek@naver.com, hyemin36@hanmail.net, archons1004@naver.com, and yomust7@jejunu.ac.kr. Gwanghun Kim and Nam-Hyuk Cho, Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea, E-mails: kimgh@snu.ac.kr and chonh@snu.ac.kr. Roger Hewson, Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom, E-mail: roger.hewson@phe.gov.uk. Won Sup Oh, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea, E-mail: onesbi@gmail.com. Seong Yeol Ryu, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea, E-mail: 121rsy@hanmail.net. Ki Tae Kwon, Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea, E-mail: idktkwon@gmail.com. Jolyon M. Medlock, Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Wiltshire, United Kingdom, E-mail: jolyon.medlock@phe.gov.uk.

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