Characterization of the Puumala orthohantavirus Strains in the Northwestern Region of the Republic of Tatarstan in Relation to the Clinical Manifestations in Hemorrhagic Fever With Renal Syndrome Patients

Abstract

Over 1,000 cases of hemorrhagic fever with renal syndrome (HFRS) were recorded in the Republic of Tatarstan (RT) in 2015. HFRS is a zoonotic disease caused by several different Old World hantaviruses. In RT, Puumala orthohantavirus (PUUV) is a prevalent etiological agent of HFRS. We looked for the genetic link between the PUUV strains isolated from the bank voles and from the infected humans. In addition, possible correlation between the genetic makeup of the PUUV strain involved and different clinical picture of HFRS was investigated. Partial PUUV small (S) genome segment sequences were retrieved from 37 small animals captured in the northwestern region of RT in 2015. Phylogenetic analysis revealed that 34 PUUV sequences clustered with strains of the previously identified “Russia” (RUS) genetic lineage, while 3 remaining PUUV sequences clustered with the known lineage from Finland (FIN). Sequence comparisons showed that the majority of the S-segment sequences isolated in the current study displayed 98.2–100.0% sequence identity when compared with the strains isolated earlier from the HFRS patients hospitalized in Kazan city. HFRS patients infected with PUUV strains of either RUS or FIN genetic lineages were observed to have consistent differences in clinical presentation of the disease and laboratory findings. These findings indicated a strong genetic link between the infected bank voles and human HFRS cases from the same localities. Thus, S-segment sequences of the PUUV strains isolated from HFRS patients could serve as a molecular marker for determining the likely geographic area where infection occurred.

Cytokine, Chemokine, and Metalloprotease Activation in the Serum of Patients with Nephropathia Epidemica from the Republic of Tatarstan and the Republic of Mordovia, Russia

“…We therefore identified PUUV as the causative infectious agent of NE from the RT and the RM. These data support previous observations that PUUV is the prevalent etiological agent of NE in the Volga Federal District [38,40,41], which includes the RT, the RM, the RB, and Udmurtia. Therefore, we suggest that differences in cytokine activation in NE from the RT and the RM could be explained by host immune response mechanisms to viral infection.…”

Prevalence of the Puumala orthohantavirus Strains in the Pre-Kama Area of the Republic of Tatarstan, Russia

“…PUUV strains from cluster A and the subclades' Northwest of RT', including strains circulating in the bank vole populations west and north of Kazan [17], appear genetically distant, although the geographical distance between these areas is in the range of 20-70 km. This suggests that a group of strains in the North-West of RT was also formed as a result of a separate migration wave of bank voles.…”

“…In the previous investigations, we have performed a comparative analysis of partial S and M segment sequences of the PUUV strains circulating in the Pre-Kama and Trans-Kama area and have demonstrated a significant variation of PUUV strains' genome in the RT [15,16]. It has been shown that the PUUV strains in the bank voles from Zelenodolsky and Vysokogorsky districts diverged significantly from the virus strains found in Laishevsky and Pestrechinsky districts [17]. The current study aims to analyze the genetic variability of PUUV in the Pre-Kama region.…”

Serum Cytokine Alterations Associated with Age of Patients with Nephropathia Epidemica

“…NE is endemic in the republic of Tatarstan, Russia [16]. We have previously demonstrated that Puumala orthohantavirus (PUUV) is the primary cause of NE in Tatarstan [17]. It is believed that endothelial cells are the primary targets of PUUV, where the virus can replicate without a cytopathic effect [18].…”