Epidemiological Study of Nephropathia epidemica in Finland 1989-96

Abstract

This study presents data on 33,000 serum samples studied from July 1989 to June 1996 in Finland, with 6,701 serologically confirmed Puumala virus (PUU) infections. In addition, a PUU serosurvey of 8,000 sera from Finland is presented. On average, 957 PUU infections were detected annually, resulting in an incidence of 19/100,000; mortality was less than 0.1%. The infection was most common in the district of Ita-Savo with an incidence of 90/100,000. The seasonal peak was in November-December; however, the urban population had its incidence peak in August. Local epidemics mirrored bank vole densities, with 3-4-y cycles. Males contracted the disease at a mean age of 40 y, females at 44 y (male:female ratio 2:1). The disease was relatively rare in children and elderly people. The nationwide PUU antibody prevalence for women entering Finnish maternity clinics was 3%, suggesting 5% for the total population. The highest prevalences (7% for young women) were encountered in eastern Finland. In the district with the highest clinical alert, approximately 30% of all PUU infections were estimated to lead to clinical disease with serological confirmation.

Survey and case-control study during epidemics of Puumala virus infection

“…Only a few people have died in the past due to PUUV infection and the casefatality rate is usually below 0 . 5% [4,25]. From the 1089 case-patients of this outbreak no death was reported.…”

“…Such high incidences of PUUV infections have only been previously reported from Scandinavian countries and Finland [4,7,24]. Additionally, seroprevalence studies with a human antibody prevalence of about 3 % in the epidemic regions of Baden-Wuerttemberg suggest, that only a small fraction (5-10 %) of PUUV infections are notified [2,22].…”

“…The predominant species in Western and Northern Europe is Puumala virus (PUUV). It causes nephropathia epidemica (NE), a mild form of haemorrhagic fever with renal syndrome (HFRS) [2][3][4][5][6]. Typical symptoms are fever, headache, muscle pain, nausea and impaired renal function [7,8].…”

Non-Invasive Methods for Monitoring Individual Bioresponses in Relation to Health Management

“…PUUV causes a general mild form of hemorrhagic fever with renal syndrome called nephropathia epidemica (NE) (Clement et al, 2006). In general, only 13% of all PUUV infections are serodiagnosed, the other being interpreted as 'a bad flu' (Brummer-Korvenkontio et al, 1999;Clement et al, 2007) or remaining unnoticed. HFRS, including NE, is now the most underestimated cause of infectious acute renal failure worldwide, so the officially registered NE is only the top of the iceberg.…”

Global Warming and Epidemic Trends of an Emerging Viral Disease in Western-Europe: The Nephropathia Epidemica Case

“…mind that probably less than 20% of all PUUV infections are actually registered as such (Brummer-Korvenkontio et al, 1999), the real number of PUUV infections may well have been in fact 5 times higher. Looking at the yearly NE numbers over this long time scale (Fig.…”