Chinese Scientists Discover New Pathogenic Orthonairovirus Called ALTNV Causing Flu-Like Illness in Hundreds of Patients
Nikhil Prasad Fact checked by:Thailand Medical News Team Sep 06, 2026 15 minutes ago
Chinese researchers working with collaborators in the United States have identified a previously unrecognized tick-borne virus that appears to be responsible for hundreds of febrile illnesses in China. Named Asian longhorned tick nairovirus (ALTNV), the pathogen belongs to the Orthonairovirus genus and was detected during surveillance of people who developed fever after tick exposure.
Scientists have identified ALTNV, an emerging tick-borne orthonairovirus linked to flu-like febrile illness and
potentially severe disease when combined with DBV infection.
The discovery is particularly important because some patients suspected of having severe fever with thrombocytopenia syndrome (SFTS) test negative for Dabie bandavirus (DBV), the established cause of SFTS. More than 30% of clinically diagnosed SFTS cases can be DBV-negative, suggesting other infectious agents may be circulating in endemic regions.
Extensive Surveillance Uncovers ALTNV
Researchers conducted hospital-based surveillance at sentinel hospitals in Chinese regions where tick-borne diseases are endemic. They used metatranscriptomic sequencing and virus isolation to investigate samples from febrile patients with previous tick exposure.
Genomic analysis classified ALTNV within the Orthonairovirus genus of the Nairoviridae family. Importantly, the virus showed less than 80.04% amino-acid identity with other orthonairovirus species, supporting its identification as a distinct virus. Scientists also successfully grew ALTNV after inoculating Vero cells with serum from ALTNV-positive patients. Viral antigen was confirmed by immunofluorescence, while electron microscopy revealed morphological characteristics consistent with orthonairoviruses.
The figure accompanying the research further shows ALTNV obtained from humans, questing ticks and feeding ticks, while laboratory images demonstrate infected Vero cells and virus particles visualized by electron microscopy.
More Than 10 Percent of Febrile Patients Tested Positive
One of the most striking findings came from screening 3,163 febrile patients with histories of tick exposure. ALTNV positivity, determined through detection of viral RNA or IgM antibodies, was found in 10.4% of those tested. Among patients who were negative for DBV, ALTNV positivity reached 15.1%.
These percentages indicate that ALTNV infection is not merely an isolated laboratory finding. A 10.4% positivity rate among 3,163 patients corresponds to roughly 329 people testing positive by the study's RNA-or-IgM definition.
In 56 patients with ALTNV monoinfection, illness was predominantly influenza-like. Fatigue occurred in 84%, gastrointestinal symptoms in 80%, thrombocytopenia in 38%, and elevated aminotransferase levels, indicating liver involvement, in 36%. Encouragingly, every patient in this monoinfection group recovered without reported sequelae.
This
Thailand Medical News report also highlights an important warning from the study: ALTNV may become considerably more concerning when it occurs
alongside DBV. Furthermore the long term effects of such an infection on humans who survive and so-called “recover” are not yet known although preliminary data indicates many suffer from severe fatigue coupled with renal impairment!
Coinfection Linked to More Severe Disease
Among 38 patients coinfected with ALTNV and DBV, respiratory symptoms occurred in 61%, compared with 38% among patients infected with DBV alone. Renal impairment was also more frequent, affecting 84% of coinfected patients compared with 66% of those with DBV alone.
Most concerning, seven of the 38 coinfected patients died, representing a mortality rate of 18.4%. The researchers therefore concluded that coinfection with DBV appears to exacerbate disease severity.
Asian Longhorned Ticks Can Carry and Transmit ALTNV
The investigators screened 47,428 ticks across 15 Chinese provinces and detected ALTNV RNA in 1.29%. The highest prevalence was recorded in Haemaphysalis longicornis, the Asian longhorned tick, at 1.75%. Experiments demonstrated that these ticks could maintain ALTNV through horizontal, transstadial and transovarial transmission and transmit the virus to mice. Infected mice developed histopathological changes and later showed seroconversion.
Researchers and Institutions
The research team were from the State Key Laboratory of Pathogen and Biosecurity, Beijing; Academy of Military Medical Science, Beijing; 154th Hospital, Xinyang, China; Yantai Qishan Hospital, Yantai, China; Shandong Provincial Center for Disease Control and Prevention, Jinan, China; University of Washington, Seattle; and Emory University, Atlanta.
Conclusion
The findings establish ALTNV as an emerging tick-borne orthonairovirus associated with human febrile disease and indicate that it is circulating across multiple areas of China. Its overlap with DBV, use of the same tick vector, and association with more severe outcomes during coinfection underline the importance of improved diagnostic testing and surveillance in SFTS-endemic regions.
The study findings were published in the peer reviewed journal: The New England Journal of Medicine.
https://www.nejm.org/doi/full/10.1056/NEJMc2602496
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