Comparison of the effects of Puumala and Dobrava viruses on early and long-term renal outcomes in patients with haemorrhagic fever with renal syndrome

Tulumović, Denijal; Imamović, Goran; Mešić, Enisa; Hukić, Mirsada; Tulumović, Ajsa; Imamović, Alma; Zerem, Enver

doi:10.1111/j.1440-1797.2009.01195.x

Cited by 16 publications

(7 citation statements)

References 13 publications

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“…In this study, three of four hospitalized patients who presented with severe hantavirus infection were infected with PUUV, of whom one died. In other Balkan countries, severe forms and fatal cases were associated mostly with DOBV infection [4,32]. In 1995, 20.5% HFRS cases were caused by HTNV, which could explain the high frequency of the severe form of the disease.…”

Section: Discussionmentioning

confidence: 99%

Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Vilibić-Čavlek

Furic²,

Barbić

et al. 2017

J Infect Dev Ctries

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Introduction: Croatia is endemic for hemorrhagic fever with renal syndrome (HFRS), with both Puumala (PUUV) and Dobrava virus (DOBV) documented. Several large outbreaks were recorded in 1995, 2002, and 2012. We analyzed demographic, clinical, laboratory, and virological characteristics of HFRS cases detected in three geographically close natural foci (Ogulin, Slunj, and the Plitvice Lakes surroundings) during the 2014 outbreak. Methodology: From January to December 2014, 122 patients with suspected HFRS were tested for hantavirus IgM/IgG antibodies using an indirect immunofluorescence assay (IFA). Cross-reactive samples were further tested using a western blot (WB). For hospitalized patients from Ogulin area, clinical and laboratory data were analyzed. Results: Acute infection was documented in 57 (46.7%) patients, of whom 75.4% were hospitalized. Ten (8.2%) patients were found to be IgG seropositive. Patients were 15-69 years of age and predominantly male (74.5%). The outbreak started in winter months, with most cases recorded from May to July (80.7%). The most frequently reported symptoms were fever (96.3%), chills/shivering (62.9%), and lumbar pain (48.1%). Mild clinical form was found in 66.7% patients, moderate in 18.5%, and severe in 14.8% patients (all but one infected with PUUV). One patient died. Using IFA, 48.8% patients showed monotypic antibody response, while in 51.2%, cross-reactive antibodies were found. PUUV was confirmed in 94.7% and DOBV in 5.3% HFRS cases by WB. Conclusions: Central mountainous Croatian regions are still highly endemic areas for HFRS. A higher percentage of severe PUUV infections could be at least partly associated with a patient's immune status.

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Section: Discussionmentioning

confidence: 99%

Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Vilibić-Čavlek

Furic²,

Barbić

et al. 2017

J Infect Dev Ctries

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“…Nephrological Depressed tubular function [71,93,[106][107][108][109][110][111] Glomerular hyperfiltration [108,110,111] Chronic glomerulonephritis [112,113] Cardiovascular Hypertension [71,108,110,111,[114][115][116][117] Endocrinological Hypopituitarism [49,50,81,82,98,105,[118][119][120][121][122] Primary hypothyroidism [105] Testicular failure [105] In rare cases, glomerulonephritis may complicate the convalescent phase of PUUV-HFRS [112,113]. The clinical manifestation has been the nephrotic syndrome, and the renal histopathological finding has usually been membranoproliferative glomerulonephritis.…”

Section: Long-term Consequences Of Puumala and Dobrava-belgrade Infmentioning

confidence: 99%

Hantavirus infections in Europe and their impact on public health

Vaheri

Henttonen

Voutilainen

et al. 2012

Reviews in Medical Virology

268

333

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SUMMARY Hantaviruses (genus Hantavirus, family Bunyaviridae) are enveloped tri‐segmented negative‐stranded RNA viruses each carried by a specific rodent or insectivore host species. Several different hantaviruses known to infect humans circulate in Europe. The most common is Puumala (PUUV) carried by the bank vole; another two important, genetically closely related ones are Dobrava–Belgrade (DOBV) and Saaremaa viruses (SAAV) carried by Apodemus mice (species names follow the International Committee on Taxonomy of Viruses nomenclature). Of the two hantaviral diseases, hemorrhagic fever with renal syndrome (HFRS) and hantaviral cardiopulmonary syndrome, the European viruses cause only HFRS: DOBV with often severe symptoms and a high case fatality rate, and PUUV and SAAV more often mild disease. More than 10,000 HFRS cases are diagnosed annually in Europe and in increasing numbers. Whether this is because of increasing recognition by the medical community or due to environmental factors such as climate change, or both, is not known. Nevertheless, in large areas of Europe, the population has a considerable seroprevalence but only relatively few HFRS cases are reported. Moreover, no epidemiological data are available from many countries. We know now that cardiac, pulmonary, ocular and hormonal disorders are, besides renal changes, common during the acute stage of PUUV and DOBV infection. About 5% of hospitalized PUUV and 16%–48% of DOBV patients require dialysis and some prolonged intensive‐care treatment. Although PUUV–HFRS has a low case fatality rate, complications and long‐term hormonal, renal, and cardiovascular consequences commonly occur. No vaccine or specific therapy is in general use in Europe. We conclude that hantaviruses have a significant impact on public health in Europe. Copyright © 2012 John Wiley & Sons, Ltd.

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“…There are several reports on possible long-term consequences of HFRS [2], and recently this has also been investigated for HCPS [62,63]. The long-term consequences reported are most often mildly affected renal and lung function and blood pressure [62][63][64][65][66], but chronic hormonal deficiencies requiring hormone-replacement therapy have also been observed [2,67]. A follow-up 10 years after PUUVinfection revealed no clear long-term consequences [68], suggesting that hantaviruses normally do not cause long-term consequences.…”

Section: Long-term Consequences Of Hantavirus Infectionmentioning

confidence: 87%

Hantavirus protein interactions regulate cellular functions and signaling responses

Klingström

Ahlm

2011

Expert Review of Anti-infective Therapy

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Comparison of the effects of Puumala and Dobrava viruses on early and long-term renal outcomes in patients with haemorrhagic fever with renal syndrome

Cited by 16 publications

References 13 publications

Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Clinical and virological characteristics of hantavirus infections in a 2014 Croatian outbreak

Hantavirus infections in Europe and their impact on public health

Hantavirus protein interactions regulate cellular functions and signaling responses

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