Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: the impact on renal function

Hukić, Mirsada; Valjevac, Amina; Tulumović, Denijal; Numanovic, Fatima; Heyman, Paul

doi:10.1007/s10096-010-1097-6

Cited by 11 publications

(6 citation statements)

References 11 publications

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“…The more severe clinical picture of infection with DOBV compared to PUUV corresponds to the observations made in other studies that compared infections with PUUV and different DOBV genotypes. Patients with DOBV infections were more often hypotensive, exhibited higher levels of serum creatinine, displayed more severe thrombocytopenia and required dialysis more often compared to patients infected with PUUV [34–36]. Our analysis of the clinical course of the two infections revealed further differences between the two infections.…”

Section: Discussionmentioning

confidence: 68%

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

et al. 2016

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BackgroundHantavirus disease belongs to the emerging infections. The clinical picture and severity of infections differ between hantavirus species and may even vary between hantavirus genotypes. The mechanisms that lead to the broad variance of severity in infected patients are not completely understood. Host- and virus-specific factors are considered.Case presentationWe analyzed severe cases of hantavirus disease in two young women. The first case was caused by Puumala virus (PUUV) infection in Germany; the second case describes the infection with Dobrava-Belgrade virus (DOBV) in Russia. Symptoms, laboratory parameters and cytokine levels were analyzed and compared between the two patients. Serological and sequence analysis revealed that PUUV was the infecting agent for the German patient and the infection of the Russian patient was caused by Dobrava-Belgrade virus genotype Sochi (DOBV-Sochi). The symptoms in the initial phase of the diseases did not differ noticeably between both patients. However, deterioration of laboratory parameter values was prolonged and stronger in DOBV-Sochi than in PUUV infection. Circulating endothelial progenitor cells (cEPCs), known to be responsible for endothelial repair, were mobilized in both infections. Striking differences were observed in the temporal course and level of cytokine upregulation. Levels of angiopoietin-2 (Ang-2), vascular endothelial growth factor (VEGF), and stromal derived factor-1 (SDF-1α) were increased in both infections; but, sustained and more pronounced elevation was observed in DOBV-Sochi infection.ConclusionsSevere hantavirus disease caused by different hantavirus species did not differ in the general symptoms and clinical characteristics. However, we observed a prolonged clinical course and a late and enhanced mobilization of cytokines in DOBV-Sochi infection. The differences in cytokine deregulation may contribute to the observed variation in the clinical course.

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Section: Discussionmentioning

confidence: 68%

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

et al. 2016

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“…Recent study of clinically manifested hantavirus infections in Bulgaria revealed that infections in 16/23 (69.6%) patients with HFRS recognized for 2 years, 2013‐2014, were caused by DOBV while PUUV was shown as prevalent in Slovenia, Croatia, Bosnia, and Herzegovina . Initial investigation of Bulgarian patients with HFRS revealed only DOBV‐specific sequences .…”

Section: Discussionmentioning

confidence: 99%

Country‐wide seroprevalence studies on Crimean‐Congo hemorrhagic fever and hantavirus infections in general population of Bulgaria

Christova

Panayotova

Trifonova

et al. 2017

Journal of Medical Virology

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Crimean-Congo hemorrhagic fever (CCHF) and hantavirus infections are the two viral hemorrhagic fevers spread in Europe. To test actual circulation of CCHF virus (CCHFV) and hantaviruses in Bulgaria, we conducted country-wide seroepidemiological studies. Serum samples were collected prospectively from 1500 residents of all 28 districts in Bulgaria. CCHFV seroprevalence of 3.7% was revealed. Anamnesis for tick bites, contact with livestock, age over 40 years and residency in Haskovo district were found as risk factors. The highest CCHFV seroprevalence was observed in the known endemic districts in southeastern Bulgaria: Haskovo (28%) and Yambol (12%). Reactive samples were found in residents of 20 of the 28 districts in Bulgaria. In comparison with the previous studies, the data presented indicate that CCHFV increased substantially its circulation in the endemic regions and was introduced in many new areas. Hantavirus seroprevalence was based on results of the immunoblot and estimated as 3.1%. Surprisingly, contrary to all available data, Puumala virus seroprevalence rate was 2.3% versus 0.8% of Dobrava-Belgrade virus. Evidence for hantavirus IgG seropositivity was found in residents of 23 of the 28 districts in the country. The first hantavirus seroprevalence study in Bulgaria showed that Puumala virus is probably more wide-spread in the country than Dobrava-Belgrade virus.

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“…Dialysis treatment is needed in 0%-6% of PUUVinfection-induced acute renal failure [73,93,97]. In DOBV infection, the corresponding figures have been 16%-48% [47,97].…”

Section: Clinical Picturementioning

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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Pathogenicity and virulence of the present hantaviruses in Bosnia and Herzegovina: the impact on renal function

Cited by 11 publications

References 11 publications

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

Clinical characterization of two severe cases of hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses Puumala and Dobrava-Belgrade genotype Sochi

Country‐wide seroprevalence studies on Crimean‐Congo hemorrhagic fever and hantavirus infections in general population of Bulgaria

Hantavirus infections in Europe and their impact on public health

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